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Pancreatic cancer research

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.   

Research and clinical trials

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 video below shows what it is like to take part in a trial.

If you are looking to take part in a trial for pancreatic cancer in the UK, go to Cancer Research UK’s clinical trials database. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

Research into the causes of 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 have been collecting samples of pancreatic tissue from people who have pancreatic cancer and from people who don’t. 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 (biomarkers) in people with cancer.

Some other researchers have collected blood samples from people with pancreatic cancer and other types of cancer, to look for circulating tumour cells. These are cancer cells, or parts of cancer cells, that are in the bloodstream. They hope to be able to develop a test that can pick up pancreatic cancer at an early stage.

Other researchers are looking at breath samples to see if substances in the exhaled breath can show if someone has cancer.

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 genetic make up. 

Genes contain coded messages that tell cells how to behave. They control the growth and development of cells. 

The 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.

  • PRIMUS 001 for people with pancreatic cancer that has spread
  • PRIMUS 002 for people with pancreatic cancer that can be removed with surgery

PRIMUS 003 looked at second treatments for pancreatic cancer that had spread elsewhere in the body. This part of the study has now closed.

Chemotherapy

Before surgery (neo adjuvant)

Chemotherapy before surgery is called neo adjuvant treatment. The idea is that the treatment might shrink the cancer and make it easier to remove with surgery. 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. 

After surgery (adjuvant)

Having chemotherapy after surgery to remove pancreatic cancer helps to reduce the risk of the cancer coming back. It is due to the results of trials that FOLFIRINOX and GemCap are now standard treatments after surgery for people well enough to have them.

But doctors continue to look for other combinations of treatment to help further improve survival, including nab-paclitaxel with gemcitabine.

Advanced pancreatic cancer  

Advanced 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. It includes folinic acid and the chemotherapy drugs:

  • fluorouracil (5FU)
  • oxaliplatin
  • nab paclitaxel 

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. 

Doctors have looked at using SBRT to shrink pancreatic cancer before surgery.

Combined radiotherapy and chemotherapy (chemoradiotherapy)

The chemotherapy drugs used with radiotherapy, for example capecitabine or 5FU, are radiosensitisers. 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 also want to see if giving another drug (called nelfinavir) with chemoradiotherapy makes the treatment better.

Targeted cancer drugs

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.

Researchers have been looking into different types of targeted drugs for pancreatic cancer, often in combination with other treatments such as chemotherapy or chemoradiotherapy.  These drugs include:

  • olaparib
  • vantedanib
  • defactinib
  • pamrevlumab
  • dasatinib

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. 

Last reviewed: 
20 Dec 2020
Next review due: 
20 Dec 2023
  • Cancer Research UK clinical trials database
    Accessed December 2020

  • ClinicalTrials.gov
    Accessed December 2020

  • An update on treatment options for pancreatic adenocarcinoma
    A Lambert and others
    Therapeutic Advances in Medical Oncology, 2019. Sep 25;11:1758835919875568.

  • Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. E-Update 19th March 2019
    Accessed December 2020

  • The role of irreversible electroporation (IRE) for locally advanced pancreatic cancer: a systematic review of safety and efficacy
    D Ansari and others
    Scandinavian Journal of Gastroenterology, 2017. Volume 52, Issue 11

  • Multi-disciplinary management of locally advanced pancreatic cancer with irreversible electroporation
    R Martin
    Journal of Surgical Oncology, 2017. Volume 116, Issue 1, Pages 35-45

  • The radiosensitizing effects of Nelfinavir on pancreatic cancer with and without pancreaticstellate cells
    O Al- Assar and others
    Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology, 2016. Volume 119, Issue 2, Pages 300-305