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Pancreatic Cancer: Biomarker Testing

Biomarker testing can help guide pancreatic cancer treatment. Learn about how these tests may impact treatment options.
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What are pancreatic cancer biomarkers?

Biomarkers are substances in blood, tumor or other tissue that can give doctors clues for treating cancer. Testing for are performed in a lab. tests that are performed on blood are sometimes called liquid biopsies. The results may help doctors understand: 

  • how fast the cancer is growing
  • which treatments are most likely to work
  • whether or not the cancer is responding to treatment or growing
  • whether or not the cancer has come back after remission

tests may be used to select treatments, and help patients avoid side effects from treatments that will not work for them. tests used to select a specific treatment are sometimes called companion diagnostic tests. These tests may be done on tumor tissue or (in some cases) on blood. See our  Testing section for more information. 

Biomarkers for treatment selection

Examples of tests used for pancreatic cancer include:

  • Some pancreatic cancers will have an abnormality known as (microsatellite instability-high or MSI-H) or a related abnormality known as "" ( or ). MSI-H and cancers are common in people with a gene mutation. These cancers may respond well to a type of treatment known as an immune checkpoint inhibitor. Examples of agents used for MSI-H cancers are Jemperli (dostarlimab) and Keytruda (pembrolizumab).
  • Pancreatic cancers with a known as an NRG1 gene fusion may be treated with Bezengri (zenocutuzumab-zbco).
  • tumors may respond to treatment with Enhertu (trastuzumab deruxtecan). 
  • Tumors that test positive for a RET gene fusion may respond to the drug Retevmo (selpercatinib). 
  •  known as an NTRK fusion can  predict who might benefit from the  Vitrakvi (larotrectinib).
  • Additional tumor  testing may help people learn if they are eligible for certain clinical trials. 

Biomarkers to monitor recurrence or response to treatment

CA19-9 is a type of protein that is produced in large amounts by some pancreatic cancers. Doctors may use CA19-9 blood tests monitor recurrence or response to treatment. 

Clinical trials are studying whether other blood tests known as liquid biopsies can be used to detect recurrence in people who have completed treatment for pancreatic cancer.  These tests check the blood for abnormal from tumor cells (known as circulating tumor or ).

Genetic testing for inherited mutations to guide treatment selection

All people diagnosed with pancreatic cancer should be offered genetic testing for an . Genetic test results  may be used to guide treatment selection.  

  • People who test positive for an inherited or mutation may respond better to a treatment regimen that includes a type of chemotherapy known as platinum. They may also benefit from  with a type of known as a .  
  • People who test positive for other inherited gene mutations may qualify for clinical trials looking at targeted therapies. 
  • People who test positive for a  gene mutation may benefit from treatment with an  agent
  • People who test positive for a gene mutation may benefit from treatment with an agent. 

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Last updated October 23, 2025