Pancreatic Cancer: Often Diagnosed Late, Limited Treatment Options
Pancreatic cancer remains a particularly challenging malignancy, often diagnosed at a late stage when treatment options are limited. An estimated 13,585 new cases were diagnosed in 2024 in Italy alone (6,873 men and 6,712 women) and the disease is known for its insidious nature, frequently presenting with vague symptoms or no noticeable signs in its early stages.
“Pancreatic cancer can remain completely asymptomatic in the early stages or be associated with general symptoms,” explained Nicola Silvestris, national secretary of the Italian Association of Medical Oncology (AIOM), to Adnkronos Salute. This makes early detection difficult, contributing to poorer outcomes.
As the disease progresses, more typical symptoms emerge, including sudden weight loss, abdominal pain, digestive difficulties, jaundice, dark urine, pale stools, and, sometimes, the sudden onset of diabetes. However, by the time these signs appear, surgical intervention – currently possible in only 15-20% of cases – is often no longer feasible because the tumor has become unresectable.
Research into personalized medicine approaches for pancreatic cancer is ongoing, but currently limited. According to Silvestris, “To date, we don’t have many molecular targets for targeted drugs. The only exception concerns patients with germline mutations in the BRCA 1 and BRCA 2 genes.”
Recently, the Italian Medicines Agency (AIFA) approved reimbursement for a PARP inhibitor drug for patients with these specific genetic mutations who haven’t experienced disease progression after initial platinum-based chemotherapy. Clinical trials are as well underway to evaluate both targeted therapies and immunotherapy.
Further research is focused on improving treatment for operable tumors as well. Prof. Dr. Michele Reni, an experienced medical oncologist at Ospedale San Raffaele in Milan, is Coordinator of the AIOM guidelines for treating and managing pancreatic cancer. He notes that pancreatic cancer is “rare and different from others,” and explains why it can be difficult to cure.
Reni has been serving as the Director of the Strategic Program of Clinical Coordination at the Pancreas Center in IRCCS Ospedale San Raffaele since 2016. He also works as a Specialist in Medical Oncology at the Department of Medical Oncology at the San Raffaele Research Hospital. Panavance Therapeutics highlights his role as a member of the multidisciplinary team involved in managing pancreatic adenocarcinoma.
A recent study suggests that pancreatic cancer can develop years before it is detectable, potentially opening avenues for new diagnostic and treatment approaches. This underscores the necessitate for continued research into early detection methods and more effective therapies for this challenging disease.
