Advances in Pancreatic Cancer Research
NCI-funded researchers are working to advance our understanding of how to prevent, detect, and treat pancreatic cancer, which includes pancreatic ductal adenocarcinoma (PDAC) and pancreatic neuroendocrine tumors (PNET). PNET is much less common than PDAC and has a better prognosis.
This page highlights some of the latest research in pancreatic adenocarcinoma, including clinical advances that may soon translate into improved care, NCI-supported programs that are fueling progress, and research findings from recent studies.
Early Detection of Pancreatic Cancer
Currently, no screening tests exist that can catch pancreatic cancer early, before symptoms develop. NCI is now funding several large research projects that are working to develop such an early-detection tool.
One known risk factor for developing pancreatic cancer is a new diagnosis of diabetes, sometimes called new-onset diabetes. About 1 in 100 people with new onset diabetes are diagnosed with pancreatic cancer within 3 years after learning they have diabetes. And 1 in 4 people who get pancreatic cancer had already been diagnosed with diabetes.
The NCI-funded New Onset Diabetes (NOD) Study, which is scheduled to run through 2025, is currently enrolling 10,000 people with new-onset diabetes or hyperglycemia (also known as prediabetes). The NOD researchers hope to develop a blood test that can identify the few individuals with a new diabetes diagnosis who may need further testing for pancreatic cancer.
Other NCI-funded teams, coordinated through the Pancreatic Cancer Detection Consortium (PCDC), are trying to create a blood test that could pick up early pancreatic cancer in the general population. PCDC researchers are also working to improve imaging of the pancreas, by developing methods that may be able to pick up tiny deposits of tumor cells.
Pancreatic Cancer Treatment
Pancreatic cancer can be hard to treat surgically due to the location of the organ, and because the disease has often spread in the body by the time it is diagnosed.
Standard treatment for pancreatic cancer usually consists of surgery, chemotherapy, radiation, or combinations of each, depending on the cancer’s stage. Beyond these standard treatments, NCI scientists continue to look for ways to treat pancreatic cancer more effectively. Researchers are looking at the potential of new drugs, ways to combine standard drugs, and new modalities (such as immunotherapy) to give to patients.
Patients with pancreatic cancer are generally recommended to have both biomarker testing and testing for inherited genetic changes. Both types of testing can help suggest possible treatments and can indicate with a patient’s family members might have an increased risk for pancreatic cancer or other types of cancer.
Testing treatments for early-stage pancreatic cancer
Therapies for early-stage disease that are being tested in clinical trials right now include
- new adjuvant chemotherapy drug combinations
Some of these postsurgical drug combinations are already known to extend the lives of patients with metastatic disease, but it's not clear if they are better at killing cancer cells left behind after surgery than standard treatments.
- neoadjuvant chemotherapy
This form of chemotherapy is given before surgery, with the goal of improving outcomes by shrinking the tumor before it’s removed. Pre-surgical chemotherapy also may help by killing cancer cells that have escaped from the tumor that would continue to grow as the patient recovers from surgery.
- cancer treatment vaccines
Cancer treatment vaccines help the body’s immune system recognize and destroy cancer cells. Cancer cells contain substances, called tumor-associated antigens, that are not present in normal cells or, if present, are at lower levels. Treatment vaccines can help the immune system learn to recognize and react to these antigens and destroy cancer cells that contain them.
Testing treatments for advanced pancreatic cancer
New treatments for metastatic pancreatic cancer that are being investigated in clinical trials include immunotherapy and targeted therapy. Immunotherapy uses substances to stimulate or suppress the immune system to help the body fight cancer. Targeted therapy uses drugs or other substances to target specific molecules that cancer cells need to survive and spread.
- Targeted therapies
- Ras-directed therapies. The RAS genes makes proteins that take part in signaling pathways that control cell growth. Altered forms of these genes are found in more than 90% of pancreatic cancers. Drugs that target mutant forms of RAS are now being tested. One example is a drug that targets a form of RAS that has a mutation called G12C and another drug that targets a more common mutation, G12D.
