"Next Year We Could Have the First Effective Drug Against Pancreatic Cancer"

Alicante hosts a charity run this Sunday for one of the least visible yet deadliest cancers: pancreatic cancer. The event, spearheaded by Alicante doctor and researcher Enrique de Madaria, has raised over a million euros for research against this disease over its 11 editions.

Progress in new treatments is slow but promising, with the potential for a major breakthrough next year in developing the first effective drug against the disease. Time is of the essence, as over 90% of patients die within the first five years, and cases among young people are on the rise.

The pancreas is a gland located behind the stomach, deep in the upper abdomen. It is an inaccessible and quite hidden organ. It performs two essential functions: controlling blood glucose levels by producing insulin, which allows glucose to enter cells to be used as energy; when this function fails and insufficient insulin is produced, glucose accumulates in the blood, leading to diabetes.

The second function is to produce a liquid loaded with digestive enzymes that is released into the duodenum, allowing the digestion of fats, proteins, and carbohydrates. It is a crucial organ, though discreet: its activity goes unnoticed daily, and many only think of it when a pancreatic disease arises.

In a way, yes, because known risk factors explain only a small part of the cases. Smoking, for example, doubles the risk of pancreatic cancer, but this increase is small compared to its effect on lung cancer, where it multiplies the risk by 40. Obesity, high alcohol consumption, and certain genetic syndromes, including some that predispose to breast cancer, also play a role. However, these causes only explain about 10% of cases. Therefore, many seem to arise unpredictably.

So far, not enough progress has been made. We do not really know why some people develop this tumour and others do not. Future research must identify new risk factors and help detect the disease early.

It is a complex, very aggressive, and relatively rare cancer compared to breast, prostate, colon, or lung cancer. However, its mortality is much higher: only between 7% and 10% of patients survive five years. It is a harsh statistic, which is why advancing new treatments is so necessary.

Every year, around 8,000 cases are diagnosed. This prevalence, that is, the number of people living with the disease at a given time, is low due to the high mortality. Moreover, more cases are being seen in young people.

There are three main scenarios. The first is when the tumour can be operated on from the start. This occurs in about 20% of cases, and surgery is currently the only curative route, followed by chemotherapy to reduce the risk of relapse.

The second scenario involves locally advanced tumours without metastasis but affecting nearby blood vessels. In these cases, chemotherapy or chemoradiotherapy is administered to try to reduce the tumour and make it operable. The third includes unresectable tumours or those with metastasis, where surgery is not possible, and the goal is to slow the disease with chemotherapy, although it is not curative.

Yes. KRAS inhibitors are emerging, a mutation present in 90% of pancreatic cancers for which there were no effective treatments until now. In 2026, we will know the first results of clinical trials, and there is much anticipation because they could significantly improve the prognosis. It is too early to know if they will be revolutionary, but they are the most promising therapies in a long time. They are already being used in clinical trials.

Symptoms such as recent and progressive pain in the upper abdomen, significant weight loss (more than 4 or 5 kilos), and the recent development of diabetes should prompt a medical consultation. They do not necessarily indicate pancreatic cancer, but they do require evaluation to rule out this or other serious conditions. Interestingly, those who turn yellow due to bile duct blockage sometimes have smaller and potentially more treatable tumours.