Road to early detection of pancreatic cancer: Attempts to utilize epigenetic biomarkers

The prognosis of pancreatic cancer is extremely poor, mainly because of its aggressive biological behavior and late onset of symptoms for clinical diagnosis; these impose limitations on therapeutic intervention. Deeper genomic sequencing analyses of pancreatic cancers revealed 12 core pathways and a long duration, nearly 20 years from initiation to distant metastases. This evidence will offer a broader aspect and time window of opportunity for early detection, thus preventing deaths from this cruel cancer. Epigenetic biomarkers can be utilized for assessing cancer risk, early detection, and predicting prognosis and therapeutic responses. In this review, we briefly summarize relevant issues associated with pancreatic cancer progression and recent advances in epigenetic biomarkers such as DNA methylation, miRNAs, satellite repeats, and histone modifications for early diagnosis.