Patients Involved: Patients with localised stage 1-3 pancreatic cancer (cancer that has not spread to other areas of the body) who will be undergoing surgery or who have recently undergone surgery to remove their cancer.

Rationale for Treatment: Pancreatic cancer cells have DNA mutations that are not present in normal cells.  Cancer-specific DNA can be found in the bloodstream of some people after they have had surgery to remove their pancreatic cancer - this may be evidence that some of the cancer cells have escaped before the pancreatic cancer was removed.  The DYNAMIC-Pancreas clinical trial uses a genetic blood test called “circulating tumour DNA” (ctDNA) to more effectively decide the type and duration of post-surgery chemotherapy based on the presence or absence of circulating tumour DNA in a patient's blood after their surgery to remove the cancer.  

Treatment Given: Patients can receive a shorter duration of standard chemotherapy if their ctDNA blood test is negative.  If a patient’s ctDNA blood test is positive, they may receive a longer duration of standard chemotherapy.  Some patients with a positive ctDNA blood test may be able to have a different type of chemotherapy (gemcitabine plus Abraxane) instead of the standard chemotherapy of mFOLFIRINOX.

Recruitment: DYNAMIC-Pancreas has now closed to recruitment with 118 patients currently being followed up on the trial.

Sites involved: There are 26 sites across Victoria, New South Wales, Queensland, Western Australia, South Australia and Tasmania involved in the trial.

research article ANZCTR

Patients Involved: Patients with stage 3 pancreatic cancer that has not spread to other areas of the body, but whose cancer cannot be removed safely with surgery. 

Rationale for Treatment: It is hoped that the DIRECT-InspIRE trial will show that the NanoKnife system is safe to use, improves survival, reduces pain, and increases quality of life in these pancreatic cancer patients compared to patients who receive chemotherapy alone.

Treatment Given: This trial provides access to a novel technology that would otherwise be outside the reach of most patients: the NanoKnife® system.  This machine is used during surgery to produce electrical pulses that make small holes in cancer cells, causing these treated cancer cells to die.

Recruitment: The trial started enrolling patients in August 2021, with an aim to enrol 20 patients.  To date, 4 patients have joined the study.

Sites involved: There are currently 2 sites in Victoria involved in the trial - Peter Mac and the Epworth Hospital.

ANZCTR 

Patients Involved: Patients with pancreatic cancer of any stage, who have had a biopsy or surgery for their cancer (the tissue from the biopsy or surgery is needed for the trial).

Treatment Given: There are no additional treatments given as part of this project as all patients will already be undergoing diagnostic testing or surgery for pancreatic lesions.  The project will use the leftover fresh tissue samples from consenting patients, as well as a sample of their blood.

Rationale for Project: Leftover patient tissue samples will be used to grow 3-dimensional tissue-like structures; mini tumours which have been termed “organoids”. These organoids can mimic how a cancer would grow within the body, and may allow us to better understand how cancer-specific mutations in pancreatic cells affect the development and function of the pancreas.  It is hoped that this will help lead to a deeper understanding of pancreatic cancer and aid in developing future technology that will personalise an individual’s cancer response to treatment.

Recruitment: Commencing in 2017, recruitment continues in Victoria; 254 participants have been enrolled in this study.

Sites involved: Royal Melbourne Hospital, Epworth Richmond, Cabrini Health, Western Health, Austin Health, St Vincent’s Health Melbourne, Northern Health, Melbourne Private Hospital, Warringal Private Hospital, Monash Health.

Patients Involved: Patients with pancreatic cancer of any stage, who have had a biopsy or surgery for their cancer (the tissue from the biopsy or surgery is needed for the trial).

Rationale for Treatment: Cancer cells can release unique molecules into the body, and sometimes normal cells within the body may also release molecules in response to cancer - these molecules are called biomarkers.  This project aims to explore and validate new methods to help in the detection and monitoring of pancreatic cancer by identifying new pancreatic cancer biomarkers.  It is hoped that identification of new effective diagnostic, predictive, and prognostic biomarkers will lead to clinical trials that will ultimately have a positive impact and improve the diagnosis and management of patients with pancreatic cancer.    

Treatment Given: There are no additional treatments given as part of this trial - all patients will be treated with the most appropriate standard therapy available as decided by their usual oncologist.

Recruitment: The study started enrolling patients in 2018, with recruitment ongoing.  To date, 38 patients have joined the study.

Sites involved: There are currently 3 sites in Victoria participating in the study.

The target population for this early detection screening program are people who have a “high risk” of developing pancreatic cancer due to their genetics or family history and who are not currently experiencing any symptoms. These “high risk” individuals include people who have a condition called Peutz-Jeghers syndrome or Hereditary Pancreatitis; people with a genetic variant that increases pancreatic cancer risk, including a “faulty” copy of the BRCA2, ATM, PALB2 or CDKN2A gene or one of the genes that causes Lynch syndrome and a close relative with pancreatic cancer; and those with two or more first-degree relatives (e.g. a parent and sibling or two siblings) with pancreatic cancer, even if no gene fault has been identified in the family.

Studying high-risk individuals gives us the best chance of understanding more about how pancreatic cancer develops, and how we can best detect it at an early stage.  If successful, this trial may form the basis for more widespread screening for early pancreatic cancer and, in turn, improve patient and physician access to screening. 

The Australian Pancreatic Cancer Screening Program was established in collaboration with the Cancer of the Pancreas Screening (CAPS) consortium, and the lead study site is St Vincent’s Hospital, Sydney. This study has human research ethics approval and is supported by the PURPLE Translational Registry. High-risk individuals are currently being enrolled at multiple hospitals across Australia.

You can find out more information about the Australian Pancreatic Cancer Screening Program, including your closest screening site and site coordinator contact details below

Screening trial