IU researcher identifies biomarkers that could improve early detection of pancreatic cancer

A researcher at the IU Indianapolis Fairbanks School of Public Health has identified a set of novel biomarkers that could significantly improve early detection of pancreatic cancer, a disease with a five-year survival rate of just 13%, the lowest among major cancers.

In collaboration with other researchers, Jianjun Zhang, MD, PhD, professor of epidemiology at the Fairbanks School and adjunct professor of surgery at the Indiana University School of Medicine, focused on identifying the disease at its earliest, most curable stages.

With over 80% of patients diagnosed at an advanced stage, early detection is the single most critical factor in changing outcomes.

Key research highlights:

• Early-warning proteins: Zhang, in collaboration with investigators at Indiana University and the University of Texas MD Anderson Cancer Center, identified a group of proteins in pancreatic cyst fluid that can help doctors tell which cysts are likely to become cancerous. These cysts, known as intraductal papillary mucinous neoplasms (IPMNs), are one of the few known early warning signs of pancreatic cancer.
• Early metabolic changes: Studies found distinct metabolic changes. Specifically, increased activity in a special fat-and-sugar molecule called sulfatides that appears very early in the disease process and continues as cancer develops. Elevated levels of cyst fluid polyamines (small molecules made from amino acids) are associated with malignancy risk of IPMNs. These changes give researchers new biological signals to look for in screening tests.
• A better use of an existing test: The researchers created a new way to use the existing pancreatic cancer blood test, called CA19-9, by examining repeated measurements over time rather than relying on a single timepoint measurement. This approach improves the test’s accuracy and can detect hidden cancers earlier than current methods.

These discoveries hold great potential for improving risk stratification for patients with pancreatic cysts and lay the foundational science for developing new, non-invasive screening tools.

“For a disease as aggressive as pancreatic cancer, early detection is key to saving lives,” said Dr. Zhang. “These discoveries bring us closer to finding cancer when patients still have a real chance at a cure.”

Four papers were published in 2025 across three high-impact medical journals including Clinical Cancer Research, Gut and two publications in Cancer Letters.

Dr. Jianjun Zhang is a member of the research team studying novel biomarkers in pancreatic cancer. Other researchers in the team include C. Max Schmidt of the IU School of Medicine and Johannes Fahrmann and Samir Hanash of the University of Texas MD Anderson Cancer Center.