Pancreatic Cancer (PDAC) Clinical Trials

About Pancreatic Cancer (PDAC) trials

Pancreatic cancer trials test for a smaller set of biomarkers than most other solid tumors, but each one matters. KRAS is mutated in over 90% of pancreatic adenocarcinoma, with G12D, G12V, and G12R the most common variants. Newer KRAS-targeted trials usually require a specific subtype confirmed by sequencing. BRCA1, BRCA2, and PALB2 are tested for both germline and somatic mutations because they define eligibility for PARP inhibitor trials. HER2 (ERBB2) amplification is rare in pancreatic cancer (around 2%) but gates HER2-targeted trials when present. NTRK fusions (NTRK1, NTRK2, NTRK3) are very rare but actionable across tumor types. MMR deficiency is uncommon in pancreatic cancer but qualifies the small subset of patients for immunotherapy trials. NRAS, HRAS, EGFR, and TP53 round out the panel, with TP53 status providing context for trial stratification rather than direct eligibility.

Trials open right now reflect both the difficulty and the activity in the field. First-line metastatic trials test additions to the standard chemotherapy backbones (either FOLFIRINOX or gemcitabine + nab-paclitaxel). The added agents may be novel chemotherapy, an immunotherapy combination, or a targeted compound for selected genotypes. KRAS-targeted trials are an active emerging space, with separate trials for G12C, G12D, and pan-KRAS approaches. PARP inhibitor maintenance trials enroll BRCA-mutated patients who haven't progressed after first-line chemotherapy. Neoadjuvant trials test chemoradiation, chemo-only, or combination regimens for borderline resectable and locally advanced disease. HER2-amplified trials and MMR-deficient IO trials open enrollment for the small but identifiable subgroups. Phase 1 trials in pancreatic cancer often test novel mechanisms because the unmet need is high and standard salvage options are limited.

Pancreatic cancer trials typically check factors specific to this disease, in addition to biomarker status. KRAS status: many trials require KRAS confirmation (mutant or wild-type) and some require a specific variant (G12C, G12D). BRCA1, BRCA2, or PALB2 status (germline or somatic) for PARP eligibility. Prior systemic therapy lines: most trials specify either treatment-naïve, post-first-line, or post-second-line eligibility. Recent surgery and biliary stent status, where many trials require a resolved post-op course or stable biliary drainage. Weight loss in the recent past is sometimes a stratification factor. ECOG performance status of 0 or 1 is the most common requirement. Adequate organ function, with bilirubin cutoffs that often need to be normalized after stenting.

Biomarkers tested in Pancreatic Cancer (PDAC) trials

These are the molecular markers most commonly required or evaluated in Pancreatic Cancer (PDAC) eligibility criteria. OncoMatch extracts them from each trial's protocol and matches them against your test results.