The five-year survival rate for pancreatic cancer is around 10%, a number that has remained nearly stagnant for decades. High mortality rates are attributed to a lack of effective screening methods and access to early detection. Focused on improving access and methods for early detection and then developing novel clinical pathways for patients diagnosed with early-stage disease, Duke Cancer Institute (DCI) formalized a new Pancreatic Cancer Center in January 2026. 

“Pancreatic cancer is expected to rise to be the second leading cause of cancer deaths in the United States, and our goal is to change that trajectory. There is a great deal of excitement around bridging clinical care and research to transform the current practice of pancreatic cancer care,” says Peter J. Allen, MD, DCI Pancreatic Cancer Center executive director and chair of the department of surgery. Daniel Nussbaum, MD, surgical oncologist and gastrointestinal (GI) surgeon, and John Strickler, MD, GI medical oncologist, serve as deputy co-directors. 

The DCI Pancreatic Cancer Center integrates existing expertise in pancreatic cancer clinical care and research, with plans to expand programs that position DCI as a regional and national destination for novel pancreatic cancer trials and treatments. Nussbaum comments, “While tremendous progress has been made in treating pancreatic cancer, we recognize that existing standard approaches are simply not good enough. Our goal is to offer our patients not only standard treatments, which are critically important, but also novel therapies that might improve their chance of cure.”

Allen explains that the center will uniquely focus its care model and clinical trial portfolio expansion on early-stage disease. “We will expand our program to identify patients at a high risk for pancreatic cancer and operationalize a screening platform to monitor these patients.” For example, patients with a family history of pancreatic cancer, a cystic precursor lesion, or certain germline mutations are considered high-risk and will be targeted by these new screening efforts. 

“Referring providers can feel confident sending patients to us for a complete risk assessment and know we have a system in place to screen and monitor them,” Allen adds. This screening and early detection effort is led by gastroenterologist Alyson Johnson, MD, who has partnered with the DCI GI oncology team to build a multi-institutional platform for high-risk screening. 

The focus on early disease treatment carries into the center’s research priorities. “We are expanding our clinical trials portfolio to have an immediate impact on patient care, and particularly for patients with earlier-stage disease. We have very promising perioperative trials actively running, and we’re adding trials for prevention and early-stage disease, which many centers aren’t doing,” says Allen. The team is actively engaged in translational research and lab studies to examine the biology of pancreatic cancer development, which can influence the discovery of more targeted treatments.

Perioperative pancreatic cancer trials:

• NCT05634720: Hepatic Artery Chemotherapy for Patients With Localized Pancreas Cancer
• NCT05968326 (IMCODE003): A Study of the Efficacy and Safety of Adjuvant Autogene Cevumeran Plus Atezolizumab and mFOLFIRINOX Versus mFOLFIRINOX Alone in Participants With Resected PDAC
• NCT04207944 (The 3P-C Trial): The Prevention of Progression to Pancreatic Cancer Trial
• NCT07024615: A Study of ASP2138 Given Before Surgery, Then Chemotherapy After Surgery, in People With Pancreatic Ductal Cancer
• NCT07252232 (RASolute 304): A Study of Daraxonrasib (RMC-6236) in Patients With Resected Pancreatic Ductal Adenocarcinoma (KRAS inhibitor trial opening soon)

Emily Bolch, senior research program leader, says, “Our multidisciplinary team of surgeons, medical oncologists, gastroenterologists, endocrinologists, palliative care specialists, advanced practice providers, and scientists collaborate to support patients through every aspect of their journey. The center aims to be the referral center of choice for providers, giving their patients access to a wide variety of therapy options and clinical trials.”

DCI aims to be a leading center in the United States in the emerging field of cell therapy as a treatment for pancreatic cancer, which will be conducted through clinical trials. In cell therapy, a patient’s own immune cells are harvested and manipulated to target their unique cancer. Cell therapy has the potential to be a highly personalized form of immunotherapy.

“We’ve been collaborating with the National Cancer Institute (NCI) on this science via laboratory studies for some time, and we’re very excited about bringing the research on this promising treatment in-house,” says Allen. He continues, “We’ve been working with Nicholas Klemen, a key member of cell therapy pioneer Steve A. Rosenberg’s senior staff at the NCI, and he just started as a member of our faculty. We anticipate rapid building of our pancreatic cancer cell therapy research program and launching new trials in the next six to 12 months.” 

For example, T-cell receptor-engineered T-cell (TCR-T cell) therapy is a form of cellular therapy that uses a patient’s own T cells that are genetically engineered to recognize targets present in the cancer. “Pancreatic cancers often express unique mutations in genes such as KRAS and TP53, and in some patients, we can target these mutations using TCR-T cells. We’ve developed some simple manufacturing strategies that make these TCR-T cells more potent. Also, there is some evidence that the immune system can more effectively fight the cancer when there is less of it. Therefore, our goal is to use TCR-T cells to treat patients with pancreatic cancer when their metastases are invisible to scans but detectable by other means, which may give the immune system a better chance of fighting it off,” explains Klemen.

One challenge with TCR-T cell therapy is that only about 10% of patients will be eligible for it, because certain tissue types required for the treatment to be effective are rare. For years, researchers have attempted to isolate cancer-fighting T cells from the blood, which could allow a highly personalized therapy from a simple blood draw. One significant challenge has been isolating sufficient numbers of these cells from the blood, or figuring out how to get the ‘right’ ones. 

Klemen brings to Duke a novel approach to overcome this obstacle, which has the potential to enable a highly personalized cellular therapy from a simple blood sample. Klemen adds, “We require some tumor tissue from this approach, but we can use bits of a pancreatic cancer specimen that are removed during routine surgery for everything we need. We need to know what part of the tumor can be seen by cancer-fighting immune cells, because this allows us to pull new immune cells out of the blood for a treatment.” 

Klemen says that his lab’s goal is to make this therapy more effective, more broadly applicable, and operationalize it through Duke’s existing Cell Therapy Program. “There’s a famous quote from Wayne Gretzky where he says he skates to where the puck is going to be, not to where it has been. We know that most pancreatic cancers come back after surgery. We don’t want to start thinking about cell therapy when that happens. Our plan is to have a highly personalized cell therapy product cryopreserved before that happens, so we can hit the cancer hard the moment it returns,” he concludes.