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Surgery is currently the most effective option, yet only 10–20% of cases are resectable at diagnosis. The only US-FDA-approved biomarker, CA19-9, is mainly limited for early detection. Recent research explores biomarker combinations and liquid biopsy approaches using microRNAs, circulating tumor DNA, and circulating tumor cells. The review summarizes biomarker advances and highlights emerging strategies for earlier PC detection and improved screening decisions.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-quest-for-survival-a-review-of-the-early-biomarkers-of-pancreatic-cancer-and-the-most-effective-approaches-at-present/330327/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-quest-for-survival-a-review-of-the-early-biomarkers-of-pancreatic-cancer-and-the-most-effective-approaches-at-present/330327.png","ImageObject",300,407,{"name":92,"@type":93},"Lucas Martin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is pancreatic cancer hard to diagnose early?","Question",{"text":113,"@type":114},"Early-stage PC often has no or non-specific symptoms, and many patients are diagnosed only after the disease advances, limiting effective treatment options. Its subtle and insidious nature also contributes to delayed detection.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What biomarker is currently approved by the US FDA for pancreatic cancer?",{"text":118,"@type":114},"Carbohydrate antigen 19-9 (CA19-9) is the only US-FDA-approved biomarker for PC, but its use is limited for early diagnosis.",{"name":120,"@type":111,"acceptedAnswer":121},"Which liquid biopsy components are discussed as promising tools for early detection?",{"text":122,"@type":114},"The review highlights liquid biopsy approaches using microRNAs (miRNAs), circulating tumor DNA (ctDNA), and circulating tumor cells (CTCs) to support earlier diagnosis and screening decisions.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},330327,1790220066,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":36,"preview_page_count":4},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","biomolecules  \nReview  \nA Quest for Survival: A Review of the Early Biomarkers of Pancreatic Cancer and the Most Effective Approaches at Present  \nMuhammad Begawan Bestari 1, *, Ignatius Ronaldi Joewono 2 and Ari Fahrial Syam 3  \nCitation: Bestari, M.B.; Joewono, I.R.;  \nSyam, A.F. A Quest for Survival: AReview of the Early Biomarkers of Pancreatic Cancer and the Most Effective Approaches at Present. Biomolecules 2024, 14, 364. [https://](https://)[ ](https://)[doi.org/10.3390/biom14030364](doi.org/10.3390/biom14030364)  \nAcademic Editor: Lukasz Kurgan  \nReceived: 13 February 2024  \nRevised: 28 February 2024  \nAccepted: 16 March 2024  \nPublished: 19 March 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Division of Gastroenterohepatology, Department of Internal Medicine, Hasan Sadikin General Hospital, Faculty of Medicine, University of Padjadjaran, Bandung 40161, Indonesia  \n2 Mochtar Riady Comprehensive Cancer Center, Siloam Hospitals, Jakarta 12930, Indonesia; [ignatius.joewono@gmail.com](ignatius.joewono@gmail.com)  \n3 Division of Gastroenterology, Department of Internal Medicine, Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, University of Indonesia, Jakarta 10430, Indonesia; [ari_syam@hotmail.com](ari_syam@hotmail.com)  \n* [Correspondence: begawan@unpad.ac.id](Correspondence: begawan@unpad.ac.id); Tel.: +62-812-2198-9999  \nAbstract: Pancreatic cancer (PC) is the most lethal type of cancer; it has the lowest 5-year survival rate among all other types of cancers. More than half of PC cases are diagnosed at an advanced stage due to PC’s insidious and non-specific symptoms. Surgery remains the most efficacious treatment option currently available, but only 10–20% of PC cases are resectable upon diagnosis. As of now, the sole biomarker approved by the United States Food and Drug Administration (US-FDA) for PC is carbohydrate antigen 19-9 (CA19-9); however, its use is limited for early diagnosis. An increasing number of studies have investigated a combination of biomarkers. Lately, there has been considerable interest in the application of a liquid biopsy, including the utilization of microRNAs (miRNAs), circulating tumor DNA (ctDNA), and circulating tumor cells (CTCs) . Screening for PC is indicated for high-risk patients; studies on new diagnostic models combined with biomarkers for early detection have also shown promising results in terms of the ability of these models and biomarkers to aid clinicians in deciding on whether to start screening. This review seeks to provide a concise overview of the advancements in relation to existing biomarkers and explore novel strategies for the early detection of PC.  \nKeywords: pancreatic cancer; early biomarker; early diagnosis  \n1. Introduction  \nPancreatic cancer (PC) is currently the most lethal type of cancer, exhibiting the lowest 5-year survival rate among all cancer types. The survival rate is estimated at 8% for all PC stages combined and only 3% when PC is diagnosed at a later stage [1] . More than 50% of PC patients are diagnosed at an advanced stage, at which point there are only limited treatment options due to the highly metastatic nature of this disease [1–3] . According to GLOBOCAN, global statistics indicate that PC leads to approximately 432,000 deaths, with 459,000 new cases reported in 2018 [4] . In contrast to other cancer types with declining rates, PC is expected to rank as the third most common cause of cancer-related fatalities by the year 2025, surpassing even breast cancer [5] .  \nAt an early stage, PC rarely shows any symptoms. If there are any symptoms at all, they are mostly non-specific. The common symptoms include weight","cbCairtAHGjodakM","https://ap.wps.com/l/cbCairtAHGjodakM","pdf",322753,16,"English","# Introduction\n## Clinical burden and survival outcomes\n## Symptoms across stages and diagnostic challenges\n## Screening and imaging role\n# Biomarkers and emerging strategies","[{\"question\":\"Why is pancreatic cancer hard to diagnose early?\",\"answer\":\"Early-stage PC often has no or non-specific symptoms, and many patients are diagnosed only after the disease advances, limiting effective treatment options. Its subtle and insidious nature also contributes to delayed detection.\"},{\"question\":\"What biomarker is currently approved by the US FDA for pancreatic cancer?\",\"answer\":\"Carbohydrate antigen 19-9 (CA19-9) is the only US-FDA-approved biomarker for PC, but its use is limited for early diagnosis.\"},{\"question\":\"Which liquid biopsy components are discussed as promising tools for early detection?\",\"answer\":\"The review highlights liquid biopsy approaches using microRNAs (miRNAs), circulating tumor DNA (ctDNA), and circulating tumor cells (CTCs) to support earlier diagnosis and screening decisions.\"}]","A Quest for Survival - A Review of the Early Biomarkers of Pancreatic Cancer and the Most Effective Approaches at Present | PDF",1789988189]