Biomarkers in Pancreatic Cancer

Abstract

Disclosed herein is a method for diagnosing, monitoring, detecting, or treating pancreatic cancer in a patient, inter alia, by detecting the expression level of an RNA biomarker in a biological sample.

Description

Technical Field

[0001] (Cross - Reference to Related Applications) This application claims the benefit of priority of U.S. Application No. 63 / 359,270, filed Jul. 8, 2022, and U.S. Application No. 63 / 351,212, filed Jun. 10, 2022, which are hereby incorporated by reference in their entirety.

[0002] (Statement Regarding Rights to Inventions Made Under Government Sponsorship in the Course of R & D) This invention was made with government support under Grant No. CA214254 awarded by the National Institutes of Health. The government has certain rights in this invention.

Background Art

[0003] Pancreatic ductal adenocarcinoma (PDAC) is the most common malignancy of the pancreas. PDAC represents a substantial health problem with increasing incidence and is predicted to be the second leading cause of cancer - related mortality in the United States within this decade. According to standard treatment strategies, surgical removal of localized tumors presents the only potential curative option for this disease. Recent clinical findings have clearly established that surgery followed by up - to - date adjuvant chemotherapy significantly improves patient outcomes with a median overall survival in the range of 46 - 54 months in PDAC patients. Unfortunately, however, patients presenting with localized, resectable, and potentially curable tumors at initial diagnosis represent less than 15 - 20% of all cases, and the remainder have more advanced unresectable or metastatic disease. This is reflected in data that the 5 - year survival rate in PDAC patients has not been substantially and significantly improved in the last few decades, despite recent advancements in treatment modalities.

[0004] One of the themes that have emerged in recent years is that early diagnosis of the disease provides a promising opportunity for timely intervention and subsequent improvement in the survival of patients suffering from this lethal malignancy. In this context, several blood-based biomarkers have been evaluated for their clinical utility for the early diagnosis of PDAC to date. Serum carbohydrate antigen 19-9 (CA19-9) remains the most well-established and widely used serum biomarker in patients with PDAC. CA19-9 is commonly used to monitor disease progression and treatment response, but it lacks sufficient sensitivity or specificity for screening and early detection of patients with PDAC. Importantly, 15-25% of patients with PDAC often exhibit CA19-9 levels below 37 U / ml, which are considered normal, including at the initial stage. Furthermore, 5-10% of the general population are Lewis antigen-negative and do not secrete or secrete low levels of CA19-9. Considering these clinical challenges in the art, the present disclosure is directed to the urgent need to develop robust and alternative, preferably non-invasive, biomarkers for the early diagnosis of PDAC.

Summary of the Invention

[0005] A method of treating pancreatic cancer in a patient in need thereof, comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, subjecting the patient to image-based screening, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient comprises RNA having an elevated expression level as compared to a control, and the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof.

[0006] A method of treating pancreatic cancer in a patient in need of treatment for pancreatic cancer, comprising: (i) detecting an elevated expression level of RNA in a biological sample obtained from the patient, the RNA comprising cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof, as compared to a control; and (ii) administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, subjecting the patient to image-based screening, surgically removing all or a portion of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof.

[0007] A method for diagnosing a patient with pancreatic cancer, comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing the patient as having pancreatic cancer, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof.

[0008] These and other embodiments of the disclosure are described herein.

Brief Description of the Drawings

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Best Mode for Carrying Out the Invention

[0010] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. See, for example, Singleton et al., Dictionary of Microbiology and Molecular Biology 2nd ed., J. Wiley & Sons (New York, NY 1994), Sambrook et al., Molecular Cloning, A Laboratory Manual, Cold Springs Harbor Press (Cold Springs Harbor, NY 1989). Any methods, devices, and materials similar or equivalent to those described herein can be used in the practice of the present disclosure. The following definitions are provided to facilitate understanding of certain terms frequently used herein and are not meant to limit the scope of the present disclosure.

[0011] As used herein, the term "tumor-derived exosome" or "exosome" refers to small vesicles (between 20 and 300 nm in diameter) that contain a lipid bilayer membrane surrounding an internal space, which are generated from cancer cells by direct plasma membrane budding or by fusion of late endosomes with the plasma membrane. The components of tumor-derived exosomes include proteins, DNA, mRNA, microRNA, long non-coding RNA, circular RNA, etc., which play a role in regulating tumor growth, metastasis, and angiogenesis during the process of cancer development.

[0012] "Exosomal RNA" refers to RNA within tumor-derived exosomes or RNA obtained from within tumor-derived exosomes. In a plurality of embodiments, "exosomal RNA" is exosomal miRNA. In a plurality of embodiments, "exosomal RNA" is exosomal mRNA. Exosomal RNA can be detected and measured by methods known in the art such as those described herein.

[0013] "Cell-free RNA" or "cf-RNA" refers to RNA that is not within tumor-derived exosomes or has not been obtained from within tumor-derived exosomes. Cell-free RNA can be detected and measured by methods known in the art, such as those described herein.

[0014] "Cell" refers to a cell that performs metabolic or other functions sufficient to preserve or replicate its genomic DNA. A cell can be identified by methods well known in the art, including, for example, the presence of an intact membrane, staining with specific dyes, the ability to produce progeny, or, in the case of gametes, the ability to combine with a second gamete to produce viable progeny. Cells can include prokaryotic and eukaryotic cells. Prokaryotic cells include, but are not limited to, bacteria. Eukaryotic cells include, but are not limited to, yeast cells and cells derived from plants and animals, such as mammalian (e.g., human) cells. Cells can be useful when they are naturally non-adherent or have been treated, for example, by trypsin treatment, so as not to adhere to a surface.

[0015] "Nucleic acid" refers to nucleotides (e.g., deoxyribonucleotides or ribonucleotides) and their polymers in any form of single-stranded, double-stranded, or multi-stranded, or their complements, or nucleosides (e.g., deoxyribonucleosides or ribonucleosides). In multiple embodiments, "nucleic acid" does not include nucleosides. Terms such as "polynucleotide", "oligonucleotide", "oligo" refer to a linear sequence of nucleotides in the usual and customary sense. The term "nucleoside" refers to a glycosylamine containing a nucleobase and a pentose sugar (ribose or deoxyribose) in the usual and customary sense. Non-limiting examples of nucleosides include cytidine, uridine, adenosine, guanosine, thymidine, and inosine. The term "nucleotide" refers to a single polynucleotide unit, i.e., a monomer, in the usual and customary sense. Nucleotides can be ribonucleotides, deoxyribonucleotides, or modified forms thereof. Examples of polynucleotides contemplated herein include single-stranded and double-stranded DNA, single-stranded and double-stranded RNA, and hybrid molecules having mixtures of single-stranded and double-stranded DNA and RNA. Examples of nucleic acids contemplated herein, e.g., polynucleotides, include all types of RNA, e.g., mRNA, siRNA, miRNA, and guide RNA, and all types of DNA, genomic DNA, episomal DNA, and minicircle DNA, and any fragments thereof. The term "double-stranded" in the context of polynucleotides refers to double-strandedness in the usual and customary sense. Nucleic acids can be linear or branched. For example, a nucleic acid can be a linear chain of nucleotides, or a nucleic acid can be branched, e.g., such that the nucleic acid contains one or more arms or branches of nucleotides. Optionally, branched nucleic acids repeatedly branch to form higher-order structures such as dendrimers.

[0016] Polynucleotides generally consist of a specific sequence of four nucleotide bases: adenine (A), cytosine (C), guanine (G), and thymine (T) (uracil (U) in place of thymine (T) if the polynucleotide is RNA). Thus, the term "polynucleotide sequence" is an alphabetical representation of a polynucleotide molecule, and alternatively, this term can be used for the polynucleotide molecule itself. This alphabetical representation can be input into the data system of a computer equipped with a central processing unit and can be used in bioinformatics applications such as functional genomics and homology searches. Polynucleotides may optionally contain non-standard nucleotides, nucleotide analogs, and / or modified nucleotides.

[0017] "Conservatively modified variants" applies to both amino acid and nucleic acid sequences. With respect to a particular nucleic acid sequence, a "conservatively modified variant" refers to a nucleic acid encoding the same or essentially the same amino acid sequence. Due to the degeneracy of the genetic code, many nucleic acid sequences encode any given protein. For example, the codons GCA, GCC, GCG, and GCU all encode the amino acid alanine. Thus, at every position where an alanine is specified by a codon, the codon can be changed to any of the corresponding codons described without changing the encoded polypeptide. Such nucleic acid variations are "silent variations", a type of conservatively modified variation. The entire nucleic acid sequences herein that encode polypeptides also describe every possible nucleic acid silent variation. One of ordinary skill in the art will understand that each codon in a nucleic acid (except for the AUG which is usually the only codon for methionine and TGG which is usually the only codon for tryptophan) can be modified to yield a functionally identical molecule. Thus, each silent variation of a nucleic acid encoding a polypeptide is implicitly disclosed in each of the sequences described.

