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  • Dr. Robert A. Nagourney, MD

STAGE 4 PANCREATIC CANCER - DOING MORE WITH LESS

There were 60,430 new diagnoses and 48,220 deaths from pancreatic cancer in 2021. With a 5-year survival of 3% for advanced disease, pancreatic cancer kills more patients than breast cancer and is now the third leading cause of cancer death in America.


Of the National Institute of Health (NIH) annual budget of $51.6 billion the National Cancer Institute (NCI) receives $6.56 billion to study diseases like pancreatic cancer. To advance pancreatic cancer research, organizations like The Lustgarten Foundation have raised over $50 million and the Pancreatic Cancer Action Network (PANCAN) set a goal of $200 million by 2020. Indeed in 2018 PANCAN received a single gift of $25 million.


Clearly, there is a lot of money in pancreatic cancer research. The problem is that there hasn’t been much headway. Yes, we have a few moderately active treatments like FOLFIRINOX with a 31% response rate or gemcitabine plus Nab-paclitaxel at 23% but the cure rates in this disease haven’t changed in decades.


Our group has a particular interest in pancreatic cancer. Beyond genomics, we are examining functional biology and most recently cellular metabolism. Applying laboratory analyses to select amongst the treatment options, we have improved outcomes and seen cures even in advanced metastatic pancreatic cancer. Interestingly several years ago when I participated in one prominent pancreatic cancer organization’s fundraiser luncheon, the two longest-surviving patients in the room turned out to both be my patients; something met with more than a bit of discomfort on the part of the luncheon’s sponsor.


The American people are by nature generous. They do all in their power to support good work. The problem lies in defining good work. Few in the general public have MD, Ph.D.’s so they must rely upon the experts. For the large funding agencies, good work is defined by a small group of “insiders” mostly at major universities who distribute the funds to one another. If you are not part of the favored few you simply do not get funded.


The study of human tumor biology at the level of cellular biology is a fundamental breakthrough in the treatment of advanced pancreatic cancer. We welcome the opportunity to study pancreatic cancer patients and believe that combining the right drugs, the right way the first time is the best way for patients to get ahead of their disease.


We applaud the generosity of Americans who nobly support these well-meaning organizations but how many of these sponsors have seen a return on their investment? Cancer research moves forward one patient at a time and it is individualized patient treatments predicated on cellular biological measures that will advance treatments in this disease.