pancreatic cancer
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies, with a 5-year survival rate under 13% due to late-stage diagnosis and poor response to conventional chemotherapy. Clinical trials are urgently needed: fewer than 10% of patients are eligible for curative-intent surgery at diagnosis, and systemic therapy extends median survival in metastatic disease by only months. This landscape makes PDAC one of the most active and highest-priority areas in oncology research.
Active trials investigate KRAS inhibitors (adagrasib, sotorasib in KRAS-mutant disease — nearly universal in PDAC), antibody-drug conjugates (zolbetuximab for CLDN18.2-positive tumors), cancer vaccines including mRNA neoantigen approaches (Moderna/Merck mRNA-4157), CAR-T cell therapies, and PARP inhibitors for the ~5–7% with germline BRCA mutations. Combination approaches with targeted stromal modulators aim to overcome the desmoplastic tumor microenvironment.
Germline testing for BRCA1/2, PALB2, and ATM is recommended for all PDAC patients, as mutations alter both prognosis and eligibility for PARP inhibitor trials.