Dittmar RL, Liu S, Tai MC, et al. - For improving patient survival, development of minimally invasive biomarker assays for identification of premalignant disease and early-stage pancreatic cancer is crucial. Researchers herein used a novel miRNA profiling platform (Abcam Fireplex-Oncology Panel) to examine the feasibility of developing early detection miRNA biomarkers with 20 μL plasma from a training set (58 stage II pancreatic ductal adenocarcinoma (PDAC) cases and 30 controls) and two validation sets (34 stage II PDAC cases and 25 controls; 44 stage II PDAC cases and 18 controls). Plasma from stage II PDAC vs controls showed significantly differentially abundant expression of miR-34a-5p, miR-130a-3p, and miR-222-3p. Individually, none of the miRNAs performed better than the currently used serologic biomarker for PDAC, carbohydrate antigen 19-9 (CA19-9), however, improved AUCs were generated on combining the miRNAs with CA 19-9. These miRNA biomarkers, assayed in limited volume plasma along with CA19-9, differentiate stage II PDAC from controls with good sensitivity and specificity. Hence, researchers herein present a limited volume plasma miRNA biomarker assay that can aid in identification of early-stage resectable pancreatic cancer in clinical samples.