Pancreatic cancer is often diagnosed late, when the tumor has already spread beyond the pancreas. Surgery offers the only chance for long-term survival, but most people aren't candidates because the cancer is too advanced at diagnosis. Current treatment typically combines chemotherapy regimens like FOLFIRINOX or gemcitabine-based combinations, with survival measured in months for advanced disease.
What's actually going on in research
Trials are testing immunotherapy combinations to overcome pancreatic cancer's ability to hide from the immune system, targeted therapies for tumors with specific mutations like BRCA or KRAS G12C, earlier detection methods including blood tests and imaging, and new surgical approaches. Researchers are also studying the dense tissue surrounding pancreatic tumors, which blocks drugs from reaching cancer cells.
KRAS-targeted drugs
About 90% of pancreatic cancers have KRAS mutations. New drugs targeting the KRAS G12C mutation and related pathways are showing activity in trials, and broader KRAS inhibitors are being developed.
Immunotherapy combinations
Pancreatic cancer surrounds itself with tissue that blocks immune cells. Trials are testing drugs that break down this barrier combined with checkpoint inhibitors to help the immune system attack the tumor.
Early detection
Blood tests measuring circulating tumor DNA and other biomarkers aim to catch pancreatic cancer before symptoms appear. Finding the disease earlier could dramatically improve survival by making surgery possible.
What to know before you search
Eligibility typically depends on disease stage, whether the tumor can be surgically removed, prior treatments received, and specific mutations found in tumor testing.
What types of trials are currently open
- Chemotherapy trials — Testing new combinations of chemotherapy drugs or adding targeted drugs to standard regimens like FOLFIRINOX or gemcitabine.
- Targeted therapy trials — Testing drugs aimed at specific mutations in the tumor, such as KRAS, BRCA, or other DNA repair genes.
- Immunotherapy trials — Testing checkpoint inhibitors, cancer vaccines, and drugs that modify the tumor environment to help the immune system recognize and attack cancer cells.
- Surgical trials — Studying new surgical techniques, timing of surgery relative to chemotherapy, and expanded criteria for who can benefit from surgery.
- Detection studies — Testing blood tests, imaging methods, and screening strategies to find pancreatic cancer earlier, especially in high-risk individuals.
Recently added Pancreatic Cancer trials
Indocyanine Green-Guided Versus Standard Laparoscopic Distal Pancreatectomy for Pancreatic Body and Tail Lesions
Postoperative pancreatic fistula is the most important complication after laparoscopic distal pancreatectomy for tumors of the body and tail of the pancreas. It can cause infection, bleeding, longer hospital stay, and even death. New imaging technology using indocyanine green (ICG) dye and near-infrared fluorescence may help surgeons see blood flow to the pancreatic stump, spleen, and nearby vessels during surgery and make safer decisions about where to cut and which structures to preserve. This study will compare two standard laparoscopic operations for pancreatic body and tail lesions: one with ICG fluorescence imaging at key steps of the procedure and one without ICG imaging. Adult patients who need elective laparoscopic distal pancreatectomy will be randomly assigned to one of the two groups. All other aspects of care before, during, and after surgery will be the same. The main goal is to find out whether using ICG fluorescence can reduce the rate of clinically relevant postoperative pancreatic fistula (Grade B or C) within 90 days after surgery. Secondary goals include comparing blood loss, operating time, need to convert to open surgery, spleen preservation, complications, hospital stay, and oncologic outcomes such as margin status and lymph node yield.
Assessment of the Usefulness of SMI (Superb Vascular Imaging) for the Characterisation of Pancreatic Cystic Tumours (IMAKYST)
A cystic lesion is an abnormal cavity formed within tissue or an organ, which may contain a liquid, semi-solid or gaseous substance. There are different types of pancreatic cystic lesions: lesions that may become cancerous and completely benign lesions that do not require monitoring, such as serous cystadenomas (SCs) and pseudocysts. Diagnostic difficulties mean that one in three patients with a SC undergoes unnecessary surgery with significant morbidity and mortality (risk of death). Currently, needle-based confocal laser endomicroscopy (nCLE) is the gold standard technique for the diagnosis of SC. SC is a lesion characterised by an extensive network of small blood vessels present in all the cyst walls and throughout the cyst's peripheral capsule. SMI (Superb Vascular Imaging) is a new ultrasound mode that improves the visibility of blood flow in the vessels without the injection of contrast medium (a diagnostic agent used for certain medical imaging examinations, most often administered intravenously), unlike nCLE. The Mermoz Endoscopy Centre will be equipped with an ultrasound console enabling SMI to be performed during an echoendoscopy examination. This technology is now available on the new EUS Aplio i800 console (Canon-Olympus), which is CE marked. To date, no data has been published on the potential of SMI to characterise and diagnose CS. This is why this clinical investigation is being conducted.
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