[0018] As used herein, the terms "microRNA", "microRNA nucleic acid sequence", "miR", and "miRNA" refer to nucleic acids that function in RNA silencing and post-transcriptional regulation of gene expression. The terms include all forms of miRNA, such as pre-, pre-pre-, and mature forms of miRNA. In multiple embodiments, microRNA (microRNA, miRNA) is a short (20-24 nt) non-coding RNA that is involved in the post-transcriptional regulation of gene expression in multicellular organisms by affecting both the stability and translation of mRNA. miRNA is transcribed by RNA polymerase II as part of a capped and polyadenylated primary transcript (pre-miRNA), which can be either protein-coding or non-coding. The primary transcript is cleaved by the Drosha ribonuclease III enzyme to produce a stem-loop precursor miRNA (pre-miRNA) of approximately 70 nt, which is further cleaved by a cytoplasmic Dicer ribonuclease to produce a mature miRNA and an antisense miRNA star (miRNA * ) product. The mature miRNA is incorporated into the RNA-induced silencing complex (RISC), which recognizes the target mRNA through imperfect base pairing with the miRNA and most commonly results in inhibition of translation or destabilization of the target mRNA.

[0019] A nucleic acid may contain a non-specific sequence. As used herein, the term "non-specific sequence" refers to a nucleic acid sequence that contains a series of residues that are not designed to be complementary, or are only partially complementary, to any other nucleic acid sequence. By way of example, a non-specific nucleic acid sequence is a sequence of nucleic acid residues that does not function as an inhibitory nucleic acid when contacted with a cell or organism.

[0020] As used herein, the term "complement" refers to a nucleotide (e.g., RNA or DNA) or a sequence of nucleotides that can base pair with a complementary nucleotide or sequence of nucleotides. As described herein and as is generally known in the art, the complementary (matching) nucleotide of adenosine is thymidine, and the complementary (matching) nucleotide of guanidine is cytosine. Thus, a complement may include a sequence of nucleotides that base pairs with the corresponding complementary nucleotides of a second nucleic acid sequence. The nucleotides of the complement may match the nucleotides of the second nucleic acid sequence partially or completely. When the nucleotides of the complement match each nucleotide of the second nucleic acid sequence completely, the complement forms a base pair with each nucleotide of the second nucleic acid sequence. When the nucleotides of the complement match the nucleotides of the second nucleic acid sequence partially, only some of the nucleotides of the complement form a base pair with the nucleotides of the second nucleic acid sequence. Examples of complementary sequences include coding and non-coding sequences, and the non-coding sequences contain the complementary nucleotides to the coding sequences and thus form the complement of the coding sequences.

[0021] The term "gene" means a segment of DNA involved in the production of a protein. This includes regions before and after the coding region (leaders and trailers), as well as intervening sequences (introns) between individual coding segments (exons). The leaders, trailers, and introns contain regulatory elements necessary during the transcription and translation of the gene. Further, a "protein gene product" is a protein expressed from a particular gene.

[0022] As used herein with respect to a gene, the terms "expression" or "expressed" mean the transcription and / or translation products of that gene. The expression level of a DNA molecule in a cell can be determined based on either the amount of the corresponding RNA present in the cell or the amount of the protein encoded by that DNA produced by the cell. The expression level of non-coding nucleic acid molecules (e.g., miRNA, mRNA) can be detected by standard PCR or Northern blot methods well known in the art. See Sambrook et al., 1989 Molecular Cloning: A Laboratory Manual, 18.1-18.88.

[0023] The terms "expression level", "amount", or "level" of a biomarker refer to a detectable level in a biological sample. "Expression" generally refers to the process by which information (e.g., genetic code and / or epigenetic) is converted into a structure that exists and functions within a cell. Thus, "expression" can refer to transcription into a polynucleotide, translation into a polypeptide, or even polynucleotide and / or polypeptide modification (e.g., post-translational modification of a polypeptide). Fragments of the transcribed polynucleotide, translated polypeptide, or polynucleotide and / or polypeptide modification (e.g., post-translational modification of a polypeptide) are also considered expressed, whether they are derived from transcripts generated by alternative splicing or degraded transcripts, or, for example, from post-translational processing of a polypeptide by proteolysis. "Expressed genes" include those that are transcribed into a polynucleotide as mRNA and then translated into a polypeptide, as well as those that are transcribed into RNA but not translated into a polypeptide (e.g., miRNA, transfer RNA, ribosomal RNA, non-coding RNA). The expression level can be measured by methods known to those of skill in the art and also by the methods disclosed herein. The expression level or amount of a biomarker (e.g., RNA, miRNA) can be used to diagnose and / or treat a subject having pancreatic cancer.

[0024] The term "elevated expression level" or "elevated level" of gene expression refers to the gene expression level that is higher than the gene expression level in the control. The control can be any suitable control described herein. In multiple embodiments, an "elevated expression level" of a biomarker gene (when the expression level of the biomarker is higher than the corresponding control) compared to the control is, for example, an increase at an expression level of about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, 96%, 97%, 98% or 99% or more compared to the control. In multiple embodiments, an "elevated level" of a biomarker gene is an amount that is statistically significantly higher than the expression level of the control.

[0025] The term "not having an elevated expression level" or "not elevated" expression level refers to the gene expression level that is approximately the same (or lower) than the gene expression level in the control. The control can be any suitable control described herein. In multiple embodiments, "approximately the same" is + / - 25% of the expression level of the biomarker gene in the control. In multiple embodiments, "approximately the same" is + / - 20% of the expression level of the biomarker gene in the control. In multiple embodiments, "approximately the same" is + / - 15% of the expression level of the biomarker gene in the control. In multiple embodiments, "approximately the same" is + / - 10% of the expression level of the biomarker gene in the control. In multiple embodiments, "approximately the same" is + / - 5% of the expression level of the biomarker gene in the control. In multiple embodiments, the expression level of a biomarker gene that is "not elevated" or "non-elevated" is an amount that is not statistically significantly different from the expression level of the control.

[0026] The terms "biomarker gene" and "biomarker" are used interchangeably and are used according to their plain and ordinary meaning. In multiple embodiments, a biomarker is a gene or a set of genes (i.e., a biomarker gene). Biomarkers include, but are not limited to, polynucleotides (e.g., DNA and / or RNA), polynucleotide copy number variations (e.g., DNA copy number), polypeptides, or polypeptide and polynucleotide modifications (e.g., post-translational modifications). In multiple embodiments, a biomarker refers to RNA (e.g., miRNA), and its expression level is related to a specific biological state, particularly a state associated with pancreatic cancer.

[0027] Biomarker levels can be detected either at the protein or gene expression level. Proteins expressed by biomarkers can be quantified by immunohistochemistry (IHC) using antibodies that detect the protein or by flow cytometry. Biomarker expression can be quantified by multiple platforms such as real-time polymerase chain reaction (rtPCR), Nanostring, RNAseq, or in situ hybridization. As measured by Nanostring, the range of biomarker expression varies. In multiple embodiments, quantitative rtPCR, Nanostring, RNAseq, and in situ hybridization are platforms for quantifying biomarker gene expression. In the case of Nanostring, RNA is extracted from a biological sample and a known amount of RNA is placed on a Nanostring instrument to detect gene expression using gene-specific probes. The number of counts of the biomarker in the sample is determined and normalized against a set of housekeeping genes. To determine the threshold for elevated or decreased biomarker levels, one of ordinary skill in the art would evaluate the biomarker levels in a control group of samples and could select the 10, 20, 25, 30, 40, 50, 60, 70, 75, 80, or 90 percentile of biomarker gene expression. In multiple embodiments, increased or decreased biomarker expression can be determined by calculating an H-score for biomarker expression. Thus, increased or decreased biomarker expression can have an H-score. As used herein, "H-score" or "histoscore" is a numerical value determined by a generally known semi-quantitative method for immunohistochemically evaluating protein expression in tumor samples. The H-score can be calculated using the following formula: [1x(% cells 1+) + 2x(% cells 2+) + 3x(% cells 3+)].According to this formula, the H-score is calculated by determining the percentage of cells having a given staining intensity level (i.e., level 1+, 2+, or 3+ of the lowest to highest intensity levels), and multiplying that percentage of cells by a coefficient (e.g., 1, 2, or 3) that gives relatively more weight to cells having higher intensity membrane staining, thereby weighting the percentage of cells having a given intensity level, and summing the results to obtain the H-score. Generally, the H-score ranges from 0 to 300. Further explanations regarding the determination of the H-score in tumor cells can be found in Hirsch et al, J Clin Oncol 21:3798-3807, 2003 and John et al, Oncogene 28:S14-S23, 2009. IHC or other methods known in the art can be used to detect biomarker expression.

