Pancreatic cancer (PaC) is one of the most lethal cancers, with an increasing global incidence
rate. Unfavorable prognosis largely results from associated difficulties in early diagnosis and
the absence of prognostic and predictive biomarkers that would enable an individualized therapeutic
approach. In fact, PaC prognosis has not improved for years, even though much efforts and resources
have been devoted to PaC research, and the multimodal management of PaC patients has been used in
clinical practice. It is thus imperative to develop optimal biomarkers, which would increase diagnostic
precision and improve the post-diagnostic management of PaC patients. Current trends in biomarker
research envisage the unique opportunity of cell-free microRNAs (miRNAs) present in circulation to
become a convenient, non-invasive tool for accurate diagnosis, prognosis and prediction of response
to treatment. This review analyzes studies focused on cell-free miRNAs in PaC. The studies provide
solid evidence that miRNAs are detectable in serum, blood plasma, saliva, urine, and stool, and that
they present easy-to-acquire biomarkers with strong diagnostic, prognostic and predictive potential.