Pancreatic cancer, which begins when abnormal cells in the pancreas grow out of control and form a tumor, is notoriously difficult to detect and treat. At Rutgers Cancer Institute of New Jersey, experts are advancing our understanding of this disease through research. Patrick Boland, MD, is a medical oncologist in the Gastrointestinal Oncology Program at Rutgers Cancer Institute of New Jersey and assistant professor of medicine at Rutgers Robert Wood Johnson Medical School, whose clinical expertise includes pancreatic cancer. He shares an overview of research and treatment advances that experts hope will create a future in which pancreatic cancer is more manageable to treat.

What research is currently being conducted on pancreatic cancer?

Pancreatic cancer remains a major focus of research across the world and here at Rutgers Cancer Institute. We have an active laboratory research program with a focus on developing immune-targeting strategies in pancreatic cancer. There are multiple clinical studies ongoing looking at ways to improve treatments in pancreatic cancer. One such study will evaluate the effectiveness of using newer drugs in pancreatic cancers that cannot be removed surgically. Another new study will look at a novel treatment approach in metastatic (stage 4) pancreatic cancer.  We have multiple additional studies, within our Investigational Therapeutics Program, including studies utilizing newer types of drugs or incorporating immunotherapies with standard chemotherapies or radiation.

What advancements in pancreatic cancer care have been made over the last decade?

The last decade has seen major advances in DNA sequencing technologies, with tumor gene sequencing now being recommended in expert guidelines as a standard for all patients with metastatic disease. Olaparib, a targeted drug, was approved in late 2019, for certain patients with germline BRCA-mutated pancreatic cancer. An immunotherapy drug, pembrolizumab, can be used for pancreatic cancers when an MSI-H (microsatellite unstable) tumor is found, but this is quite uncommon. Much of the ongoing research is focusing on ways to expand the number of patients who might be helped by immunotherapy based approaches, as well as to expand the use of targeted therapies for the right patients.

How will researchers continue to improve treatment for this disease?

The combination of top-notch basic science research and clinical trials remain the key to improving outcomes in pancreatic cancer. Clinical trials have led to the addition of multiple new drugs in advanced pancreatic cancer. We have shifted from single drugs to multi-drug combinations as the standard of care. In situations where we have traditionally pursued surgery first, we have good evidence that potent chemotherapy combinations significantly improve the long term outcomes. As we strive for additional improvements, both these treatment combinations and novel drugs are being used more in early stage disease, where we believe the impact may be the largest.