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About 80% of pancreatic cancers are found when the disease is in its advanced stages. That means it either cannot be removed surgically or has already spread beyond the borders of the pancreas. 

Even in patients with removable tumors, pancreatic cancer can metastasize very early. That means tiny little ¡°satellite¡± cancer cells can float away from the pancreas and make a home in nearby organs, such as the liver or the lungs.  

About 90% of pancreatic cancers are caused by a genetic mutation called KRAS, which has historically been considered ¡°undruggable.¡± That means it¡¯s a target we couldn¡¯t latch any drugs onto. 

Collectively, these three factors have made pancreatic cancer very difficult to treat. Fortunately, that is all changing through research. Read on to learn how. 

Finding ways to make immunotherapy effective

A lot of pancreatic cancer patients come to me and say, ¡°Hey, why can¡¯t you just give me immunotherapy?¡±

But many immunotherapy drugs have not proven effective against pancreatic cancer. Partly, that¡¯s because immunotherapy doesn¡¯t actually reach the tumor cells. Why? Because it turns out that pancreatic cancer doesn¡¯t exist in isolation. It¡¯s not just a ball of cancer cells. Instead, it¡¯s surrounded by other types of cells that form a kind of barrier around it, creating a protective microenvironment. 

That means even if the immunotherapies could reach these tumors, they wouldn¡¯t be able to function in the same way they would with, say, a melanoma or a lung cancer. A huge part of what we¡¯ve been trying to do here at MD Anderson is block some of those chemical signals that prevent the immunotherapy from working properly. 

Overcoming drug resistance with combination therapies

Today, we have some remarkable drugs that can actually target the KRAS mutation and block it. 

Unfortunately, we also know from early clinical data that while pancreatic cancer will often respond to these drugs, it will eventually progress. That¡¯s because it becomes resistant to these drugs¡¯ effects.  

So, another large effort among researchers here at MD Anderson is to figure out how to overcome this resistance by developing more effective combination therapies. Once we know what these combinations are, we can go back to the lab and design new clinical trials to test them.  

Developing the next generation of cancer vaccines

We also have a new generation of pancreatic cancer vaccines in development. They¡¯re designed to rev up the immune system so that it can recognize those free-floating cancer cells before they form that protective barrier around themselves.  

None of the vaccines has been approved by the Food and Drug Administration (FDA) yet, but clinical trials are showing us that patients who receive them tend to live longer after diagnosis. So, I¡¯m really hopeful for the future.   

, is a medical oncologist who specializes in the treatment of gastrointestinal cancers, including pancreatic cancer.

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