- olaparib. Olaparib (Lynparza) is used as maintenance therapy in adults with metastatic cancer that has not progressed after platinum chemotherapy and has certain mutations in the BRCA1 or BRCA2 gene.
- pembrolizumab. In rare cases, people with pancreatic cancer have mutations in their tumor that cause high microsatellite instability (MSI). Pembrolizumab (Keytruda) is an immune checkpoint inhibitor approved for patients with pancreatic cancer that has high MSI.
- novel immune checkpoint inhibitors and combinations. Using one drug for immunotherapy treatment has not been effective for most people with pancreatic cancer. Therefore, researchers are combining several immunotherapies that can act on different parts of the immune system.
- combinations of immunotherapy drugs with other treatments. These include radiation therapy, stromal modifying agents, and other targeted drugs.
- cell therapies. Researchers are exploring the use of cell-based therapies for pancreatic cancer. These therapies use immune cells such as T cells and natural killer cells that are altered in the lab to kill cancer cells.
- Stroma-modifying drugs
- the stroma is the fibrous tissue around a tumor that does not contain cancer cells. It is mostly made up of connective tissue, blood vessels, lymphatic vessels, and nerves. Some of these components can help to support cancer cells and/ or prevent the immune system from recognizing cancer cells.
- pancreatic cancers have much denser stroma than most tumors. Agents that help break down or remodel this stroma may help more chemotherapy drugs reach cancer cells. Or they may help reduce cancer cell resistance to killing by other agents.
For a list of specific drugs, see Drugs Approved for Pancreatic Cancer.
- Targeted therapies
Because of the complex nature of pancreatic cancer, many experts believe it’s important for all patients to join a clinical trial, even if they have early-stage disease. NCI funds and oversees both early- and late-phase clinical trials to develop new treatments and improve patient care. Trials are available for pancreatic cancer treatment.
NCI-Supported Research Programs
Many NCI-funded researchers at the NIH campus, and across the United States and world, are seeking ways to address pancreatic cancer more effectively. Some research is basic, exploring questions as diverse as the biological underpinnings of cancer and the social factors that affect cancer risk. And some is more clinical, seeking to translate this basic information into improved patient outcomes. The programs listed below are a small sampling of NCI’s research efforts in pancreatic cancer.
- The Pancreatic Cancer Cohort Consortium consists of more than a dozen prospective epidemiologic cohort studies that investigate the causes and natural history of pancreatic cancer. This includes the launching of a genome-wide association study (GWAS) known as PanScan.
- The Pancreatic Cancer Detection Consortium (PCDC) develops and tests biomarkers to detect early stage pancreatic cancer and identify individuals at high risk for the disease.
- The Pancreatic Ductal Adenocarcinoma (PDAC) Stromal Reprogramming Consortium (PSRC) is a multidisciplinary community of PDAC researchers that will bridge biological research with preclinical/translational research. The goal is to identify and evaluate elements in the tumor microenvironment that drive PDAC progression and response to therapy.
- The Pancreatic Specialized Programs of Research Excellence (Pancreatic SPOREs) are designed to quickly move basic scientific findings into clinical settings. The Pancreatic SPORE grants support new and diverse approaches to the prevention, early detection, diagnosis, and treatment of pancreatic cancer. Two of NCI's Gastrointestinal (GI) SPOREs also conduct research in pancreatic cancer.
- The RAS Initiative looks to understand mutations in RAS genes to ultimately create effective, new therapies for RAS-related cancers. More than 90% of pancreatic cancers are caused by mutations in the RAS family of genes.
Pancreatic Cancer Research Results
The following are some of our latest news articles on pancreatic cancer research:
- No Glucose? Pancreatic Cancer May Have a Ready Energy Alternative
- In Mouse Study, KRAS-Targeted Drug Shows Potential against Pancreatic Cancer
- Abnormal Collagen May Be Weak Spot for Pancreatic Cancer
- Belzutifan Approved to Treat Tumors Linked to Inherited Disorder VHL
- Could A Diabetes Diagnosis Help Detect Pancreatic Cancer Early?
- Boosting Dendritic Cells Helps the Immune System Find Pancreatic Cancer
View the full list of Pancreatic Cancer Research Results and Study Updates.