[0028] "Control" is used in its plain and ordinary meaning and refers to an assay, comparison, or experiment in which the subject or reagent of the experiment is treated in the same manner as a parallel experiment, except for the omission of experimental procedures, reagents, or variables. In multiple embodiments, the control is used as a standard for comparison when evaluating experimental effects. In multiple embodiments, the control is a measure of the activity or level of RNA. In multiple embodiments, the control is a healthy patient or a group of healthy patients. In multiple embodiments, the control is the average value from a group of healthy patients having similar patients, e.g., similar medical background, age, weight, etc. In multiple embodiments, the control is a healthy patient or a group of healthy patients. In multiple embodiments, a healthy patient can be referred to as a non-diseased patient or a non-disease control. In multiple embodiments, the control is a group of non-diseased patients. In multiple embodiments, a non-diseased patient is a patient without cancer. In multiple embodiments, a non-diseased patient is a patient without pancreatic cancer. In multiple embodiments, the control is a patient without cancer or a group of patients without cancer. In multiple embodiments, the control is a patient without pancreatic cancer or a group of patients without pancreatic cancer. In multiple embodiments, the control is a patient without PDAC or a group of patients without PDAC. In multiple embodiments, the control is the average value from a group of healthy patients. The control can also be obtained from the same patient, e.g., from an initially obtained sample, pre-disease, or pre-treatment. One of ordinary skill in the art will recognize that controls can be designed for any number of parameter evaluations. In multiple embodiments, the control is a negative control. In multiple embodiments, such as some embodiments regarding the detection of the expression level of a gene / protein, or a subset of a gene / protein, the control includes the average expression level (e.g., protein or mRNA) in a target population (e.g., having cancer), or in a healthy or general population. In multiple embodiments, the control includes the average amount (e.g., expression amount) in a population where the number of subjects (n) is 5 or more, 20 or more, 50 or more, 100 or more, 1000 or more, etc. In multiple embodiments, the control is a standard control. In multiple embodiments, the standard control is the expression level of a biomarker (e.g., RNA, miRNA) that correlates with the diagnosis of pancreatic cancer in a subject.In multiple embodiments, the standard control is the expression level of biomarkers (e.g., RNA, miRNA) that correlate with healthy subjects (i.e., subjects without pancreatic cancer). Those skilled in the art will understand which control is beneficial in a given situation and will be able to analyze the data based on comparison with the control values. Controls are also useful for determining the significance of data. For example, if the values of a given parameter vary widely in the control, the variation in the test sample is not considered significant.

[0029] The term "healthy patient" refers to a non-diseased patient. In multiple embodiments, a healthy patient is a patient without cancer. In multiple embodiments, a healthy patient is a patient without pancreatic cancer (e.g., PDAC).

[0030] The term "recombinant", when used with respect to, for example, a cell, or a nucleic acid, protein, or vector, indicates that the cell, nucleic acid, protein or vector has been modified by the introduction of a heterologous nucleic acid or protein or the alteration of a native nucleic acid or protein, or that the cell is derived from a cell so modified. Thus, for example, a recombinant cell expresses a gene not found in a cell in its natural (non-recombinant) form, or expresses a native gene that is otherwise abnormally expressed, under-expressed, or not expressed at all. Genetically recombinant cells and plants typically express a heterologous gene or coding sequence as a result of recombinant methods.

[0031] The term "heterologous", when used with respect to a portion of a nucleic acid, indicates that the nucleic acid contains two or more subsequences that are not found in essentially the same relationship to each other. For example, a nucleic acid typically has two or more sequences from unrelated genes that are recombinantly produced and arranged to create a new functional nucleic acid, e.g., a promoter from one source and a coding region from another source. Similarly, a heterologous protein indicates that the protein contains two or more subsequences that are not found in the same relationship to each other in nature (e.g., a fusion protein).

[0032] The terms "specifically (or selectively) binds to" or "specifically (or selectively) immunoreacts with" an antibody, when referring to a protein or peptide, often refers to a binding reaction that determines the presence of the protein in a heterogeneous population of proteins and other biologic agents. Thus, under specified immunoassay conditions, a particular antibody binds to a particular protein at least 2-fold over background, more typically over 10- to 100-fold over background. Specific binding to an antibody under such conditions requires an antibody that has been selected for its specificity to a particular protein. For example, a polyclonal antibody can be selected to obtain only the subset of antibodies that are specifically immunoreactive with the selected antigen and not immunoreactive with other proteins. This selection may be achieved by subtracting antibodies that cross-react with other molecules. Various immunoassay formats may be used to select antibodies that are specifically immunoreactive with a particular protein. For example, solid phase ELISA immunoassays are routinely used to select antibodies that specifically immunoreact with a protein (see, e.g., Harlow & Lane, Using Antibodies, A Laboratory Manual (1998) for a description of immunoassay formats and conditions that can be used to determine specific immunoreactivity).

[0033] The terms "isolated" and "isolate" when applied to a nucleic acid, virus, or protein mean that the nucleic acid, virus, or protein is substantially free of other cellular components that are associated with it in its natural state. This can be, for example, in a homogeneous state and can be either dry or in an aqueous solution. Purity and homogeneity are typically determined using analytical chemistry techniques such as polyacrylamide gel electrophoresis or high performance liquid chromatography. An RNA that is present as the major species in a preparation is substantially purified.

[0034] The "percentage of sequence identity" is determined by comparing two sequences optimally aligned over a comparison window, wherein the portion of the polynucleotide or polypeptide sequence in the comparison window may include additions or deletions (i.e., gaps) as compared to the reference sequence (not including additions or deletions) for optimal alignment of the two sequences. This percentage is calculated by determining the number of positions at which the identical nucleic acid base or amino acid residue is present in both sequences, generating the number of matched positions, dividing the number of matched positions by the total number of positions in the comparison window, and multiplying the result by 100 to generate the percentage of sequence identity.

[0035] The term "identical" or "identity" percent in the context of the sequences of two or more nucleic acids or polypeptides refers to amino acid residues or nucleotides that are identical or identical at a particular percentage (i.e., about 60% identity, preferably 65%, 70%, 75%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, 99%, or more identity for a particular region when compared and aligned to maximize correspondence with respect to a comparison window or specified region) using the BLAST or BLAST 2.0 sequence comparison algorithms with the following default parameters, or by manual alignment and visual inspection (see, e.g., www.ncbi.nlm.nih.gov / BLAST / ). Thus, such sequences are "substantially identical". This definition may also refer to, or be applied to, the complement of the test sequence. The definition also includes sequences having deletions and / or additions, as well as sequences having substitutions. As described below, preferred algorithms can calculate gaps and the like. Preferably, identity exists over a region of at least about 25 amino acids or nucleotides in length, and more preferably over a region of 50-100 amino acids or nucleotides in length.

[0036] The "position" of an amino acid or nucleotide base is indicated by a number that sequentially identifies each amino acid (or nucleotide base) in the reference sequence based on its position relative to the N-terminus (or 5'-terminus). Due to deletions, insertions, truncations, fusions, etc. that must be considered when determining the optimal alignment, generally, the number of amino acid residues in the test sequence determined simply by counting from the N-terminus is not necessarily the same as the number at the corresponding position in the reference sequence. For example, if a variant has a deletion compared to the aligned reference sequence, there will be no amino acid in the variant corresponding to the position in the reference sequence at the deletion site. If there is an insertion in the aligned reference sequence, the insertion does not correspond to a numbered amino acid position in the reference sequence. In the case of a truncation or fusion, there may be a section of amino acids in either the reference sequence or the aligned sequence that does not correspond to any amino acid in the corresponding sequence.

[0037] When used in the context of numbering a given amino acid or polynucleotide sequence, the terms "numbered relative to" or "corresponding to" refer to the numbering of the residues of a particular reference sequence when the given amino acid or polynucleotide sequence is compared to the reference sequence.

[0038] As used herein, the term "about" means a range of values that includes a particular value and that one of ordinary skill in the art would consider to be reasonably similar to the particular value. In multiple embodiments, "about" means within one standard deviation of the measured values generally accepted in the art. In multiple embodiments, "about" means a range that extends from + / −10% of a particular value. In multiple embodiments, "about" includes the particular value.

[0039] The singular terms "a", "an", and "the" include the plural referents unless the context clearly dictates otherwise.

[0040] As used herein, "therapeutic agent" or "anticancer agent" refers to an agent (e.g., a compound, a pharmaceutical composition) that, when administered to a subject, has a therapeutic effect on pancreatic cancer or the amelioration thereof, including any objective or subjective parameter of treatment, such as an intended therapeutic effect, e.g., reduction, remission, decrease in symptoms, or making cancer more tolerable to the patient, slowing the rate of degeneration or regression, making the end point of degeneration less debilitating, or improving the physical or mental health of the patient.

[0041] "Biological sample" or "sample" refers to a material obtained from or derived from a subject or patient. Biological samples include tissue sections such as biopsy samples and autopsy samples, frozen sections taken for histological purposes, and the like. Such samples include blood and blood fractions or products (e.g., serum, plasma, platelets, red blood cells, etc.), sputum, tissue, cultured cells (e.g., primary cultures, explants, and transformed cells), feces, urine, synovial fluid, joint tissue, synovial tissue, synovial cells, fibroblast-like synovial cells, macrophage-like synovial cells, immune cells, hematopoietic cells, fibroblasts, macrophages, T cells, and the like. In a plurality of embodiments, the biological sample is blood. In a plurality of embodiments, the biological sample is a serum sample (e.g., the fluid and solute components of blood without clotting factors). In a plurality of embodiments, the biological sample is a plasma sample (e.g., the liquid portion of blood). In a plurality of embodiments, the biological sample is cell-free RNA obtained from blood. In a plurality of embodiments, the biological sample is exosomes obtained from a blood sample, and the exosomes contain RNA. In a plurality of embodiments, the biological sample is exosomes obtained from a serum sample, and the exosomes contain RNA. In a plurality of embodiments, the biological sample is exosomes obtained from a plasma sample, and the exosomes contain RNA.

