Dr. Anna Berkenblit (third from right) met with clinical investigators and members of the PanCAN and Global Coalition for Adaptive Research (GCAR) teams at the ASCO GI conference. Photo credit: Global Coalition for Adaptive Research

Editor’s note: The “Research Spotlight” series is written by Dr. Anna Berkenblit, PanCAN’s Chief Scientific and Medical Officer. Each month, Dr. Berkenblit shares her insights about the latest news and research in pancreatic cancer. Follow Dr. Berkenblit on X and LinkedIn.

Pancreatic cancer is currently the third-leading cause of cancer-related deaths in the United States and is on track to become the second-leading cause in the coming years. According to the recent American Cancer Society Cancer Facts and Figures 2025 report, an estimated 67,440 new cases of pancreatic cancer will be diagnosed in the U.S. and 51,980 people will die from the disease. The five-year relative survival rate for pancreatic cancer remains flat at 13%, and just 8% for people diagnosed with the most common form of pancreatic cancer, pancreatic adenocarcinoma.

Last week I had the opportunity to attend the annual American Society of Clinical Oncology (ASCO) Gastrointestinal (GI) Cancers Symposium in San Francisco where I had the chance to network with experts from around the world focused on GI oncology. This year’s theme was ‘Taking Personalized Care to the Next Level’ and sessions focused on significant developments in treatment strategies, precision medicine, and clinical trial design. It also brought forth critical attention to the rising incidence of cancer in individuals under 50, with gastrointestinal cancers leading this trend. Discussions also highlighted the urgent need for innovative approaches, with a focus on understanding tumor biology and leveraging precision medicine to improve outcomes.

I was interested to see work from PanCAN Scientific and Medical Advisory Board (SMAB) member Dr. Shubham Pant, demonstrating the frequency of RAS mutations in a large database of pancreatic adenocarcinoma samples. RAS mutations – and specifically those in KRAS – are known to be very common alterations that drive the initiation and progression of pancreatic adenocarcinoma tumors. Here, Dr. Pant and colleagues looked at more than 27,000 tissue samples and confirmed that KRAS mutations are found in 92% of samples. Further, the investigators ascertained the frequency of changes at different locations within the KRAS protein, which might be important for clinical trial participation and guiding treatment decisions in the future.

Another SMAB member, Dr. Efrat Dotan, gave an oral presentation on the effect of baseline geriatric and quality-of-life assessments in vulnerable older patients with previously untreated metastatic pancreatic adenocarcinoma. Her team’s findings highlight that baseline assessments among vulnerable older adults with metastatic pancreatic adenocarcinoma correlate strongly with survival and treatment tolerance. Early supportive care and management of geriatric vulnerabilities may favorably affect outcomes in these patients, and physicians need to keep this in mind as they discuss treatment options, including standard of care and clinical trials of novel agents with patients to facilitate informed decision-making.

Precision Medicine and Artificial Intelligence (AI) Driven Innovations

While at ASCO GI, I attended a poster session presented by Perthera, a leader in precision oncology on research and validation of the world’s first AI-driven chemo predictor for frontline treatment in pancreatic adenocarcinoma. Data from the Pancreatic Cancer Action Network’s (PanCAN) Know Your Tumor® program was used to develop this tool, which offers oncologists potentially actionable insights by predicting the most effective chemotherapy regimens for individual patients. The latest iteration, PDACai v2.0, promises to further empower oncologists with validated, data-driven predictions, offering hope for better outcomes and an improved quality of life for patients. This innovation exemplifies how partnerships in precision medicine have the potential to transform the trajectory of care for one of the most aggressive cancer types.

Updates from the PanCAN Precision PromiseSM Trial

I was delighted to attend the oral presentation of findings from PanCAN’s Precision Promise trial. Dr. Vince Picozzi, on behalf of all the investigators, presented the pamrevlumab + nab-paclitaxel/gemcitabine results. While the addition of an investigational antibody treatment called pamrevlumab to chemotherapy did not show a benefit for patients with metastatic pancreatic cancer in Precision Promise (nor in another study called LAPIS, in locally advanced disease, also presented by Dr. Picozzi earlier in the day), Dr. Picozzi highlighted the novel nature of the Precision Promise study. The Precision Promise initiative, the first Bayesian platform trial in metastatic pancreatic adenocarcinoma, demonstrated the potential for adaptive clinical trial designs to accelerate drug development. The Bayesian design refers to a complex statistical analysis that allowed the trial to learn and adapt over time to find out faster if an investigational treatment was working or not. Key findings shared at the symposium include: the pamrevlumab outcomes, safety signals, and the importance of data sharing. PanCAN will make biospecimens and data from the trial available to the pancreatic cancer research community for exploratory analyses, emphasizing the collaborative nature of the initiative.

Dr. Namrata Vijayvergia provided an excellent discussion of the importance of Precision Promise, highlighting the numerous innovations incorporated in the study, comparing the Bayesian design to a sports car. Like a sports car, Dr. Vijayvergia likened the Bayesian design of Precision Promise to be fast, flexible, nimble, and taking you to places you never thought you would go. The tradeoffs of the Bayesian “sports car” being that the design is statistically complex, has high implementation costs, and can be difficult to replicate, as decisions are made on real-time data.

The Precision Promise trial’s novel Bayesian design highlights the need for further refinement in clinical trial methodologies. The future of platform trials in pancreatic cancer will require expanding the investigational therapeutic pipeline, enhancing master protocol design, data collection, and statistical analysis, and the development of capabilities for biomarker-driven patient subset investigations. This vision will be supported by global efforts, such as the upcoming platform trial sponsored by the Global Coalition for Adaptive Research, which aims to build on the foundation laid by Precision Promise.

A Path Forward

I am so glad that I attended ASCO GI as it truly reinforces the urgency of addressing pancreatic cancer through innovative research, collaboration, and precision medicine. The advancements in AI-driven tools like PDACai v2.0 and insights from groundbreaking trials underscore a commitment to transforming patient outcomes. While challenges remain, the strides made in understanding pancreatic cancer’s molecular drivers, including RAS and others, along with optimizing treatment approaches offer hope for improved survival rates and quality of life for those affected.