International observational study tests PANXEON for early pancreatic cancer

An international observational study found that the investigational PANXEON liquid biopsy correctly identified 87% of stage 1 and 2 pancreatic cancers and detected a precancerous pancreatic condition more than 64% of the time. Researchers led by City of Hope evaluated the blood test in nearly 1,800 patients across the United States, Europe and Asia, including people with inherited or familial genetic risk, pancreatic cysts and chronic pancreatitis rather than only healthy controls. The peer-reviewed findings were published in Nature Medicine on September 16, 2026.

The results support the diagnostic potential of the assay, but the study did not establish whether using PANXEON in routine screening would improve survival or replace imaging and other diagnostic procedures. Pancreatic cancer is often discovered after it has spread, making early detection a central research goal. City of Hope reported that 14% of patients remain alive five years after diagnosis and that approximately 90% of diagnosed patients have tumors detected at advanced stages.

The study therefore examined whether a blood-based assay could identify pancreatic cancer at stage 1 or 2, when the disease is described as more treatable and potentially curable, and whether the same test could recognize high-grade dysplasia. This advanced precancerous condition is sometimes termed “stage 0” pancreatic cancer. The test identified stage 1 and 2 disease 87% of the time and detected high-grade dysplasia in more than 64% of cases, according to the study report.

PANXEON differs from tests built around a single molecular marker because it measures three components in a blood sample: circulating microRNAs, exosomal microRNAs and the protein CA19-9. The release identifies the two RNA components by those names but does not describe their cellular and extracellular locations. An artificial-intelligence system combines the three measurements into a single score that estimates an individual patient’s risk.

According to City of Hope, PANXEON is the first investigational test to combine circulating microRNAs, exosomal microRNAs and CA19-9 in one assay. The approach is intended to draw on several biological signals rather than relying on a single measurement, which senior author Ajay Goel described as providing a clearer picture of what may be happening in the pancreas. The false-positive rate differed between the study’s low- and high-risk groups, giving a more qualified picture of the test’s performance.

PANXEON produced a false-positive rate of 3% in low-risk groups and 16% in high-risk groups. These were separate group-specific findings rather than one rate reported across the entire population. The supplied study report did not state how many participants were assigned to each risk category or provide complete clinical characteristics for every subgroup.

The reported sensitivity of 87% for stage 1 and 2 pancreatic cancer likewise does not mean that every positive PANXEON result represents cancer. The results describe how well the investigational score classified patients in this study, not the test’s definitive status in an unselected screening population. High-grade dysplasia was another notable result.

PANXEON detected the advanced precancerous condition more than 64% of the time, indicating that the assay sometimes identified pancreatic abnormalities before invasive cancer developed. City of Hope said this capability could help physicians determine which pancreatic cysts require active monitoring or intervention. That potential use depends on subsequent evaluation of a positive result: detecting high-grade dysplasia does not mean that every flagged patient has invasive cancer, nor does the observational study demonstrate that an intervention prompted by a positive PANXEON result would improve outcomes.

The finding nevertheless extends the measured scope of the assay beyond established pancreatic cancer to a condition that may precede it. Testing patients in clinically relevant risk groups was a central feature of the research. The investigators wanted to determine whether promising results from earlier work would hold in diverse clinical settings, and they assembled a large international sample spanning three continents.

Rather than restricting the study to healthy controls, the population included people with inherited or familial genetic risk, pancreatic cysts and chronic pancreatitis. These are patients who may already undergo monitoring with imaging and other tests because of their pancreatic risk or known abnormalities. The release said previous blood-based tests had fallen short, while evaluating multiple biomarkers in these higher-risk populations set PANXEON apart.

It did not provide the relative size or detailed results for every diagnostic subgroup. Goel said the findings represented progress toward detecting pancreatic cancer before symptoms appear and while more treatment options remain available. He also stressed that PANXEON was not intended to replace imaging or other diagnostic tests.

Instead, the proposed role of the liquid biopsy is to help identify high-risk patients who should undergo further evaluation. This distinction is important because the study measured diagnostic classification rather than the downstream effects of screening. The results do not show that routine PANXEON testing would lead to earlier treatment, fewer advanced diagnoses, lower mortality or longer survival.

They also do not establish how the test would perform in a broad population that includes many people without pancreatic cysts, chronic pancreatitis or inherited risk. Several limitations are apparent from the study description. PANXEON remains investigational, and the reported work was an observational diagnostic study rather than a trial comparing screening strategies or measuring patient outcomes over time.

Although nearly 1,800 participants were tested internationally, the release did not give enough demographic or subgroup information to determine whether performance differed among specific populations. It also did not report a prospective screening program in which PANXEON was used first and participants were followed through diagnosis and treatment. The difference between the 3% false-positive rate in low-risk groups and the 16% rate in high-risk groups shows why the assay’s performance must be interpreted in the context of the population being assessed.

City of Hope identified people with inherited risk, a family history of pancreatic cancer, pancreatic cysts or chronic pancreatitis as those most likely to benefit from further development of PANXEON. Existing surveillance for these groups can be invasive, expensive and only partly effective at finding pancreatic cancer at its earliest stages, according to the release. A blood assay could potentially help determine which patients receive additional evaluation, but the study does not show that PANXEON can safely replace established surveillance or that its use would change clinical outcomes.

The immediate evidence is that the multi-biomarker score performed strongly for stage 1 and 2 pancreatic cancer in the tested population, showed a measurable ability to detect high-grade dysplasia and produced different false-positive rates in low- and high-risk groups. Its ultimate role will depend on additional clinical evidence. The research is part of a wider City of Hope program covering early detection, KRAS-targeted therapies, cancer vaccines and a national clinical-trials network.

Those institutional activities are distinct from the results reported for PANXEON. City of Hope disclosed that Goel is a paid consultant to Biocartis, which has an option to acquire rights to PANXEON. The study’s concrete conclusion is that an artificial-intelligence-combined blood test detected most stage 1 and 2 pancreatic cancers and more than 64% of high-grade dysplasia cases in a nearly 1,800-patient international observational cohort, while maintaining false-positive rates of 3% in low-risk groups and 16% in high-risk groups.

Subject of Research: Diagnostic performance of a multi-biomarker blood test for early-stage pancreatic cancer and high-grade dysplasia

Article Title: New study: Blood test shows promise for detecting pancreatic cancer at its earliest stages

Article References: New study: Blood test shows promise for detecting pancreatic cancer at its earliest stages. Original publication (Bibliographic details unavailable.)

Image Credits: AI Generated

DOI: Not provided

Keywords: PANXEON, pancreatic cancer, early detection, liquid biopsy, high-grade dysplasia, CA19-9, microRNA, observational study, diagnostic accuracy, City of Hope, Blood, test