[0042] "Liquid biological sample" refers to a liquid material obtained from or derived from a subject or patient. Liquid biological samples include body fluids such as blood and blood fractions or products (e.g., serum, plasma, platelets, red blood cells, etc.), sputum, urine, synovial fluid, and the like. In a plurality of embodiments, the liquid biological sample is a blood sample.

[0043] The term "diagnosis" is used in its plain and ordinary sense and refers to the identification or likelihood of the presence of a disease (e.g., pancreatic cancer) or outcome in a subject.

[0044] "Imaging-based screening" refers to a method of using imaging techniques to detect cancer or tumors in a patient. Exemplary types of imaging-based screening include X-rays, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and ultrasound. In multiple embodiments of the methods described herein, the imaging-based screening is CT, MRI, or ultrasound. In multiple embodiments, the ultrasound is endoscopic ultrasonography (EUS). In multiple embodiments of the methods described herein, the imaging-based screening is CT, MRI, or EUS. In multiple embodiments of the methods described herein, the imaging-based screening is MRI or EUS. In multiple embodiments of the methods described herein, the imaging-based screening is CT. In multiple embodiments of the methods described herein, the imaging-based screening is MRI. In multiple embodiments of the methods described herein, the imaging-based screening is EUS.

[0045] The terms "treating" or "treatment" are used in their plain and ordinary sense and broadly include any approach for obtaining a beneficial or desired result in the condition of a subject, including clinical outcomes. Beneficial or desired clinical outcomes can include, but are not limited to, alleviation or improvement of one or more symptoms or conditions, whether partial or total and whether detectable or undetectable, reduction in the degree of a disease, stabilization of a disease state (i.e., not worsening), delay or slowing of disease progression, improvement or alleviation of a disease state, and remission. Treatment can inhibit the spread of a disease, reduce the symptoms of a disease, completely or partially remove the underlying cause of a disease, shorten the duration of a disease, or a combination thereof. A method of treatment includes administering to a subject a therapeutically effective amount of an active agent. The term "treating" does not include preventing.

[0046] The terms "preventing" or "prevention" are used in their plain and ordinary sense and refer to reducing the occurrence of disease symptoms in a patient or preventing the disease from occurring. Prevention can be complete (without detectable symptoms) or partial, and thus fewer symptoms are observed than would likely occur without treatment.

[0047] "Effective amount" is an amount sufficient to achieve a given purpose (e.g., to achieve the effect for which it is administered, to treat a disease). An example of an "effective amount" is an amount sufficient to contribute to the treatment, prevention, or alleviation of the symptoms of a disease, which may also be referred to as a "therapeutically effective amount". "Alleviation" of a symptom (singular or plural) (and grammatical equivalents of this phrase) means a reduction in the severity or frequency of the symptom, or the elimination of the symptom. The exact amount will depend on the purpose of the treatment and will be elucidated by one of ordinary skill in the art using known techniques. In multiple embodiments, the "therapeutically effective amount" refers to the amount of a therapeutic agent sufficient to treat or ameliorate pancreatic cancer, as described above. For any therapeutic agent described herein, the therapeutically effective amount can first be determined from cell culture assays. The target concentration will be the concentration of the active compound that can achieve the methods described herein when measured using the methods described herein or methods known in the art. As is well known in the art, the therapeutically effective amount for use in humans can also be determined from animal models. For example, the human dosage can be formulated to achieve the concentration found to be effective in animals. The human dosage can be adjusted as described above by monitoring the effectiveness of the compound and adjusting the dosage up or down. Adjusting the dosage to achieve maximum effectiveness in humans based on the methods described above and other methods is well within the ability of one of ordinary skill in the art. The dosage can vary depending on the requirements of the patient and the therapeutic agent used. The dosage administered to a patient should be sufficient to produce a beneficial therapeutic response in the patient over time. The size of the dosage will also be determined by the presence, nature, and extent of any adverse side effects. Determining the appropriate dosage for a particular situation is within the ability of one of ordinary skill in the art. Generally, treatment is initiated at a dosage less than the optimal dosage of the compound. Thereafter, the dosage is increased gradually until the optimal effect is achieved in the circumstances. The dosage and interval can be adjusted individually to provide the level of the administered compound effective for the particular clinical indication being treated. This will provide a treatment regimen appropriate to the severity of the patient's disease state. The "therapeutically effective amount" can also be found on the label or prescription information of a commercially available therapeutic agent.

[0048] As used herein, the term "administering" means administering to a subject by oral administration, administration as a suppository, topical contact, intravenous, parenteral, intraperitoneal, intramuscular, intralesional, intrathecal, intranasal, or subcutaneous administration, or implantation of a sustained release device, e.g., a small osmotic pump. Administration is by any route including parenteral and transmucosal (e.g., oral, sublingual, palatal, gingival, nasal, vaginal, rectal, or transdermal). Parenteral administration includes, for example, intravenous, intramuscular, arteriolar, intradermal, subcutaneous, intraperitoneal, intraventricular, and intracranial administration. Other delivery modes include, but are not limited to, the use of liposome formulations, intravenous infusions, transdermal patches, etc. In a plurality of embodiments, administration does not include the administration of any active agent other than the recited active agents.

[0049] The terms "patient" or "subject" are used in their plain and ordinary sense and refer to a living organism that has or is susceptible to a disease that can be treated by administration of a pharmaceutical composition such as an anti-cancer agent and a chemotherapeutic agent. Non-limiting examples include humans, other mammals, cows, rats, mice, dogs, cats, monkeys, and other non-mammals. In a plurality of embodiments, the patient is a human. In a plurality of embodiments, the human patient is at least 45 years old. In a plurality of embodiments, the human patient is at least 50 years old. In a plurality of embodiments, the human patient is at least 55 years old. In a plurality of embodiments, the human patient is at least 60 years old. In a plurality of embodiments, the human patient is at least 45 years old and has type 2 diabetes. In a plurality of embodiments, the human patient is at least 50 years old and has type 2 diabetes. In a plurality of embodiments, the human patient is at least 55 years old and has type 2 diabetes. In a plurality of embodiments, the human patient has a family history of pancreatic cancer. In a plurality of embodiments, the human patient has obesity. In a plurality of embodiments, the human patient has a history of pancreatitis. In a plurality of embodiments, the human patient has a history of chronic pancreatitis.

[0050] The terms "metastasis," "metastatic," and "metastatic cancer" can be used interchangeably and refer to the spread of a proliferative disease or disorder, such as cancer, from one organ or another non-adjacent organ or part of the body. Cancer originates at a site, for example, in the pancreas, and this site is referred to as the primary tumor, such as primary pancreatic cancer. Some cancer cells in the primary tumor or site of origin acquire the ability to penetrate and invade the surrounding normal tissue in the local area and / or penetrate the walls of the lymphatic or vascular system and circulate through the system to other parts and tissues of the body. Clinically detectable secondary tumors formed from the cancer cells of the primary tumor are called metastatic or secondary tumors. When cancer cells metastasize, the metastatic tumor and its cells are presumed to be the same as those of the original tumor. Thus, when pancreatic cancer metastasizes to lymph nodes, the secondary tumor at the site of the lymph nodes consists of pancreatic cancer cells and not abnormal lymph node cells. The secondary tumor in the lymph nodes is called lymph node metastasis. Thus, the phrase "metastatic cancer" refers to a disease in which a subject has one or more secondary tumors that has or had a primary tumor. The phrase "subject having non-metastatic cancer or cancer that is not metastatic" refers to a disease in which a subject has a primary tumor but does not have one or more secondary tumors.

[0051] "PDAC" refers to pancreatic ductal adenocarcinoma, a type of pancreatic cancer. PDAC accounts for more than 90% of cases of pancreatic cancer. Symptoms of pancreatic cancer include diabetes, hyperglycemia, jaundice, sudden weight loss, abdominal pain, back pain, persistent decrease in appetite, light-colored stools, bloating, nausea, vomiting, or diarrhea. In a plurality of embodiments, the symptom of pancreatic cancer is primary diabetes. In a plurality of embodiments, the symptom of pancreatic cancer is primary hyperglycemia. In a plurality of embodiments, the symptom of pancreatic cancer is diabetes. In a plurality of embodiments, the symptom of pancreatic cancer is hyperglycemia. In a plurality of embodiments, the diabetes is primary diabetes or pre-existing diabetes.

