Research is now very active against pancreatic cancer, with new perspectives in early detection and new treatments to improve prognosis. Today, this cancer remains asymptomatic for a long time. And when the first signs appear – jaundice, abdominal pain radiating to the back, deterioration in general condition, fatigue or weight loss – the disease is often already very advanced.
” The hope of early detection, from a blood test, is emerging. Because as with all tumours, the earlier the disease is diagnosed, the better the prognosis, explains Dr. Hollebecque, specialist in digestive cancers at the Gustave-Roussy Institute ofand Villejuif (Val-de-Marne). The objective of such a screening would be to do a PCR to amplify certain specific pancreatic cancer DNA sequences present in the blood. This is starting to be done experimentally, and should grow in the coming years. There are already tests on the market in the United States for this purpose. But their reliability remains to be demonstrated. It is also a question of defining the groups at risk which would benefit from such tests, carried out regularly. We are also planning at the Gustave-Roussy Institute, as part of our Interception program, to propose screening strategies for pancreatic cancer. »
On the theutic level, current management is disappointing. It is based on surgery, in the rare cases where it is possible, and on chemotherapy alone for advanced forms. New avenues, with the development of targeted therapies, are however promising.
Mutations successfully inhibited
Thus, the first drug to inhibit KRAS, a gene mutated in 90% of pancreatic cancers, has just been developed against a specific mutation (KRAS G12C). A clinical trial published in January 2023 in the “New England Journal of Medicine”, reports favorable, but still modest, results in patients with inoperable cancer. “These improve progression-free survival time and seem to be better tolerated than those used in chemotherapy,” adds Dr. Hollebecque..
The combination of several targeted therapy could have even greater effects. » targeting another mutation (KRAS G12D), which is involved in 30% of pancreatic cancers, should also begin to be tested in the coming months in France and the United States. Other treatments, such as chemotherapy-conjugated antibodies, could also open new perspectives.