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The PancChat Podcast is a collaborative effort from Let’s Win Pancreatic Cancer and the Pancreatic Cancer Action Network (PanCAN), inspired by the long-running #PancChat Twitter/X chat.
Hosted by award-winning journalist Alisyn Camerota, each episode features conversations with leading researchers, clinicians, patients, and advocates who are shaping the future of pancreatic cancer care and research. Together, we deliver expert insights, personal journeys, and the latest breakthroughs—bridging the gap between science and lived experience.
Whether you’re a patient, caregiver, healthcare professional, or simply want to learn more, join us to connect, be inspired, and learn how you can help to accelerate progress in the fight against pancreatic cancer.
Cindy Gavin: I'm Cindy Gavin, CEO and co-founder of Let's Win, and we are back for episode 15. Today, we're diving into one of the most critical topics in pancreatic cancer: the state of research and where we stand today. Our host, Alisyn Camerota, is joined by Dr. Emil Lou on today's episode to break down these complex developments and explain why what this progress means for patients and families facing pancreatic cancer. Take it away, Alisyn.
Alisyn Camerota: Thank you very much, Cindy, and welcome to our listeners to this episode of PancChat. I also want to thank our sponsor, Revolution Medicines. So today we're talking about research into pancreatic cancer and where it stands. From the KRAS targeted drugs to using AI for diagnosis to personalized treatment. And our guest, Dr. Emil Lou is here to help us understand what progress is being made and what it means for patients.
Dr. Emil Lou is a physician-scientist and professor at the University of Minnesota Medical Center. He is a fellowship-trained and board-certified medical oncologist and neurooncologist. Dr. Lou is also a member of the ASCO and the North American Neuroendocrine Tumor Society committees. Dr. Lou, thanks for being here.
Dr. Emil Lou: Thank you so much for having me, Alisyn. It's a great pleasure to be with you and your listeners.
Alisyn Camerota: I look forward to this conversation. So when we talk about research, does that mean, just so that we can level set here, things that are already being tested in clinical trials, or are these things that are maybe years away and that have not been tested yet on humans?
Dr. Emil Lou: Yes, and all of the above and more. I guess we might answer about the entire spectrum from A to Z. And so as a physician scientist, as you mentioned, my role and training and what I do in my day to day life can spend anything from looking under the microscope in the lab to running clinical trials where we're trying to help human patients in our clinic, not just with the standard of care, but trying to improve upon the standard of care.
The principle of clinical trials is really to take promising science has been developed in the lab and kind of what has emerged as potential winners in the lab. Because not every scientific idea is worthwhile to put it into clinical trials. Some trials are based on very strong science that we want to translate, but ultimately the purpose of clinical trials is to confirm whether or not those potential therapies can be translated into actual treatments that can improve upon what we already have for patients.
Alisyn Camerota: Well, that note, I am curious, how often is it that things that are really promising in mice, say the trials that have worked beautifully for mice, don't translate to humans?
Dr. Emil Lou: Overwhelmingly, not 100%, but as closer to that than 0% for sure. So, in other words, you know, we do science where we're looking at cells and you can treat cells with anything, right? And you can kill cancer cells in any way, shape or form. But the next level traditionally has been animal models because animals more simulate physiology that's closer to humans but not actually being human beings. And that's a limitation.
So even as recently as the beginning of 2026, heard a great promising story. This extremely promising research was peer reviewed; it came out of Madrid, Spain. And of course, I think the late press picked up on it, and I think the emphasis on that is a good example where it's mice not yet translated into clinical trials. If we go back over years to many decades, there are many promising therapies that were developed in labs but ultimately did not succeed in the clinical trial setting for human patients in terms of prolonging the amount of time before cancer would grow again in those patients, whether it's in combination with standard of care chemotherapies or alone with these novel experimental therapies. So, unfortunately, there are more promising ideas, including in mouse models that have actually translated into success in human beings. That's where we really need to move the needle, especially in pancreas carcinomas.
Alisyn Camerota: That's exactly the study that I was referring to obliquely, the one out of Spain. It sounded promising, but then I read further, and it was only in mice.
Dr. Emil Lou: Right. So I think, I mean, we can take heart from it and we can use cautious optimism. But I think as a scientist, I was extremely excited. As an oncologist, I'm especially excited for what is to come. It's just this was in mice and I think this lays the groundwork beautifully for clinical trials that are and will build upon this idea that the different pathways that the cells use, their circuitry, their signals to feed themselves or feed each other. These tumor cells work in synchrony.
And I think it's a beautiful study that is built upon at least 30 to 40 years of research that took what is called the great undruggable target, put in quotes in the MLA press over decades. And now in the last decade it has been druggable, right? But some of the studies are promising and then in this study they took, it was a three-pronged attack and it was very promising that they reported that many of these pancreatic tumors in mice, right, not in human beings but in mice regressed. So, in other words, shrunk or they were reporting no longer visible and they filed these mice for extended periods of time.