[0052] The stages of pancreatic cancer are known in the art. For example, "Stage 1" pancreatic cancer refers to pancreatic cancer found only in the pancreas. Stage 1 includes Stage IA and IB, where Stage IA is defined as T1, N0, M0 and Stage IB is defined as T2, N0, M0. "Stage 2" pancreatic cancer refers to pancreatic cancer that may have spread to nearby tissues and organs or lymph nodes near the pancreas. Stage 2 pancreatic cancer includes Stage IIA and IIB, where Stage IIA is defined as T3, N0, M0 and Stage IIB is defined as T1 / T2 / T3, N1, M0. "Stage 3" pancreatic cancer refers to pancreatic cancer that has spread to major blood vessels near the pancreas and may have spread to nearby lymph nodes but has not spread to distant sites (T4, any N, M0). "Stage 4" pancreatic cancer can be of any size and refers to pancreatic cancer that has spread to distant organs (e.g., liver, lung, abdomen) and may have spread to lymph nodes or organs and tissues near the pancreas (any T, any N, M1). The term "T1" means that the tumor is only in the pancreas and is 2 cm or less in size. The term "T2" means that the tumor is only in the pancreas and is larger than 2 cm and smaller than 4 cm. The term "T3" means that the tumor is larger than 4 cm and spreads beyond the pancreas but does not involve major arteries or veins near the pancreas. The term "T4" means that the tumor spreads beyond the pancreas to major arteries or veins near the pancreas. The term "N0" means that cancer was not found in regional lymph nodes. The term "N1" means that cancer has spread to 1 to 3 regional lymph nodes. The term "N2" means that cancer has spread to 4 or more regional lymph nodes. The term "M0" means that cancer has not spread to other parts of the body. The term "M1" means that cancer has spread to another part of the body, including distant lymph nodes.

[0053] The term "carbohydrate antigen 19-9" or "CA19-9" refers to serum CA19-9, the most well-documented and widely used serum biomarker in patients with PDAC (References 2, 3, 12). CA19-9 is commonly used to monitor disease progression and treatment response in pancreatic cancer, but lacks satisfactory sensitivity or specificity for screening and early detection of patients with PDAC (References 13-14). 15-25% of patients with PDAC, including those with early-stage (e.g., stage 1 and 2) disease, often exhibit CA19-9 levels below 37 U / ml, which are often considered normal (References 15-16). Furthermore, 5-10% of the general population are Lewis antigen-negative, with no or low secretion of CA19-9 (Reference 17). The phrase "normal levels of CA19-9" refers to CA19-9 levels below 37 U / ml. The phrase "elevated levels of CA19-9" refers to CA19-9 levels of 37 U / ml or higher. The phrase "rising carbohydrate antigen 19-9 levels" refers to the CA19-9 levels taken from a patient that are elevated when compared to the CA19-9 levels taken at an earlier time point. "Rising carbohydrate antigen 19-9 levels" can be either above or below 37 U / ml at any given time point.

[0054] Treatment method Disclosed herein is a method for treating pancreatic cancer in a patient in need thereof, the method comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, subjecting the patient to image-based screening, surgically removing all or a part of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient contains RNA having an elevated expression level as compared to a control, and the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA comprises at least three RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 8 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 9 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 10 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 11 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 12 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-14In multiple embodiments, the RNA comprises eight RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA is cell-free miR-30c-5p, cell-free miR. It includes nine RNAs selected from the group consisting of cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes ten RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes eleven RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes twelve RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNAs include cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 1 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 1 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 1 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer.In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method includes subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method includes surgically removing all or part of the patient's pancreas. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient, subjecting the patient to an effective amount of radiation therapy, and surgically removing all or part of the patient's pancreas. In multiple embodiments, the method includes performing image-based screening on the patient, administering an effective amount of an anti-cancer agent to the patient, and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method includes performing image-based screening on the patient and administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method includes performing image-based screening on the patient.In multiple embodiments, the biological sample obtained from the patient further comprises elevated expression levels of RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the biological sample obtained from the patient further comprises elevated expression levels of RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the biological sample obtained from the patient further comprises elevated expression levels of RNA selected from the group consisting of cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control.

[0055] Provided herein is a method of treating pancreatic cancer in a patient in need thereof, the method comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a part of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient comprises RNA having an elevated expression level as compared to a control, and the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least three RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least four RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises two RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises three RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises four RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p.In multiple embodiments, the RNAs include miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 1 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 1 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the patient has diabetes (e.g., type 1 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9.In a plurality of embodiments, the biological sample obtained from the patient has an elevated level of CA19-9. In a plurality of embodiments, the biological sample obtained from the patient is Lewis antigen negative. In a plurality of embodiments, the biological sample is a blood sample. In a plurality of embodiments, the blood sample is a serum sample. In a plurality of embodiments, the blood sample is a plasma sample. In a plurality of embodiments, the control is the average expression level of RNA in a population of healthy patients. In a plurality of embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient. In a plurality of embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient and administering an effective amount of radiation therapy to the patient. In a plurality of embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient, surgically removing all or a part of the patient's pancreas, or a combination of two or more of them. In a plurality of embodiments, the method includes administering an effective amount of radiation therapy to the patient. In a plurality of embodiments, the method includes surgically removing all or a part of the patient's pancreas. In a plurality of embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient, administering an effective amount of radiation therapy to the patient, and surgically removing all or a part of the patient's pancreas. In a plurality of embodiments, the method includes performing image-based screening on the patient, administering an effective amount of an anti-cancer agent to the patient, and administering an effective amount of radiation therapy to the patient. In a plurality of embodiments, the method includes performing image-based screening on the patient and administering an effective amount of an anti-cancer agent to the patient. In a plurality of embodiments, the method includes performing image-based screening on the patient. In a plurality of embodiments, the biological sample obtained from the patient further includes an elevated expression level of RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, and combinations of two or more of them, as compared to the control.In multiple embodiments, the biological sample obtained from the patient further comprises an elevated expression level of RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the biological sample obtained from the patient further comprises an elevated expression level of RNA selected from the group consisting of cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, and combinations of two or more thereof, as compared to a control.

[0056] Disclosed herein is a method for treating pancreatic cancer in a patient in need thereof, the method comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiotherapy, surgically removing all or a part of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient contains RNA having an elevated expression level as compared to a control, and the RNA contains exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof. In a plurality of embodiments, the RNA contains at least two RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA contains at least three RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA contains at least four RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises 2 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217- (5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA includes exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 1 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 1 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 1 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer.In multiple embodiments, pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, a biological sample obtained from a patient has normal levels of CA19-9. In multiple embodiments, a biological sample obtained from a patient has elevated levels of CA19-9. In multiple embodiments, a biological sample obtained from a patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method includes subjecting a patient to an effective amount of radiation therapy. In multiple embodiments, the method includes surgically removing all or part of the patient's pancreas. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient, subjecting the patient to an effective amount of radiation therapy, and surgically removing all or part of the patient's pancreas. In multiple embodiments, the method includes performing image-based screening on a patient, administering an effective amount of an anti-cancer agent to the patient, and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method includes performing image-based screening on a patient and administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method includes performing image-based screening on a patient.In multiple embodiments, the biological sample obtained from the patient further comprises an elevated expression level of RNA selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the biological sample obtained from the patient further comprises an elevated expression level of RNA selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the biological sample obtained from the patient further comprises an elevated expression level of RNA selected from the group consisting of exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control.

[0057] A method of treating pancreatic cancer in a patient in need of treatment for pancreatic cancer, comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiotherapy, surgically removing all or a part of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient contains RNA having an elevated expression level as compared to a control, and the RNA contains cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof. In a plurality of embodiments, the RNA with the elevated expression level indicates that the patient has pancreatic cancer. In a plurality of embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In a plurality of embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In a plurality of embodiments, the biological sample obtained from the patient has normal levels of CA19-9.In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, or a combination of two or more thereof. In multiple embodiments, the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof. In multiple embodiments, the control is the average expression level of the RNA in a population of healthy patients.

[0058] A method of treating pancreatic cancer in a patient in need of treatment for pancreatic cancer, comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a part of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient comprises RNA having an elevated expression level as compared to a control, and the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, or a combination of two or more thereof, is provided.In multiple embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least six RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least seven RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 8 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 9 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 10 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 11 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNAs are cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exo. It contains at least 12 RNAs selected from the group consisting of exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNAs are cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. It contains at least 13 RNAs selected from the group consisting of exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNAs are cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises eight RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises nine RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises 10 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145. It comprises 11 RNAs selected from the group consisting of -3p. In a plurality of embodiments, the RNAs are cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNAs are cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. It comprises 13 RNAs selected from the group consisting of the above.In multiple embodiments, the RNAs include cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA.In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient and surgically removing all or a portion of the patient's pancreas, or a combination thereof.

[0059] Provided herein is a method of treating pancreatic cancer in a patient in need of treatment for pancreatic cancer, the method comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a portion of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient comprises RNA having an elevated expression level as compared to a control, and the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least five RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p.In multiple embodiments, the RNA comprises cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 1 diabetes.In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, electronic cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient and surgically removing all or a portion of the patient's pancreas, or a combination thereof. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients.

[0060] Provided herein is a method of treating pancreatic cancer in a patient in need thereof, the method comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a portion of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient comprises RNA having an elevated expression level as compared to a control, and the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, exosomal miR-1260a, exosomal miR-14-1-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least three RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least four RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least five RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least six RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA includes exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes two RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes three RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p,. It contains exosomal miR-429 and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more of these. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients.In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient, surgically removing all or a part of the patient's pancreas, or a combination thereof.

