The Past, Present, and Future of Biomarkers for the Early Diagnosis of Pancreatic Cancer - review

Sep 21, 2026

Pancreatic cancer remains among the most aggressive malignancies, characterized by poor 5-year survival and limited treatment options when detected at an advanced stage. This review explains how major diagnostic and therapeutic efforts have driven the search for biomarkers that could enable earlier detection, expanding access to curative surgery. CA 19-9 is the current reference biomarker but suffers from low specificity and inadequate screening performance. The paper summarizes candidate biomarkers identified across serum, urine, feces, and pancreatic juice, notes the need for validation in larger cohorts, and highlights how omics science and liquid biopsy are shaping future research.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages31

Reading Time1 h 18 min

AccessFree to download

Introduction

Clinical challenge and unmet diagnostic needs

Biomarkers and diagnostic limitations

CA 19-9 as reference marker

Need for validation across patient sample types

Emerging research directions

Omics sciences and liquid biopsy

Review The Past, Present, and Future of Biomarkers for the Early Diagnosis of Pancreatic Cancer Federica Vitale 1, Lorenzo Zileri Dal Verme 1, Mattia Paratore 1, Marcantonio Negri 1, Enrico Celestino Nista 1, Maria Elena Ainora 1, Giorgio Esposto 1, Irene Mignini 1, Raffaele Borriello 1, Linda Galasso 1, Sergio Alfieri 2, Antonio Gasbarrini 1, Maria Assunta Zocco 1, * and Alberto Nicoletti 1 Citation: Vitale, F.; Zileri Dal Verme, L.; Paratore, M.; Negri, M.; Nista, E.C.; Ainora, M.E.; Esposto, G.; Mignini, I.; Borriello, R.; Galasso, L.; et al. The Past, Present, and Future of Biomarkers for the Early Diagnosis of Pancreatic Cancer. Biomedicines 2024, 12, 2840. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)biomedicines12122840 Academic Editors: Nelson Yee and David R. Wallace Received: 1 November 2024 Revised: 30 November 2024 Accepted: 11 December 2024 Published: 13 December 2024 Copyright: © 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/)) . 1 CEMAD Centro Malattie dell’Apparato Digerente, Medicina Interna e Gastroenterologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; federica.vitale@guest.policlinicogemelli.it (F.V.); [lorenzo.zileridalverme@policlinicogemelli.it](lorenzo.zileridalverme@policlinicogemelli.it) (L.Z.D.V.); [mattia.paratore@guest.policlinicogemelli.it](mattia.paratore@guest.policlinicogemelli.it) (M.P.); [marcantonio.negri@policlinicogemelli.it](marcantonio.negri@policlinicogemelli.it) (M.N.); [enricocelestino.nista@policlinicogemelli.it](enricocelestino.nista@policlinicogemelli.it) (E.C.N.); [mariaelena.ainora@policlinicogemelli.it](mariaelena.ainora@policlinicogemelli.it) (M.E.A.); [giorgio.esposto@guest.policlinicogemelli.it](giorgio.esposto@guest.policlinicogemelli.it) (G.E.); [irene.mignini@guest.policlinicogemelli.it](irene.mignini@guest.policlinicogemelli.it) (I.M.); [raffaeleborr@gmail.com](raffaeleborr@gmail.com) (R.B.); [linda.galasso@guest.policlinicogemelli.it](linda.galasso@guest.policlinicogemelli.it) (L.G.); [antonio.gasbarrini@unicatt.it](antonio.gasbarrini@unicatt.it) (A.G.); [alberto.nicoletti@policlinicogemelli.it](alberto.nicoletti@policlinicogemelli.it) (A.N.) 2 Centro Pancreas, Chirurgia Digestiva, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy; [sergio.alfieri@unicatt.it](sergio.alfieri@unicatt.it) * [Correspondence: mariaassunta.zocco@unicatt.it](Correspondence: mariaassunta.zocco@unicatt.it) Abstract: Pancreatic cancer is one of the most aggressive cancers with a very poor 5-year survival rate and reduced therapeutic options when diagnosed in an advanced stage. The dismal prognosis of pancreatic cancer has guided significant efforts to discover novel biomarkers in order to anticipate diagnosis, increasing the population of patients who can benefit from curative surgical treatment. CA 19-9 is the reference biomarker that supports the diagnosis and guides the response to treatments. However, it has significant limitations, a low specificity, and is inefficient as a screening tool. Several potential biomarkers have been discovered in the serum, urine, feces, and pancreatic juice of patients. However, most of this evidence needs further validation in larger cohorts. The advent of advanced omics sciences and liquid biopsy techniques has further enhanced this field of research. The aim of this review is to analyze the historical evolution of the research on novel biomarkers for the early diagnosis of panc

FAQs

Why is early diagnosis crucial in pancreatic cancer?

Pancreatic cancer is often diagnosed at a locally advanced or metastatic stage, which limits eligibility for curative surgery. Early diagnostic methods are therefore essential to improve survival and quality of life.

What limitations does CA 19-9 have as a biomarker?

CA 19-9 supports diagnosis and guides treatment response, but it has significant limitations, including low specificity and poor performance as a screening tool.

Which sample types are used to discover potential biomarkers?

Potential biomarkers have been identified in serum, urine, feces, and pancreatic juice. Most findings still require further validation in larger cohorts.

Sep 21, 2026

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