PHILADELPHIA, January 28, 2026 — A new blood test boasting nearly perfect accuracy could dramatically improve early detection of pancreatic cancer, a disease notorious for its late diagnoses and dismal survival rates. Researchers have identified a four-biomarker panel that significantly outperforms existing methods, offering a potential lifeline for patients.
Boosting Pancreatic Cancer Detection with a Novel Blood Test
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A four-biomarker panel enhances pancreatic cancer detection compared to current methods, potentially leading to earlier diagnoses and improved outcomes.
- Pancreatic ductal adenocarcinoma (PDAC) accounts for approximately 95% of pancreatic cancer cases.
- Early-stage PDAC has a five-year relative survival rate of about 44%, plummeting to 3% once the disease metastasizes.
- The new biomarker panel—ANPEP, PIGR, CA19-9, and THBS2—demonstrated an area under the curve (AUC) of 0.97 in distinguishing stage 1-2 PDAC from healthy individuals.
- The panel correctly identified 91.9% of pancreatic cancers across all stages, a significant improvement over the 82.7% detection rate of the CA19-9 biomarker alone.
What biomarkers show the most promise for early pancreatic cancer detection? A combination of four proteins—aminopeptidase N (ANPEP), polymeric immunoglobulin receptor (PIGR), CA19-9, and thrombospondin-2 (THBS2)—shows the greatest potential for identifying pancreatic cancer in its earliest stages, according to a study published in Clinical Cancer Research.
“Pancreatic cancer usually doesn’t present with symptoms until it’s too late for surgery, when the cancer has already metastasized to other parts of the body,” explained Kenneth S. Zaret, PhD, professor at the Perelman School of Medicine at the University of Pennsylvania. “Our goal was to look for biomarkers in the blood that appear in early-stage PDAC patients, to catch the disease early.”
Currently, CA19-9 is frequently used to monitor patients with diagnosed pancreatic cancer, but it’s unreliable as a standalone screening tool. Benign conditions can also elevate CA19-9 levels, leading to false positives, while some patients with cancer may have normal levels. THBS2, while promising, has shown inconsistent results in prediagnostic screening.
How the Study Was Conducted
Zaret and colleagues analyzed plasma samples from two independent cohorts: 537 samples from the Mayo Clinic and 135 from the Hospital of the University of Pennsylvania. These cohorts included individuals with confirmed pancreatic cancer, healthy controls, and patients with benign pancreatic diseases, allowing researchers to assess the panel’s ability to differentiate between cancer and conditions that mimic it.
By comparing protein levels, the team identified ANPEP and PIGR as proteins elevated in early-stage PDAC samples compared to those without cancer. They then developed a panel incorporating these two biomarkers alongside the previously studied CA19-9 and THBS2.
The results were compelling. Across both the Mayo and Penn cohorts, the four-biomarker panel achieved area under the curve (AUC) values of 0.97 and 0.96, respectively, when comparing stage 1-2 PDAC to healthy controls. An AUC of 1.0 represents perfect accuracy.
The panel’s ability to distinguish cancer from benign conditions was also strong, with AUCs of 0.87 for early-stage PDAC and 0.91 for all stages in the Mayo cohort. The panel correctly identified 91.9% of pancreatic cancers across all stages and 87.5% of early-stage cases, a statistically significant improvement over the 82.7% and 76.2% detection rates achieved by testing for CA19-9 alone.
While the improvement in early-stage detection wasn’t statistically significant, the panel demonstrated an 11.3% increase in sensitivity.
“With the addition of ANPEP and PIGR, the panel helps to overcome known limitations associated with CA19-9 and THBS2 testing—such as patients who genetically underexpress CA19-9 or tumors that present as different molecular subtypes—and could therefore reduce the number of missed cancer cases while keeping false positives low,” Zaret said.
Study Limitations and Future Directions
Zaret cautioned that the study had limitations. The cohorts did not include individuals at high risk for pancreatic cancer—such as those with a family history, BRCA mutations, or new-onset diabetes—potentially introducing bias. Additionally, the retrospective nature of the study necessitates larger, prospective studies to validate the panel’s performance in real-world screening scenarios.
If confirmed, this four-biomarker panel could help identify individuals who would benefit from follow-up imaging, potentially leading to earlier diagnoses and more effective treatment of pancreatic cancer.
The study was supported by the National Institutes of Health, Penn Pancreatic Cancer Research Center, A Love for Life, the Lustgarten Foundation, the Centene Foundation, and the Mayo Clinic Comprehensive Cancer Center. Zaret reported no conflicts of interest.
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