A new blood test may help doctors detect pancreatic cancer earlier, potentially improving survival rates for one of the deadliest forms of cancer.
Jared Fischer, Ph.D., left, and Jose Luis Montoya Mira, Ph.D., cancer researchers at OHSU, have developed PAC-MANN, a test that uses a small blood sample to detect changes in protease activity, a key indicator of the most common and deadliest form of pancreatic cancer. Image Credit: OHSU/Christine Torres Hicks
Researchers at Oregon Health & Science University (OHSU) have developed a test called PAC-MANN—short for "protease activity-based assay using a magnetic nanosensor." This test analyzes a small blood sample to detect changes in protease activity, a key indicator of pancreatic ductal adenocarcinoma (PDAC), the most common and lethal type of pancreatic cancer.
Pancreatic cancer is often diagnosed at an advanced stage, limiting treatment options. Current tests, like the carbohydrate antigen 19-9 (CA 19-9), are effective for prognosis but not sensitive enough for early detection. PAC-MANN addresses this gap by identifying cancer-related activity in the blood, offering a potential breakthrough in catching the disease sooner.
The problem with pancreatic cancer is that we often catch it too late.
Jared Fischer, Ph.D., Scientist, Assistant Professor and Corresponding Author, Cancer Early Detection Advanced Research Center, Knight Cancer Institute
“Our goal with PAC-MANN is to give clinicians a tool that can detect the disease much earlier when more treatment options are available and there is a better chance of survival,” continued Fischer.
Fischer, an assistant professor of molecular and medical genetics at OHSU’s School of Medicine, is the corresponding author of the study detailing the test, published in Science Translational Medicine.
Jose L. Montoya Mira, Ph.D., the study’s lead author and a research engineer at OHSU’s CEDAR, emphasized the accessibility of the test. With a background in both engineering and biology, Montoya collaborated on creating a cost-effective, high-throughput test that can be used widely, not just in specialized labs.
Our test could be used for people at high risk of pancreatic cancer, which is not targeted by current tests. It allows for a more robust and less invasive screening, unlike an endoscopic ultrasound and other liquid biopsy tests that require large volumes of blood, thus allowing our test to be performed more frequently for earlier detection.
Jose L. Montoya Mira, Ph.D., Study Lead Author and Research Engineer, CEDAR, Oregon Health & Science University
A Quick, Accessible, and Accurate Screening Tool
The researchers tested PAC-MANN using blood samples from 350 patients at OHSU’s Brenden-Colson Center for Pancreatic Care and CEDAR. Participants included individuals diagnosed with pancreatic cancer, those at high risk, and control subjects. The team analyzed specific proteins, particularly proteases, that become more active in people with PDAC. By identifying these proteins, they developed a test capable of distinguishing pancreatic cancer with high accuracy.
The PAC-MANN test correctly identified pancreatic cancer 98 % of the time and detected early-stage cancer with 85 % accuracy when combined with the CA 19-9 test.
The study also found that PAC-MANN could monitor treatment effectiveness. After surgery, researchers observed decreased protease activity, suggesting the test could help track a patient’s response to treatment.
This test isn’t just about detection — it could also help us measure how well treatments are working and guide therapeutic options.
Jared Fischer, Ph.D., Scientist, Assistant Professor and Corresponding Author, Cancer Early Detection Advanced Research Center, Knight Cancer Institute
“If we can track a patient’s response to therapy in real-time, we can make better treatment decisions and improve outcomes,” said Fisher.
Unlike traditional tests, PAC-MANN requires only a tiny blood sample and provides a simple fluorescent readout, making it a quick and accessible screening option.
“The big difference with this test is the cost: It takes only 8 microliters of blood and 45 minutes to run the test at a cost of less than a penny per sample. This could easily be used in rural and underserved settings, where traditional tests are not or cannot be used,” said Montoya.
Montoya and Fischer plan to conduct further trials, including an investigator-initiated study in collaboration with the OHSU Knight Cancer Institute and CEDAR, to assess PAC-MANN’s effectiveness in high-risk patients.
If validated in clinical trials, PAC-MANN could become a valuable tool for detecting pancreatic cancer sooner, providing patients with more treatment options and a better chance of survival.
“Hopefully, this is one step toward ending cancer as we know it,” said Fischer.
Journal Reference:
Mira, M. L., et al. (2025) Early detection of pancreatic cancer by a high-throughput protease-activated nanosensor assay. Science Translational Medicine.