Research into pancreatic cancer
Researchers around the world are looking into pancreatic cancer and want to find out:
- why it starts and what helps it grow
- if there are tests that can pick it up at an earlier stage, before symptoms start
- if there are newer treatments to help improve outlook and quality of life
- ways to help improve and manage treatment side effects
Go to Cancer Research UK’s clinical trials database if you are looking for a trial for pancreatic cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.
Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follow the patients for a period of time and collect and analyse the results. We have included this ongoing research to give examples of the type of research being carried out in pancreatic cancer.
Cancer Research UK and pancreatic cancer
Although survival for many types of cancer has improved over the last few decades, there hasn’t been the same improvements for pancreatic cancer. This is partly because it is often diagnosed at a late stage. Research into pancreatic cancer is one of Cancer Research UK’s top priorities.
What are clinical trials?
Clinical trials are medical research studies involving people. All cancer treatments must be fully researched before they can be used for everyone. This is so we can be sure that:
- they work
- they work better than the treatments already available
- they are safe
The short video below explains what it is like to take part in a trial.
Ash: I was offered a place on a trial by my cancer nurse
Jean: There was a new trial with new drugs and they were confident it would work and they offered it to me and I’m so glad I took it.
Nilesh: What we did, my wife and I, was to do some research on the internet. We came across the source trial which is what I went on and we took that to the doctor and then requested that we be put on to that.
Amy: The only thing that did sort of trouble us as a family when they did tell us was that it was possibly quite painful and there may be some side effects that they didn’t know about.
Ash: I was quite concerned about taking part in a trial because you hear the word trial and you think its test.
Nilesh: You know you hear about trials, clinical trials, drug trials things like that. My reservations were what the side effects were going to be.
Ash: I decided it was the right thing for me because it would potentially offer patients in the future less side effect risk.
Jean: There were lots of questions I had to ask and they were all answered and I was confident in going through the trial and the after care.
Nilesh: Right from day one they’ve been monitoring me. You know I have regular checkups and all that.
Amy: Any symptoms that arose with Poppy, somebody was always there to make sure that she wasn’t in any pain or any suffering.
Ash: I didn’t feel that they were hiding anything from me which when you’re talking about a clinical trial is so important.
Jean: It’s a really warm feeling knowing that what you did has helped other people.
Nilesh: I just hope that I played a part in a new drug that’s out there.
Ash: For other patients and also for society in general.
Nilesh: You’ve got to feel comfortable about the trial itself before you sign up for it. So do your background knowledge and just be 100% that that’s where you want to go.
Ash: Think about it very carefully. Read all of the background literature and ask lots and lots of questions because there’s no harm in doing that.
Research into the causes of pancreatic cancer
Cancer of the pancreas is often diagnosed when it is advanced and difficult to treat. Researchers want to learn more about why pancreatic cancer starts and what helps it to grow.
Some researchers are collecting samples of blood and pancreatic tissue from people who have pancreatic cancer. As well as from people who have a problem with their pancreas. Doctors hope that a better understanding of how pancreatic cancer develops might lead to better treatments in the future.
Tests to diagnose pancreatic cancer
Doctors are always looking for better ways to diagnose pancreatic cancer. Some researchers are collecting blood, urine and tissue samples from people with symptoms of a possible pancreatic or bile duct cancer. They are looking to see if there are particular proteins (
) in people with cancer.
Circulating tumour DNA (ctDNA)
A number of researchers are looking at blood samples from people with pancreatic cancer or those having tests for pancreatic cancer to check for . Cancers can release small bits of into the bloodstream which may be picked up on a blood test. Researchers hope that testing for circulating tumour DNA may help to diagnose cancers such as pancreatic cancer at an early stage.
Breath test
Other researchers are looking at breath samples to see if substances in the exhaled breath can show if someone has cancer.
Diabetes over 50
Some researchers are looking at the blood samples of people over 50 years old who have recently been diagnosed with type 2 . For a small number of people diabetes may be linked with pancreatic cancer. Researchers want to find out if there is a way of telling the difference between type 2 diabetes and diabetes linked to pancreatic cancer. They hope it may help to identify early signs of pancreatic cancer.
Risk assessment tool for symptoms
General practitioners (GPs) can find it difficult to know who they need to send for tests with the possible symptoms of cancer. Some GPs have been using an electronic risk assessment tool (eRATS) when figuring out who needs to have further tests based on their symptoms.
Researchers hope that using this tool will help diagnose cancer at an earlier stage and help reduce NHS costs of tests for people that don’t need them.
Screening
Screening means testing people for early stages of a disease before they have any symptoms. Diagnosing a cancer earlier may mean that treatment is more successful and may save lives. There is no national screening programme for pancreatic cancer, but people at high risk of developing it, may be able to have regular tests.
Doctors for the EUROPAC study are looking to see if tests can pick up early signs of pancreatic cancer in people who are at high risk of developing it.
Research into treatment
Researchers are always looking into ways to improve treatment, reduce side effects, and control symptoms.
Matching treatment to an individual cancer - PRECISION-Panc
This is a large programme of research aiming to understand more about the individual make up of pancreatic cancers. The researchers want to collect samples of pancreatic cancer tissue to examine its make up.