And this was extremely promising and I think this is something to build upon, very promising for patients on the horizon. It's but I inevitably I saw that study and I also thought tomorrow, next week and in the months to come, patients already have and will continue to cite that study. And of course, you know, it's an opportunity for education about science and how it works, but it's not always enough for the patients sitting in front of me for the time they need it.
Alisyn Camerota: Definitely. I mean, definitely. But you saying that that study in mice that showed so much promise that it will, you predict it will become a clinical trial for humans or are we far away from that?
Dr. Emil Lou: So maybe you just take a step back and discuss together this promising target, the great undruggable target, it's called KRAS. So it was discovered basically in the 70s and developed more into the 80s. So it's been around and it drives about twenty percent of all cancers, but in no cancer, is it more prominent than in pancreas adenocarcinoma, pancreas cancer where it's seen and drives essentially 90 to 95 percent of all pancreas cancers.
So, this is really the holy grail. And we've been waiting for a long time and it was called undruggable. It was kind of an easy tagline to use for many years.
But of course with decades of effort, I mean, you wouldn't imagine biochemists and medicinal chemists and other people who are not day to day that someone wouldn't be from an oncology clinic have been working so hard to take this target and try to develop drugs.
So, drug development reverse engineering. There's actually not just one form of this, but there's nearly 10 or so or a dozen types. And so a drug tailored towards one form of it won't fit the other. And so this study that came out of Spain that made international news headlines use a very sophisticated method of three pronged attack of attacking it for all the potential forms that might exist even in the same tumor in the same patient might be different forms. And so this is really next level, next generation version of it. But the trials have been ongoing leading the way the last few years we've seen in lung cancer, colorectal cancer drugs targeting this gene called KRAS and its protein there and its target. It hasn't been 100% successful. It can vary from cancer to cancer, but it's really important that we do this successfully in pancreas cancer because of how common it is.
Some of the preliminary studies to date in pancreas cancer have shown promise, maybe like a one in four or one in three chance that there will be a tumor response and studies like this using multipronged attack are looking to improve upon that even further. Very promising.
I think it's virtually certain to be coming into clinical trials in the coming months or in calendar year 2026. I'm sure it's in the works.
Alisyn Camerota: Well, just one more thing on the KRAS, because I am familiar with it because that my husband was lucky enough to be the recipient of one of these very cutting edge, very new clinical trials that was the KRAS, a KRAS targeting drug. And it was amazing. And it was so much more easily tolerated than chemo. And we lived our — we had a very high quality of life lived our regular life.
And the only problem with that KRAS clinical trial that he was on was the durability issue. It just didn't last. It worked. It was highly effective for the short time that it worked. And so, in terms of research, are people trying to figure out and where do you even begin in terms of lengthening the time that it works?
Dr. Emil Lou: Absolutely. I think that's a story of drug resistance, whether it be chemotherapy, biologic agents. I think the last few years everyone will ask on their prepared list of questions, is immunotherapy right for me? And that's always on the tip. But no matter what the type of treatment is, what is the strategy and the tactic, the way I refer to them,
Cancer is smart. Pancreas cancer is particularly smart.
It finds a way, it evolves and that's what we call drug resistance. And so even for targeted therapies that are of intelligent design, here's a target, here's a drug designed to fit that target. It's a designer medicine, really precision oncology. Even then the cancer is smart enough to eventually find ways around it.
And so with this first wave in pancreas and then lung cancer and colorectal cancer, even though they're different cancers that we think of them traditionally as being so separate, what they have in common is when an individual patient's tumor is tested and they have that target, they're potentially going to benefit from that drug until they don't. And so that's where research comes into play.
We make these observations in the clinic and on clinical trials, then we need to go back to the lab and basically reverse engineer, understand what happened, how did it evolve and how do we next develop a companion drug or a separate drug that can block the resistance mechanism. So it's really, it's somewhat of a cat and mouse game.
And honestly, Alisyn, where we feel like drug resistance, we're always a step behind but doing the multi pronged attack of doing two or three drugs at once that are all intended to block any potential thing that might cause what your husband and so many others experience that drug resistance, I think is going to be the solution in many cases where it's anticipating what will happen after drug one is given works for some period of time and no longer works.
How can we preemptively block any other counterattack that a cancer might provide for itself?
Alisyn Camerota: So Dr. Lou, beyond the KRAS, the advent and really cutting edge technology or discovery of the KRAS targeted drugs, give us a status report on the rest of the landscape. So in terms of new chemotherapy approaches, surgery, radiation, where is research with those?
