A three-marker blood test flagged 87% of stage 1 and 2 pancreatic cancers in 1,800 patients
A City of Hope team reports catching stage 1 and 2 pancreatic cancer from a three-marker blood score. The trial does not settle what a positive means in the high-risk groups a screening programme would enrol first.
The Scientist · Science desk
What happened
- A liquid biopsy tested in 1,800 patients across the U.S., Europe and Asia identified stage 1 and 2 pancreatic cancer 87 percent of the time, with results published in Nature Medicine.
- The test reads three markers in blood, circulating microRNAs, exosomal microRNAs and the protein CA19-9, and uses artificial intelligence to fold them into a single risk score.
- False positives ran at 3 percent in low-risk groups and 16 percent in high-risk groups, according to the Discover Magazine account of the study.
Why it matters
- Who has to decide decision Anyone building a programme on this test has to fix eligibility first. The false-positive workload it generates depends on who you enrol.
- What's now possible capability Pancreatic cyst surveillance gains a molecular reading on the precancerous state itself, so clinicians choosing which cysts to intervene on would have a graded score to work from.
- What it limits constraint Clinic use waits on confirmatory trials. Those trials will fix the eligible population, and the eligible population determines how many negatives are worked up for each cancer found.
- What doesn't add up contradiction Scientific American summarised the same result as a low rate of false positives while Discover published the rates group by group, and a reader given only the first would not know they differ by risk group.
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The false-positive rate scales with who you test. In this trial the high-risk figure was more than five times the low-risk one [5][20]. High-risk people are the ones a screening programme enrols first. Discover Magazine reported that the accuracy gained from combining three biomarkers should especially benefit people at high risk [28][29], and Scientific American reported that doctors would use the score particularly in people with inherited risk or a history of pancreatitis [16]. There is no routine screening test for pancreatic cancer the way there is for breast or colon cancer [13]. A flagged patient goes on to further evaluation [17].
How tolerable that burden is depends on how many people in the screened group actually have cancer. Neither account reports how many cancers were found among the 1,800 enrolled [2][3]. The positive predictive value of a flag cannot be computed from what has been published. The 87 percent covers stage 1 and stage 2 pooled [4].
The test also misses cancers. About 13 of every 100 stage 1 and 2 cancers in the trial went unflagged [21]. For high-grade dysplasia, the precancerous state found in people with high-risk pancreatic cysts, detection ran above 64 percent, meaning under 36 percent were missed [7][8][22]. Discover reported that identifying dysplasia could help physicians monitor cysts and decide which ones might require intervention [15].
Ajay Goel, the study's senior author and chair of molecular diagnostics and experimental therapeutics at City of Hope, framed the result around timing [10]. "For patients, these findings represent progress toward finding pancreatic cancer before symptoms appear and while more treatment options remain available," he said in a statement [11]. "A stage shift is not just a statistic," Goel said [12].
Late-stage treatment shows what a stage shift would be worth. The Food and Drug Administration has approved daraxonrasib for people with late-stage pancreatic cancer who have already been through chemotherapy [18]. It puts survival at 13.2 months against 6.7 months for chemotherapy alone, a gain of 6.5 months [19][23]. Five-year survival after diagnosis is 13 percent in Scientific American's account and 14 percent in Discover's, which cites the National Pancreatic Foundation [24][25].
The enrolment was an early-stage clinical trial, and Scientific American reported that more advanced trials are needed before the test could be used in the clinic [3][14]. The two publishers also spell it differently: Discover writes PANXEON, Scientific American writes PAXEON [26][27].
What to watch
- A stage 1 sensitivity figure reported separately from stage 2. Stage 1 sensitivity is what bears on resectable disease.
- The size and cancer count of the confirmatory trial. Cancers per thousand enrolled set the positive predictive value.
- Whether any guideline body defines an eligible high-risk population, since eligibility rules decide how many negatives get worked up.
Clarity's read
What the record supports and how the coverage leans. The claims behind it follow.
Reality
- Evidence57
- Adoption8
- Hype gap+33
- Incentives63
- Confidence61
Claim ledger
Ranked by verification strength, evidence, and original report placement.