Genes contain coded messages that tell cells how to behave. They control the growth and development of cells.
Researchers hope that understanding more about the genetic make up of pancreatic cancers will help doctors decide the best treatment. The researchers also want to learn more about when, how and why people develop pancreatic cancer. And to predict who is more at risk of developing it.
The researchers are doing their research in 2 stages. The PRECISION Panc study is stage 1. Based on the information from the tissue samples, they will ask people to join a study to have treatment in stage 2.
In stage 2, the researchers will look at new treatments for pancreatic cancer. These research studies are called Pancreatic canceR Individualised Multi-arm Umbrella Studies (PRIMUS):
PRIMUS 001
This trial is for people with pancreatic cancer that has spread (metastatic pancreatic cancer). The researchers are looking at a combination of chemotherapy drugs called FOLFOX-A. This contains:
- fluorouracil (5FU)
- oxaliplatin
- nab-paclitaxel
- folinic acid
The main aim is to find out if FOLFOX-A is better at keeping the cancer under control compared to standard treatment of nab-paclitaxel and gemcitabine.
PRIMUS 005
This trial is for people with locally advanced pancreatic cancer. It’s looking at a drug called ATRA, which is similar to vitamin A.
Thick tissue (called stroma) surrounds pancreatic cancer which may stop chemotherapy drugs from getting through. Vitamin A can weaken this tissue. The researchers hope that having ATRA with chemotherapy will help the drugs get to the cancer cells.
Chemotherapy
Before surgery (neo adjuvant)
Chemotherapy before surgery is called neo adjuvant treatment. The idea is that the treatment might shrink the cancer enough to make it possible for the surgeon to remove it. Several studies have shown that neo adjuvant treatment may be helpful for pancreatic cancer. But more research is needed to get a fuller picture of how well neo adjuvant treatment works, who benefits most and what the best treatment is.
Metastatic pancreatic cancer
Metastatic pancreatic cancer means cancer that has spread away from the pancreas to another part of the body. One of the standard chemotherapy regimes for advanced pancreatic cancer is gemcitabine and nab-paclitaxel. The PRIMUS 001 trial (part of PRECISION PANC study) is comparing this with a newer combination of drugs called FOLFOX-A.
Other research
Other researchers are looking at comparing Acelarin with gemcitabine. Acelarin is a type of chemotherapy similar to gemcitabine. Researchers want to find which is better at controlling cancer growth.
Radiotherapy
Stereotactic body radiotherapy (SBRT) directs radiotherapy beams at the cancer from different positions around the body. It accurately delivers a high dose of treatment to the cancer, while surrounding tissue only receives a low dose.
Early trials are looking at SBRT to shrink pancreatic cancer before surgery. Researchers are also looking into a new drug called GC4711 to see if it helps radiotherapy work better.
Other researchers are looking at to see if it safe to give radiotherapy in a fewer number of treatments.
Combined radiotherapy and chemotherapy (chemoradiotherapy)
The chemotherapy drugs used with radiotherapy, for example capecitabine are . You have them to make the cancer more sensitive to the radiotherapy.
Doctors want to know if chemotherapy on its own or chemotherapy and radiotherapy together is better before surgery to remove pancreatic cancer.
Researchers have also been looking at giving other drugs with chemoradiotherapy to make the treatment better. Researchers are looking at:
- nelfinavir – a type of anti retroviral used to treat human immunodeficiency virus (HIV)
- olaparib – a targeted cancer drug called a PARP inhibitor
Targeted cancer drugs and immunotherapy
Targeted cancer drugs are newer drugs and work in a different way to chemotherapy.
Targeted cancer drugs change the way that cells work. They can boost the body’s immune system to fight off or kill cancer cells. Or they can block signals that tell cells to grow.
Saruparib also known as AZD5305 is a type of treatment called a PARP inhibitor. PARP is a protein found in our cells. It stands for poly-ADP ribose polymerase. It helps damaged cells to repair themselves. This is early research and they want to see how well it works on its own and with other chemotherapy drugs. Not all parts of this study are open yet.
Another type of PARP inhibitor being looked at is olaparib (Lynparza). In people with metastatic pancreatic cancer and an inherited BRCA , it was shown that olaparib given after chemotherapy could delay the cancer from regrowing. It did not however lead to people living longer. Olaparib is not routinely available for people with pancreatic cancer, but there are clinical trials which are looking at its role.
A small number of pancreatic cancers might respond to a type of treatment called . They block proteins that stop the immune system from attacking cancer cells. Some of these drugs include nivolumab and pembrolizumab.
The following is a list of some of the other types of targeted and immunotherapy drugs being looked at. These include:
- nisevoktug
- trastuzumab deruxtecan
- zenocutuzumab
- defectinib
Irreversible electroporation (IRE)
This treatment uses needles to pass an electrical current to the cancer cells. This destroys the cancer cells. Your doctor might call this Nanoknife.
This treatment is not a standard treatment in the UK. You might have it as part of a clinical trial.
We need much more research about how this treatment might work in pancreatic cancer.
