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Research into the causes, diagnosis, and treatment of pancreatic cancer is underway in many medical centers throughout the world.

Early detection

Screening tests for pancreatic cancer are recommended for patients with high-risk features. These features are generally the presence of genetic predispositions (i.e., BRCA) or with premalignant lesions (i.e., IPMN).  However, the majority of pancreatic adenocarcinomas are diagnosed when it’s already developed into late-stage cancer. The medical community continues to search for screening tests. Studies include:

• Understanding if certain gene mutations in pancreatic precancerous conditions (benign and precancerous growths in the pancreas) increases risk for cancer
• Understanding if certain proteins found in the blood can be used to find pancreatic cancer early when it is likely to be easier to treat
• Understanding if a blood test can be developed to test people with new-onset diabetes for possible pancreatic cancer   

Treatment

A lot of research is focused on finding better treatments for pancreatic cancer. Improving surgery and radiation therapy are major goals, as is determining the best combination of treatments for people with certain stages of cancer.

Radiation therapy

Some studies are looking at different ways to give radiation to treat pancreatic cancer. These include intraoperative radiation therapy (in which a single large dose of radiation is given to the area of the cancer in the operating room at the time of surgery) and proton beam radiation (which uses a special type of radiation that might do less damage to nearby normal cells).

Chemotherapy

Many clinical trials are testing new combinations of chemotherapy drugs for pancreatic cancer. Other newer chemo drugs are also being tested, as are combinations of chemo drugs with newer types of drugs.

Targeted therapies

Targeted drugs work differently from standard chemotherapy drugs in that they attack only specific targets on cancer cells (or nearby cells). Targeted therapies may prove to be useful along with, or instead of, current treatments. In general, they seem to have different side effects than traditional chemo drugs. Looking for new targets to attack is an active area of cancer research.

Immunotherapy

Immune therapies attempt to boost a person’s immune system or give them ready-made components of an immune system to attack cancer cells. Some studies of these treatments have shown promising results.

Monoclonal antibodies: One form of immune therapy uses injections of man-made monoclonal antibodies. These immune system proteins are made to hone in on a specific molecule, such as carcinoembryonic antigen (CEA), which is sometimes found on the surface of pancreatic cancer cells. Toxins or radioactive atoms can be attached to these antibodies, which bring them directly to the tumor cells. The hope is that they will destroy cancer cells while leaving normal cells alone. For use in pancreatic cancer, these types of treatments are available only in clinical trials at this time.

Cancer vaccines: Several types of vaccines for boosting the body’s immune response to pancreatic cancer cells are being tested in clinical trials. Unlike vaccines against infections like measles or mumps, these vaccines are designed to help treat, not prevent, pancreatic cancer. One possible advantage of these types of treatments is that they tend to have very limited side effects. At this time, vaccines are available only in clinical trials.

Drugs that target immune system checkpoints: The immune system normally keeps itself from attacking other normal cells in the body by using “checkpoints” – proteins on immune cells that need to be activated (or inactivated) to start an immune response. Cancer cells sometimes find ways to use these checkpoints to avoid being attacked by the immune system. Drugs that target these checkpoints have shown promise in treating some types of cancer. Some of these are now being studied for use in pancreatic cancer.

Individualization of therapy

Some drugs seem to work better if certain types of mutations can be found in the patient’s tumor. For example, olaparib may work better in patients whose tumors have a particular inherited change in the BRCA gene. This concept is an area of intense study. Identifying markers that can predict how well a drug will work before it is given is an important area of research in many types of cancer.