- [1]
Results for the pancreatic cancer liquid biopsy were published in Nature Medicine.
- [2]
The test was evaluated in 1,800 patients across the U.S., Europe and Asia.
- [3]
About 1,800 people enrolled in an early-stage clinical trial to test the efficacy of the blood test across the U.S., Europe and Asia.
- [4]
The test correctly identified stage 1 and 2 pancreatic cancer 87 percent of the time.
- [5]
The test's false-positive rate was 3 percent in low-risk groups and 16 percent in high-risk groups.
- [6]
Scientific American reported that the test accurately detected stage 1 and 2 pancreatic cancers approximately 87 percent of the time, with a low rate of false positives.
- [7]
The test detected high-grade dysplasia, a precancerous condition often described as stage 0 pancreatic cancer, more than 64 percent of the time.
- [8]
The blood test identified advanced dysplasia more than 64 percent of the time in people with high-risk pancreatic cysts.
- [9]
The test measures three markers in blood: circulating microRNAs, exosomal microRNAs, and a protein called CA19-9, and uses artificial intelligence to combine them into a single score estimating a patient's cancer risk.
- [10]
Ajay Goel, the study's senior author, is chair of the Department of Molecular Diagnostics and Experimental Therapeutics at City of Hope.
- [11]
"For patients, these findings represent progress toward finding pancreatic cancer before symptoms appear and while more treatment options remain available," said Ajay Goel in a statement.
- [12]
"A stage shift is not just a statistic," said Goel.
- [13]
There is no routine screening test for pancreatic cancer, as there is for breast cancer or colon cancer, and most diagnoses happen only at advanced stages.
- [14]
More advanced clinical trials are needed before this blood test could possibly be used in the clinic.
- [15]
Pinpointing high-grade dysplasia could help physicians monitor pancreatic cysts and decide which ones might require intervention.
- [16]
Doctors can use the risk score to determine whether more investigation or treatment is necessary, particularly in people who have inherited risk of pancreatic cancer or who have had pancreatitis.
- [17]
The testing results suggest the test could help identify high-risk patients who need to undergo further evaluation for pancreatic cancer.
- [18]
The U.S. Food and Drug Administration approved a drug for pancreatic cancer called daraxonrasib, aimed at people with late-stage cancer who have already been through chemotherapy.
- [19]
Daraxonrasib improves survival by about half a year compared with chemotherapy alone: 13.2 months versus 6.7 months.
- [20]
The high-risk false-positive rate is more than five times the low-risk rate.
- [21]
At 87 percent detection, about 13 of every 100 stage 1 and 2 cancers in the trial were not flagged.
- [22]
Detection of high-grade dysplasia above 64 percent means fewer than 36 percent of those cases were missed.
- [23]
Daraxonrasib's survival gain over chemotherapy alone is 6.5 months.
- [24]
The five-year survival rate for pancreatic cancer is just 13 percent.
- [25]
Just 14 percent of pancreatic cancer patients live five years after diagnosis, according to the National Pancreatic Foundation.
- [26]
Discover Magazine refers to the liquid biopsy as PANXEON.
- [27]
Scientific American refers to the same blood test as PAXEON.
- [28]
The key differentiator of the test compared with other blood-based tests is its ability to combine three biomarkers.
- [29]
The enhanced accuracy that comes from combining three biomarkers could especially benefit those who have a high pancreatic cancer risk.
Sources
2 independent publishers whose own reporting we read for this story.
- discovermagazine.comNew Blood Test Could Catch Pancreatic Cancer at Its Earliest Stages, Helping Fight the "Silent Killer"
1 article · September 16, 2026
- scientificamerican.comBlood test shows promise in detecting pancreatic cancer early—a 'Holy Grail' for the field
1 article · September 16, 2026
Topics and entities
Topics
- AI in diagnostics
- Clinical trials
- Pancreatic Cancer
- Cancer early detection
Entities
- Nature Medicine
- Food and Drug Administration
- National Pancreatic Foundation