Dr. Emil Lou: Right, right. So I think the very sobering news of pancreas cancer is a five year survival. We need to improve well beyond just celebrating reaching ten percent but not exceeding, and that hasn't changed for many years. We know that only ten to fifteen percent of pancreas carcinomas, pancreas cancers are detected early enough that they're potentially surgically removable. Surgery has to be, it remains the foundation of intent to cure strategy.
About half of all cases are stage IV or metastatic at the time of diagnosis, meaning they go far away from where they started. Liver, lungs and bone are common places. And those are not curable with current chemotherapies, but we're greatly trying to improve upon that. And radiation, the role of that still remains somewhat controversial, but it's still limited to the approximately third of the remaining cases where the tumor is has not yet spread, but it's too large or invasive to be surgically removed, even by the best surgeons in the world. And so where I would say now enter the chat artificial intelligence — AI is on the tip of everyone's minds, up on everyone's tongues. I know it's on the minds of patients who come in and say, got this diagnosis. I went to ChatGPT or equivalent AI.
But from the medical standpoint, I think there are some very exciting and promising ways we're trying to integrate this into research.
One aspect of that is early detection. And that's been a very, very difficult thing to pin down. We have screening tests looking for early detection of cancer only for a few limited forms of cancer, colorectal, breast, and only a couple of others. But what has been elusive is getting that in pancreas cancer. But leveraging AI and applying it to scans that people might have or blood tests really is starting to, it will revolutionize. It's not yet in prime time, I think many studies internationally in Scandinavia and in many North American institutions or in collaboration are really making inroads on this. And at least one study has used AI to comb through reams or just, you know, a thousand pound pages of people's medical documentation to pick up symptoms that might herald a higher risk of pancreas cancer being diagnosed even months or years after that.
Even for people who have scans or certain blood tests, the AI is being trained or to try and detect patterns in that that might be predictive of someone having higher risk that might need more intensive screening with CT scan imaging, just as an example. So that's remarkable. And it also goes to the other end of the spectrum, detecting drug resistance, like you're given a drug like your husband and how can that predict when and how to avoid drug resistance.
So I think AI being applied is a really exciting avenue. And there are so many aspects and potential.
Alisyn Camerota: Yeah, have a couple more questions about AI. So what about in terms of predicting treatment response? How would AI be able to tell a doctor which treatment a patient might respond most favorably to?
Dr. Emil Lou: Right. So currently for pancreas cancer, like for many cancers, we rely upon imaging, whether it be CT scan or MRI, but basically pictures taken of the insides of someone's organs that also visualize the tumors, the masses that are inside the organs that shouldn't be there but constitute pancreas cancer. And so, know, Alisyn, I think it's been very rudimentary.
We look at a three-dimensional human being, a three-dimensional organ, three-dimensional tumors in two dimensions. And we, as physicians and radiologists with our radiology colleagues, we scroll through it, we measure. If the tumor grows while in therapy, then you say the tumor treatment no longer works, we must go to something else. And it's very basic, but applying AI is starting to allow us a higher level of sophistication.
So believe it or not, and it took me some time to really absorb this, is that some forms of AI can be trained to even pick out the shape or the different elements of organs or tumors that might be more associated with drug resistance or a higher risk of cancer or higher risk of cancer spread called metastasis.
Even to the point of picking out pockets of cancers and the blood vessels and associating the cancer is very smart, it will produce more blood vessels to nourish itself. But if there are clusters of blood vessels picked up by AI from CT scans that everyone will get, that's giving us information that might be associated with prognosis and treatment resistance, or maybe giving us indication treatment may need to be changed soon in order to gain some more success.
It's very remarkable, I think.
Alisyn Camerota: It really is remarkable. I mean, AI obviously causes great concern as it should in lots of other avenues. But in medical research, I mean, this is earth shattering. You know how many advances are possible, I guess.
Dr. Emil Lou: Right, it really accelerate exponentially rather than, I mean, traditionally we might be able to do some of the things I just described manually, but it's tedious, right? It takes a long time and it would never be available or feasible to do in a large scale clinical trial. Some of the large kind of the pattern of clinical trials is to enroll not just a few patients, but hundreds of patients, sometimes in some clinical trials could be thousands, getting a new treatment versus standard of care to answer the question is the new thing, the new experimental drug or combination better than what we had before.
Implementing AI, but first validating and proving the AI works really can speed up immensely how we can answer those questions. And then I would say I also want to include the idea of identifying promising candidates. Sometimes the limitation is there are thousands of drugs that have been produced or repurposed, but testing one by one would take decades to do it. Even if you have an idea today, I would answer the question decades later.
But AI is being used to produce virtual experiments that would fit drugs and targets. And then from that emerging suggestions of the top 1% that are most likely to fit based on mathematical modeling by AI. And that's really speeding up drug development as well.
