Current Research

Research for pancreatic cancer is ongoing. The following advances may still be under investigation in clinical trials and may not be approved or available at this current time. Always discuss all diagnostic and treatment options with your doctor.

Early detection. Because the best chance of successful treatment occurs when pancreatic cancer is detected early, several efforts are ongoing to find and use specialized blood tests, diagnostic imaging tools, and other approaches to detect pancreatic cancer at its earliest stages, even at precancerous stages (known as pancreatic intraepithelial neoplasia, or PanIN lesions), before it has had the opportunity to spread. These screening efforts are typically being used for individuals at particularly high risk for pancreatic cancer, such as those with a strong family history or a known genetic predisposition to pancreatic cancer. It remains uncertain whether these tools will be useful for the general population.

Genetic studies. In cancer, damaged or abnormal genes cause uncontrolled cell growth. Many of the new developments are based on fixing or correcting damaged genes and proteins. Genetic studies are being done to find defective genes that are involved in pancreatic cancer. Once genes are identified, doctors can begin to screen people who may be at risk for pancreatic cancer.

Immunotherapy. Immunotherapy (also called biologic therapy) is designed to boost the body’s natural defenses to fight cancer. It uses materials either made by the body or in a laboratory to bolster, target, or restore immune system function. One example of immunotherapy is cancer vaccines, which stimulate a person’s immune system to recognize and attack cancer cells. A number of clinical trials have been done or are in progress studying vaccines in a variety of types of cancer, including pancreatic cancer. To date, however, there have been no vaccines with sufficient outcomes for them to become a standard treatment.

Targeted therapy.Targeted therapy is a treatment that targets faulty genes or proteins that contribute to cancer growth and development. Erlotinib is the only targeted therapy currently approved for pancreatic cancer, in combination with gemcitabine. Erlotinib is a small molecule inhibitor that disrupts signaling through a pathway called epidermal growth factor receptor (EGFR). This EGFR can be overactivated and lead to tumor cell growth. Other agents targeting different pathways important to tumor cell survival, division, and metastasis are under investigation in pancreatic cancer, both as single agents and as part of combination therapy. However, to date none (including bevacizumab [Avastin] and cetuximab [Erbitux]) have demonstrated survival benefit when evaluated in large phase III clinical trials.

Gene therapy. Gene therapy involves delivery of specific genes to cancer cells, which are often carried by specially designed viruses. These include normal genes that are delivered into the core of cancer cells; as the cancer cells divide, functional genes replace defective ones. Another strategy under investigation involves delivery of the gene TNF-alpha (an immune system protein) by direct injection into the tumor. This gene gets activated or “turned on” when radiation therapy is given, possibly enhancing anti-tumor activity.

Other chemotherapy agents. Several other chemotherapy agents have shown promise in advanced pancreatic cancer and have been studied in combination with gemcitabine. These include new formulations of paclitaxel (Taxol) that may improve drug delivery, such as nanoparticle albumin-bound paclitaxel (Abraxane), EndoTAG-1, and TS-1. These agents are currently undergoing testing in phase III clinical trials. TS-1 is an oral drug similar to capecitabine in how it works; it is approved for use in parts of Asia, but is not readily available in the United States.

Multidrug therapy. Multidrug or combination therapy combines existing drugs to fight pancreatic cancer; new combinations are under review. Researchers think that killing cancer cells with different kinds of drugs may be more effective than using a single drug.

The website www.cancermap.org is the National Cancer Institute’s Cancer Research Map, a listing of all public and privately funded research in pancreatic cancer.

Cancer stem cells.Pancreatic cancer stem cells represent a subset of cells within the tumor that may be particularly resistant to standard therapies. Research is currently focusing on identifying therapeutic agents that may specifically target those cancer stem cells.