[0061] Methods of detection and treatment Provided herein is a method of treating pancreatic cancer in a patient in need thereof, the method comprising: (i) detecting an elevated expression level of RNA in a biological sample obtained from the patient, the RNA comprising cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof, as compared to a control; and (ii) administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a portion of the patient's pancreas, or a combination of two or more thereof. The RNA having an elevated expression level as compared to the control indicates that the patient has pancreatic cancer. When the patient is diagnosed with pancreatic cancer, the treatment is initiated by administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a portion of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method comprises subjecting the patient to image-based screening, administering to the patient an effective amount of an anti-cancer agent, and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method comprises subjecting the patient to image-based screening and administering to the patient an effective amount of an anti-cancer agent. In multiple embodiments, the method comprises subjecting the patient to image-based screening. In multiple embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 3 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 8 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 9 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 10 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 11 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 12 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNAs are cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomes. It includes seven RNAs selected from the group consisting of miR-429 and exosomal miR-145-3p. In a plurality of embodiments, the RNA includes eight RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA includes nine RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA includes ten RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises 11 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises 12 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old.In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or a history of diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, electronic cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method comprises administering to the patient an effective amount of an anti-cancer agent.In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient and administering an effective amount of radiation therapy to the patient. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient, surgically removing all or a part of the patient's pancreas, or a combination of two or more of these. In multiple embodiments, the method includes administering an effective amount of radiation therapy to a patient. In multiple embodiments, the method includes surgically removing all or a part of the patient's pancreas. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient, administering an effective amount of radiation therapy to the patient, and surgically removing all or a part of the patient's pancreas. In multiple embodiments, the method includes performing image-based screening on a patient, administering an effective amount of an anti-cancer agent to the patient, and administering an effective amount of radiation therapy to the patient. In multiple embodiments, the method includes performing image-based screening on a patient and administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method includes performing image-based screening on a patient. In multiple embodiments, the biological sample obtained from the patient further includes an elevated expression level of RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control.In multiple embodiments, the biological sample obtained from the patient further comprises an increased expression level of RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the biological sample obtained from the patient further comprises an increased expression level of RNA selected from the group consisting of cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control.

[0062] Provided herein is a method of treating pancreatic cancer in a patient in need thereof, the method comprising: (i) detecting an elevated expression level of RNA in a biological sample obtained from the patient, the RNA comprising cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, or a combination of two or more thereof, as compared to a control; and (ii) administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a portion of the patient's pancreas, or a combination of two or more thereof. The RNA having an elevated expression level as compared to the control indicates that the patient has pancreatic cancer. When the patient is diagnosed with pancreatic cancer, the treatment is initiated by administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a portion of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method comprises subjecting the patient to image-based screening, administering to the patient an effective amount of an anti-cancer agent, and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method comprises subjecting the patient to image-based screening and administering to the patient an effective amount of an anti-cancer agent. In multiple embodiments, the method comprises subjecting the patient to image-based screening. In multiple embodiments, the RNA comprises at least two RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises at least three RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises at least four RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p.In multiple embodiments, the RNA comprises miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 1 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 1 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 1 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, electronic cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma.In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has a normal level of CA19-9. In multiple embodiments, the biological sample obtained from the patient has an elevated level of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method comprises subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method comprises surgically removing all or part of the patient's pancreas. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient, subjecting the patient to an effective amount of radiation therapy, and surgically removing all or part of the patient's pancreas.In multiple embodiments, the method includes subjecting a patient to image-based screening, administering an effective amount of an anti-cancer agent to the patient, and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method includes subjecting a patient to image-based screening and administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method includes subjecting a patient to image-based screening. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, and combinations of two or more thereof, as compared to a control.

[0063] Disclosed herein is a method for treating pancreatic cancer in a patient in need thereof, the method comprising: (i) detecting, in an RNA in a biological sample obtained from the patient, an elevated expression level of an RNA comprising exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof, as compared to a control; and (ii) administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. The RNA with an elevated expression level, as compared to the control, indicates that the patient has pancreatic cancer. When the patient is diagnosed with pancreatic cancer, the treatment is initiated by administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the method comprises subjecting the patient to image-based screening, administering to the patient an effective amount of an anti-cancer agent, and subjecting the patient to an effective amount of radiation therapy. In a plurality of embodiments, the method comprises subjecting the patient to image-based screening and administering to the patient an effective amount of an anti-cancer agent. In a plurality of embodiments, the method comprises subjecting the patient to image-based screening. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 3 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA includes exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes two RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes three RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes four RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes five RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 1 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 1 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 1 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma.In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient and administering an effective amount of radiation therapy to the patient. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient, surgically removing all or part of the patient's pancreas, or a combination of two or more of these. In multiple embodiments, the method includes administering an effective amount of radiation therapy to the patient. In multiple embodiments, the method includes surgically removing all or part of the patient's pancreas. In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to the patient, administering an effective amount of radiation therapy to the patient, and surgically removing all or part of the patient's pancreas.In multiple embodiments, the method includes subjecting a patient to image-based screening, administering an effective amount of an anti-cancer agent to the patient, and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method includes subjecting a patient to image-based screening and administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method includes subjecting a patient to image-based screening. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method includes exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, and combinations of two or more thereof. The method further includes detecting an elevated expression level of an RNA selected from the group consisting of exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control.

[0064] A method of treating pancreatic cancer in a patient in need of treatment for pancreatic cancer, comprising: (i) detecting an elevated expression level of RNA in a biological sample obtained from the patient, the RNA comprising cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof, as compared to a control; and (ii) administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a part of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method comprises subjecting the patient to image-based screening, administering to the patient an effective amount of an anti-cancer agent, and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method comprises subjecting the patient to image-based screening and administering to the patient an effective amount of an anti-cancer agent. In multiple embodiments, the method comprises subjecting the patient to image-based screening. In multiple embodiments, the RNA with the elevated expression level indicates that the patient has pancreatic cancer. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer.In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, or a combination of two or more thereof. In multiple embodiments, the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof. In multiple embodiments, the control is the average expression level of the RNA in a population of healthy patients.

[0065] A method for treating pancreatic cancer in a patient in need of treatment for pancreatic cancer, comprising: (i) detecting an elevated expression level of RNA in a biological sample obtained from the patient, the RNA comprising cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, or a combination of two or more thereof, as compared to a control; and (ii) administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof.In multiple embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least six RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least seven RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 8 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 9 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 10 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 11 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNAs are cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exo. It contains at least 12 RNAs selected from the group consisting of exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNAs are cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p, and contains at least 13 RNAs selected from the group consisting of them. In multiple embodiments, the RNAs contain cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises eight RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises nine RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises 10 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-42. It includes 11 RNAs selected from the group consisting of extracellular let-7e-5p, extracellular miR-26a-5p, extracellular miR-223-3p, extracellular miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, extracellular miR-30c-5p, extracellular miR-142-3p, extracellular miR-340-5p, extracellular miR-335-5p, extracellular miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes 12 RNAs selected from the group consisting of extracellular let-7e-5p, extracellular miR-26a-5p, extracellular miR-223-3p, extracellular miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, extracellular miR-30c-5p, extracellular miR-142-3p, extracellular miR-340-5p, extracellular miR-335-5p, extracellular miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes 13 RNAs selected from the group consisting of extracellular let-7e-5p, extracellular miR-26a-5p, extracellular miR-223-3p, extracellular miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, extracellular miR-30c-5p, extracellular miR-142-3p, extracellular miR-340-5p, extracellular miR-335-5p, extracellular miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA includes cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA.In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method comprises administering to the patient an effective amount of an anti-cancer agent and surgically removing all or a portion of the patient's pancreas, or a combination thereof.

[0066] A method for treating pancreatic cancer in a patient in need of treatment for pancreatic cancer, the method comprising: (i) detecting an elevated expression level of RNA in a biological sample obtained from the patient, the RNA comprising cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, or a combination of two or more thereof, as compared to a control; and (ii) administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiotherapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p.In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises 2 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises 3 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises 4 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises 5 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p.In multiple embodiments, the RNA includes cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients.In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient, surgically removing all or a portion of the patient's pancreas, or a combination thereof.

[0067] A method for treating pancreatic cancer in a patient in need of treatment for pancreatic cancer, comprising: (i) detecting an elevated expression level of RNA in a biological sample obtained from the patient, the RNA comprising exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, or a combination of two or more thereof, as compared to a control; and (ii) administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiotherapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 3 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA includes exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes two RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes three RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-. It includes 5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more of these. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients.In multiple embodiments, the method includes administering an effective amount of an anti-cancer agent to a patient, surgically removing all or a part of the patient's pancreas, or a combination thereof.