Alisyn Camerota: It's kind of mind blowing. So you alluded earlier to the standard of care treatment, which is not very satisfying in pancreatic cancer. And so, terms of research, where are we now with standard of care? And by that, I mean the FOLFIRINOX version of chemotherapy that people have gotten for decades versus something more tailor made for each patient's own particular molecular profile.
Dr. Emil Lou: Right. And that is the promise of precision medicine. And for pancreas cancer, we need to and are catching up in terms of the torch bearers that have been lung cancer. So when I trained at Memorial Sloan Kettering Cancer Center about two decades ago, lung cancer led the way from being a death sentence and the prognosis people living well under a year from time of stage IV. And then the emergence of understanding of here are drug targets and the drug targets may be in one in four patients or as little as five percent of those patients, but it really mattered to those five percent and to this day.
And with the development of drugs and the next generation of those drugs and the third generation and so on, patients are living longer and you're seeing the survival of patients even with stage IV cancer approaching four or five years and perhaps longer.
That's where we need to get in pancreas cancer and we're getting there. Part of the challenge is what I see in the lab and in scientific studies is the composition of pancreas cancer is different. So we have to crack that nut. Some of the strategies will be different.
We're in an era where certainly I, like many other oncologists across the country will request genomic profiling of the tumors from patients. And I review the results with my patients, but I quote, I would say conservatively under twenty percent and probably more realistically under ten to fifteen percent of the time will we get back information that would then indicate I can now make, I can now add another drug to the arsenal of therapy that we can use for you.
It's much higher in many other types of cancers, but with the emergence of more drugs KRAS, as I said earlier in the conversation, ninety to ninety five percent of pancreas cancers involved or driven basically by this target. Until last few years, it was not, we didn't have the drugs. We knew the target, we could identify it easily.
The problem is we didn't have the drugs to fit, but now we do. So I think that can really vault us into the stratosphere in the next half decade with clinical trials that will hopefully prove that the concepts we see in the lab and in mice are working in human beings.
Alisyn Camerota: So Dr. Lou, what do you want our listeners to know about where research is and what they can hope for? Yes.
Dr. Emil Lou: I think research brings hope. Research has the potential to save lives. It already does save lives in many types of cancer. And that's where research is really important. And I think where every individual, patients, caregivers, anybody in any sphere of life who has encountered anyone with pancreas cancer, you have a voice through advocacy organizations that help patients, but also a voice at the national level, you need to be heard because the funding for research that drives the changes over the last half century and the next year, the next decade and the next half century and more to come is in trouble.
We are in dire straits in terms of national funding from, I would say through federal funding sources and others in terms of a depletion of funds available to drive research that is going to discover or help us discover cures that will change patients' lives for the clinical trials that will take place five years from now, ten years from now. The science, the seeds are here. There is no lack of ideas. There is a wellspring of ideas and very scientifically sound concepts that may never see the light of day until people speak up and demand through the representatives and in DC that funding be restored and even then not just restored, but elevated to higher levels.
The time is now and we have to make our voices known and this is something that everyone can do. And it's only together through a critical mass that we can ensure that the research pipeline doesn't run dry. We need to help patients of today and also think of patients of tomorrow who are yet to hear those dreaded words, you have cancer.
Alisyn Camerota: Such a good reminder because what we don't want is all of these promising things on the horizon to backslide now. Exactly. Yeah. Dr. Lou, thank you. Really great to talk to you about all of this. Thanks for sharing all of your expertise.
Dr. Emil Lou: It's my great pleasure. Thank you so much.
Alisyn Camerota: And we want to thank all of you for listening as well. Thanks to Revolution Medicines, our sponsor. I'm your host, Alisyn Camerota, and I'll see you next time on PancChat.
Julie Fleshman: Hi, I'm Julie Fleshman, President and CEO of PanCAN. If you or a loved one has been diagnosed with pancreatic cancer, navigating this journey can feel overwhelming, but you don't have to do it alone. Be sure to explore resources available to patients and caregivers through Let's Win and PanCAN.
You can find PanCAN at pancan.org and Let's Win at letswinpc.org.
Don't forget to visit PanCAN and Let's Win clinical trial finders for more information on clinical trials. PanCAN's patient services can also run a personal clinical trial search for you.
Together, Let's Win and PanCAN are committed to guiding you through every step of the pancreatic cancer journey, offering support, information, and hope.
Thanks so much for joining us today as we look at where we currently stand with pancreatic cancer research.
Join us in episode 16 of PancChat to learn more where we are going. Don't forget to follow PancChat to get new episodes delivered twice a month right in your podcast feed. PancChat is available on all major platforms wherever you get your podcasts.