Pancreatic Cancer Early Detection Biomarkers for High-Risk Individuals: Insights From the PRECEDE Consortium
Cet article passe en revue les modalités d'imagerie et les biomarqueurs basés sur des biopsies liquides pour détecter précocement un cancer du pancréas
Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest cancers due to its asymptomatic progression, late-stage diagnosis, and treatment resistance. Efforts in early detection have centered on identifying imaging features and liquid biopsy biomarkers capable of detecting PDAC and its high-grade precursors before clinical symptoms arise in patients at elevated risk of PDAC development. Classical imaging-based surveillance strategies, aligned with current guidelines, form the foundation of screening high-risk individuals, while organ-specific fluid analyses—such as cyst fluid and pancreatic juice—offer promising complementary tools with enhanced specificity. Recent advances in radiomics, liquid biopsy, microbiome, and multi-omics profiling are expanding the frontier of early detection. Despite advances, significant challenges persist. Precursor lesions are difficult to non-invasively diagnose; are not radiologically or endosonographically visible, or cannot be definitively graded prior to resection. Though biomarkers show promise for early detection, they present unique challenges: early-stage neoplasias release low levels of many biomarkers and thresholds for these biomarkers that define malignant transformation—and thus guide surgical intervention—remain poorly established. Multi-institutional initiatives like the Pancreatic Cancer Early Detection consortium (PRECEDE) are critical to bridging discovery and clinical translation. Our international cohort study of high-risk individuals was designed to discover and validate diagnostic biomarkers according to the PROBE study design. Continued collaboration, technological integration, and patient-centered approaches are essential to transform early detection research into tangible survival benefits for those at risk of PDAC.
International Journal of Cancer , article en libre accès, 2026