[0068] Method of diagnosis A method for diagnosing a patient having pancreatic cancer, the method comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing a patient having pancreatic cancer, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof. The RNA having an elevated expression level as compared to the control indicates that the patient has pancreatic cancer. In a plurality of embodiments, the RNA having an elevated expression level as compared to the control indicates that the patient is likely to have pancreatic cancer. When the patient is diagnosed as having pancreatic cancer, treatment is initiated by administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 3 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 8 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 9 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 10 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 11 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 12 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA is cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exo. It includes 8 RNAs selected from the group consisting of exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes 9 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes 10 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes 11 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises 12 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer.In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient and administering an effective amount of radiation therapy to the patient. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method comprises administering an effective amount of radiation therapy to the patient. In multiple embodiments, the method comprises surgically removing all or part of the patient's pancreas. In multiple embodiments, the method comprises administering an effective amount of an anti-cancer agent to the patient, administering an effective amount of radiation therapy to the patient, and surgically removing all or part of the patient's pancreas.In multiple embodiments, the method includes subjecting a patient to image-based screening, administering an effective amount of an anti-cancer agent to the patient, and subjecting the patient to an effective amount of radiation therapy. In multiple embodiments, the method includes subjecting a patient to image-based screening and administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method includes subjecting a patient to image-based screening. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control.

[0069] A method for diagnosing a patient with pancreatic cancer, the method comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing a patient with pancreatic cancer, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, or a combination of two or more thereof. The RNA with an elevated expression level as compared to the control indicates that the patient has pancreatic cancer. In a plurality of embodiments, the RNA with an elevated expression level as compared to the control indicates that the patient is likely to have pancreatic cancer. The RNA with an elevated expression level as compared to the control indicates that the patient has pancreatic cancer. In a plurality of embodiments, the RNA with an elevated expression level as compared to the control indicates that the patient is likely to have pancreatic cancer. When a patient is diagnosed with pancreatic cancer, treatment is initiated by administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least three RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least four RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p.In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA comprises miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 1 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 1 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 1 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA.In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method further comprises administering an effective amount of an anti-cancer agent to the patient. In multiple embodiments, the method further comprises administering an effective amount of an anti-cancer agent to the patient and administering an effective amount of radiation therapy to the patient. In multiple embodiments, the method further comprises administering an effective amount of an anti-cancer agent to the patient, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method further comprises administering an effective amount of radiation therapy to the patient. In multiple embodiments, the method further comprises surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method further comprises administering an effective amount of an anti-cancer agent to the patient, administering an effective amount of radiation therapy to the patient, and surgically removing all or part of the patient's pancreas. In multiple embodiments, the method comprises performing image-based screening on the patient, administering an effective amount of an anti-cancer agent to the patient, and administering an effective amount of radiation therapy to the patient.In multiple embodiments, the method includes subjecting a patient to image-based screening and administering to the patient an effective amount of an anti-cancer agent. In multiple embodiments, the method includes subjecting a patient to image-based screening. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further includes detecting an elevated expression level of an RNA selected from the group consisting of cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, and combinations of two or more thereof, as compared to a control.

[0070] A method for diagnosing a patient with pancreatic cancer, the method comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing a patient with pancreatic cancer, wherein the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof. An RNA with an elevated expression level as compared to the control indicates that the patient has pancreatic cancer. In a plurality of embodiments, an RNA with an elevated expression level as compared to the control indicates that the patient is likely to have pancreatic cancer. Once a patient is diagnosed with pancreatic cancer, treatment can be initiated by administering an effective amount of an anti-cancer agent to the patient, subjecting the patient to an effective amount of radiation therapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA comprises at least three RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA. In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA.In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer or stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 4 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, or stage 3 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer, stage 2 pancreatic cancer, stage 3 pancreatic cancer, or stage 4 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method further comprises administering to the patient an effective amount of an anti-cancer agent. In multiple embodiments, the method further comprises administering to the patient an effective amount of an anti-cancer agent and administering to the patient an effective amount of radiation therapy. In multiple embodiments, the method further comprises administering to the patient an effective amount of an anti-cancer agent, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In multiple embodiments, the method further comprises administering to the patient an effective amount of radiation therapy. In multiple embodiments, the method comprises surgically removing all or part of the patient's pancreas. In multiple embodiments, the method further comprises administering to the patient an effective amount of an anti-cancer agent, administering to the patient an effective amount of radiation therapy, and surgically removing all or part of the patient's pancreas.In multiple embodiments, the method further comprises detecting an elevated expression level of an RNA selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further comprises detecting an elevated expression level of an RNA selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, and combinations of two or more thereof, as compared to a control. In multiple embodiments, the method further comprises detecting an elevated expression level of an RNA selected from the group consisting of exosomal miR-375-3p, exosomal miR-199a-5p, and combinations of two or more thereof, as compared to a control.

[0071] A method for diagnosing a patient with pancreatic cancer, comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing a patient with pancreatic cancer, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof. In a plurality of embodiments, the elevated expression level of RNA indicates that the patient has pancreatic cancer. In a plurality of embodiments, the method further comprises administering to the patient an effective amount of an anti-cancer agent, administering to the patient an effective amount of radiation therapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the method further comprises administering to the patient an effective amount of an anti-cancer agent. In a plurality of embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In a plurality of embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In a plurality of embodiments, the biological sample obtained from the patient has normal levels of CA19-9.In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, or a combination of two or more thereof. In multiple embodiments, the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof. In multiple embodiments, the control is the average expression level of the RNA in a population of healthy patients.

[0072] A method for diagnosing a patient with pancreatic cancer, comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing a patient with pancreatic cancer, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 8 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 9 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 10 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 11 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p. It contains at least 12 RNAs selected from the group consisting of exosomal miR-429 and exosomal miR-145-3p. In a plurality of embodiments, the RNAs are cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNAs contain cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises eight RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises nine RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises 10 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises 11 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA is cell-free let-7e-5p, cell-free miR-26a-5p,... It includes 12 RNAs selected from the group consisting of cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA includes 13 RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA includes cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre-diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IA.In multiple embodiments, the pancreatic cancer is stage IB. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage IIA. In multiple embodiments, the pancreatic cancer is stage IIB. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In an embodiment, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method comprises administering to the patient an effective amount of an anti-cancer agent, surgically removing all or a part of the patient's pancreas, or a combination thereof.

[0073] A method for diagnosing a patient with pancreatic cancer, the method comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing a patient with pancreatic cancer, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In a plurality of embodiments, the RNA comprises at least five RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p.In multiple embodiments, the RNA includes cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA includes two RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA includes three RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA includes four RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA includes five RNAs selected from the group consisting of cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the RNA includes cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. In multiple embodiments, the patient has type 2 diabetes.In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient is at least 45 years old. In multiple embodiments, the patient has type 2 diabetes and is at least 50 years old. In multiple embodiments, the human patient is at least 55 years old. In multiple embodiments, the human patient is at least 60 years old. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre - existing diabetes), obesity, elevated carbohydrate antigen 19 - 9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more thereof. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e - cigarettes) or has a nicotine smoking history. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient has a history of chronic pancreatitis. In multiple embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In multiple embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19 - 9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19 - 9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of RNA in a population of healthy patients. In multiple embodiments, the method includes administering to the patient an effective amount of an anti - cancer agent and surgically removing all or a part of the patient's pancreas, or a combination thereof.

[0074] A method for diagnosing a patient with pancreatic cancer, comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing a patient with pancreatic cancer, wherein the RNA comprises exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA comprises at least three RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the patient has symptoms of pancreatic cancer. Multiple. In an embodiment, the patient has primary diabetes. In a plurality of embodiments, the patient has diabetes. In a plurality of embodiments, the patient is at least 45 years old. In a plurality of embodiments, the patient has primary diabetes and is at least 50 years old. In a plurality of embodiments, the human patient is at least 55 years old. In a plurality of embodiments, the human patient is at least 60 years old. In a plurality of embodiments, the patient has diabetes (e.g., primary diabetes or pre-existing diabetes), obesity, elevated carbohydrate antigen 19-9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or a combination of two or more thereof. In a plurality of embodiments, the patient has obesity. In a plurality of embodiments, the patient smokes nicotine (e.g., cigarettes, cigars, e-cigarettes) or has a nicotine smoking history. In a plurality of embodiments, the patient has a history of pancreatitis. In a plurality of embodiments, the patient has a history of chronic pancreatitis. In a plurality of embodiments, the pancreatic cancer is pancreatic ductal adenocarcinoma. In a plurality of embodiments, the pancreatic cancer is stage 1 pancreatic cancer or stage 2 pancreatic cancer. In a plurality of embodiments, the pancreatic cancer is stage 1 pancreatic cancer. In a plurality of embodiments, the pancreatic cancer is stage IA. In a plurality of embodiments, the pancreatic cancer is stage IB. In a plurality of embodiments, the pancreatic cancer is stage 2 pancreatic cancer. In a plurality of embodiments, the pancreatic cancer is stage IIA. In a plurality of embodiments, the pancreatic cancer is stage IIB. In a plurality of embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In a plurality of embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In a plurality of embodiments, the biological sample obtained from the patient is Lewis antigen negative. In a plurality of embodiments, the biological sample is a blood sample. In a plurality of embodiments, the blood sample is a serum sample. In a plurality of embodiments, the blood sample is a plasma sample. In a plurality of embodiments, the control is the average expression level of RNA in a population of healthy patients. In a plurality of embodiments, the method includes administering to the patient an effective amount of an anti-cancer agent and surgically removing all or a portion of the patient's pancreas, or a combination thereof.

[0075] Method of Monitoring A method for monitoring a patient at risk of developing pancreatic cancer, comprising: (i) detecting the expression level of RNA in a biological sample obtained from the patient at a first time point; and (ii) detecting the expression level of RNA in a biological sample obtained from the patient at a second time point, the second time point being after the first time point, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof is provided.A method of monitoring a patient at risk of developing pancreatic cancer, the method comprising: (i) detecting the expression level of RNA in a biological sample obtained from the patient at a first time point; and (ii) detecting the expression level of RNA in a biological sample obtained from the patient at a second time point, the second time point being after the first time point, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, or a combination of two or more thereof. A method of monitoring a patient at risk of developing pancreatic cancer, the method comprising: (i) detecting the expression level of RNA in a biological sample obtained from the patient at a first time point; and (ii) detecting the expression level of RNA in a biological sample obtained from the patient at a second time point, the second time point being after the first time point, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof.In multiple embodiments, the RNA expression level at the second time point is elevated when compared to the RNA expression level at the first time point. In multiple embodiments, when compared to the RNA expression level at the first time point, the elevated RNA expression level at the second time point indicates that the patient has an increased risk of developing pancreatic cancer or that the patient has developed pancreatic cancer. In multiple embodiments, the RNA expression level at the second time point is approximately the same as the RNA expression level at the first time point. In multiple embodiments, the RNA expression level at the second time point, which is approximately the same as the RNA expression level at the first time point, indicates that the patient does not have an increased risk of developing pancreatic cancer. In multiple embodiments, the second time point is about 6 months after the first time point. In multiple embodiments, the second time point is about 1 year after the first time point. In multiple embodiments, the second time point is about 18 months after the first time point. In multiple embodiments, the second time point is about 2 years after the first time point. In multiple embodiments, the method of monitoring the patient is repeated once every 6 months, once every year, once every 18 months, once every 2 years, once every 3 years, once every 4 years, or once every 5 years. In multiple embodiments, the patient is at risk of developing pancreatic cancer. In multiple embodiments, the patient has diabetes (e.g., type 2 diabetes or pre - existing diabetes), obesity, elevated carbohydrate antigen 19 - 9 levels, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, or has a smoking history, or a combination of two or more of these. In multiple embodiments, the patient is at risk of developing pancreatic cancer. In multiple embodiments, the patient has diabetes. In multiple embodiments, the patient has type 2 diabetes. In multiple embodiments, the patient has pre - existing diabetes. In multiple embodiments, the patient has obesity. In multiple embodiments, the patient has elevated carbohydrate antigen 19 - 9 levels. In multiple embodiments, the patient has a family history of pancreatic cancer. In multiple embodiments, the patient has a history of pancreatitis. In multiple embodiments, the patient is 40 years of age or older. In multiple embodiments, the patient smokes. In multiple embodiments, the patient has a smoking history.In multiple embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least three RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least four RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least five RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 8 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 9 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 10 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 11 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA is. It contains at least 12 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNAs include cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNAs include two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNAs include three RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises seven RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises eight RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises nine RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises ten RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises eleven RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises 12 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the biological sample obtained from the patient has normal levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient has elevated levels of CA19-9. In multiple embodiments, the biological sample obtained from the patient is Lewis antigen negative. In multiple embodiments, the biological sample is a blood sample. In multiple embodiments, the blood sample is a serum sample. In multiple embodiments, the blood sample is a plasma sample. In multiple embodiments, the control is the average expression level of the RNA in a population of healthy patients. In multiple embodiments, the method further comprises administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or a part of the patient's pancreas, or a combination of two or more thereof.

[0076] Method of detection A method for detecting RNA biomarkers in a patient having or suspected of having pancreatic cancer, the method comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof, and wherein the RNA comprises an RNA biomarker. In a plurality of embodiments, the patient has pancreatic cancer. In a plurality of embodiments, the patient is suspected of having pancreatic cancer. RNA having an elevated expression level as compared to the control indicates that the patient has pancreatic cancer. In a plurality of embodiments, RNA having an elevated expression level as compared to the control indicates that the patient is likely to have pancreatic cancer. In a plurality of embodiments, the method further comprises administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof. In a plurality of embodiments, the RNA comprises at least two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 3 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 4 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 5 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 6 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 7 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 8 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 9 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 10 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises at least 11 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises at least 12 RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises two RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In multiple embodiments, the RNA comprises three RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises four RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises five RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA comprises six RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.In a plurality of embodiments, the RNA comprises seven RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In a plurality of embodiments, the RNA is cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosome. It includes eight RNAs selected from the group consisting of miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes nine RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes ten RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p. In multiple embodiments, the RNA includes eleven RNAs selected from the group consisting of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, ...

Claims

**Claim 1** A method for detecting RNA biomarkers in a patient having or suspected of having pancreatic cancer, the method comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof. **Claim 2** A method for treating pancreatic cancer in a patient in need thereof, the method comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, subjecting the patient to image-based screening, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof, wherein a biological sample obtained from the patient comprises an RNA having an elevated expression level as compared to a control, and the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-·200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof.

3. A method for treating pancreatic cancer in a patient in need thereof, the method comprising (i) Detecting an increased expression level of RNA in a biological sample obtained from a patient, the RNA comprising cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof, as compared to a control; and (ii) A method comprising administering to the patient an effective amount of an anti-cancer agent, subjecting the patient to an effective amount of radiation therapy, subjecting the patient to image-based screening, surgically removing all or part of the patient's pancreas, or a combination of two or more thereof.

4. A method for diagnosing a patient having pancreatic cancer, the method comprising detecting an elevated expression level of RNA in a biological sample obtained from the patient as compared to a control, thereby diagnosing that the patient has pancreatic cancer, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof.

5. A method for monitoring a patient at risk of developing pancreatic cancer, the method comprising (i) detecting the expression level of RNA in a biological sample obtained from the patient at a first time point; and (ii) detecting the expression level of RNA in a biological sample obtained from the patient at a second time point, the second time point being after the first time point. The method, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof.

6. The method according to claim 5, wherein an increased expression level of the RNA at the second time point, when compared to the expression level of the RNA at the first time point, indicates that the patient has an increased risk of developing pancreatic cancer.

7. The method according to claim 1, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, or a combination of two or more thereof.

8. The method according to claim 1, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, or a combination of two or more thereof.

9. The method according to claim 1, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.

10. The method according to claim 1, wherein the RNA consists of cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, and cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, and exosomal miR-145-3p.

11. The method according to claim 1, further comprising detecting the level of carbohydrate antigen 19-9 (CA19-9) in the biological sample obtained from the patient.

12. The method according to claim 1, wherein the biological sample obtained from the patient is Lewis antigen negative.

13. The method according to claim 1, wherein the biological sample is a blood sample.

14. The method according to claim 1, wherein the patient has newly diagnosed diabetes, a history of diabetes, obesity, elevated levels of carbohydrate antigen 19-9, a family history of pancreatic cancer, a history of pancreatitis, is 40 years of age or older, smokes, has a smoking history, or any combination of two or more thereof.

15. The method according to claim 1, further comprising administering to the patient an effective amount of an anti-cancer agent.

16. The method according to claim 15, wherein the anti-cancer agent comprises everolimus, erlotinib, olaparib, mitomycin, sunitinib, gemcitabine, 5-fluorouracil, irinotecan, oxaliplatin, paclitaxel, capecitabine, cisplatin, docetaxel, or any combination of two or more thereof.

17. The method according to claim 15, wherein the anti-cancer agent is a chemotherapeutic agent.

18. The method according to claim 17, wherein the chemotherapeutic agent comprises gemcitabine, 5-fluorouracil, irinotecan, oxaliplatin, paclitaxel, capecitabine, cisplatin, docetaxel, or any combination of two or more thereof.

19. The method according to claim 17, wherein the chemotherapeutic agent is an alkylating agent, an antimetabolite compound, an anthracycline compound, an antitumor antibiotic, a platinum compound, a topoisomerase inhibitor, a vinca alkaloid, a taxane compound, an epothilone compound, or a combination of two or more thereof.

20. A kit comprising a reagent capable of detecting the expression level of RNA from a biological sample, wherein the RNA comprises cell-free miR-30c-5p, cell-free miR-142-3p, cell-free miR-340-5p, cell-free miR-335-5p, cell-free miR-23b-3p, exosomal miR-1260b, exosomal miR-145-5p, exosomal miR-200a-3p, exosomal miR-200b-3p, exosomal miR-216b-5p, exosomal miR-217-5p, exosomal miR-429, exosomal miR-145-3p, cell-free let-7e-5p, cell-free miR-26a-5p, cell-free miR-223-3p, cell-free miR-340-3p, exosomal miR-1260a, exosomal miR-141-3p, exosomal miR-143-3p, exosomal miR-148a-3p, exosomal miR-200c-3p, exosomal miR-216a-5p, exosomal miR-34a-5p, cell-free let-7f-5p, cell-free miR-369-3p, cell-free miR-125a-5p, cell-free miR-495-3p, exosomal miR-375-3p, exosomal miR-199a-5p, or a combination of two or more thereof.

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