Research Spotlight by Dr. Anna Berkenblit: April 2025

Editor's note: The "Research Spotlight" series is written by Dr. Anna Berkenblit, PanCAN's Chief Scientific and Medical Officer. Each month, Dr. Berkenblit shares her insights into the latest news and research in pancreatic cancer. Follow Dr. Berkenblit on X and LinkedIn.

Pancreatic cancer is complex and is challenging to treat, but there are recent advances in surgical techniques and targeted therapies that offer new hope for patients. In this post, we will explore two important topics: the use of robotic Whipple surgery and the role of KRAS mutations in pancreatic cancer.

Robotic Whipple Procedure: A High-Tech Approach to a Complex Procedure

The Whipple procedure, or pancreaticoduodenectomy, is a complex surgery aimed at removing tumors located in the head of the pancreas. Traditionally, this procedure is performed as an open surgery. However, technological advances have introduced a minimally invasive approach using robotic technology assistance.

According to data by the National Cancer Database, there were less than 18,000 Whipple procedures in the United States (U.S.) from 2017 to 2024, and only 12% of those were done minimally invasively, which includes both laparoscopic and robotic methods. Specifically, the number of robot-assisted Whipple procedures remains relatively low, with less than 400 such surgeries performed in the same timeframe. Although the adoption of robotic Whipple surgery is increasing, it still represents a small fraction of the total Whipple procedures due to the complexity of the surgery and the specific criteria patients must meet to be eligible.

The robotic Whipple surgery uses robotic systems to assist surgeons in performing the procedure through small incisions. This approach offers enhanced three-dimensional visualization and precise instrument control, facilitating meticulous dissection and reconstruction. The robotic Whipple combines the best aspects of both open and laparoscopic surgery, is minimally invasive with smaller incisions, less tissue trauma, less pain and faster recovery for the patient. This technique is considered for patients with tumors located near the head of the pancreas, and who are in overall good health. Outcomes are comparable to traditional open surgery when performed by experienced surgeons.

"I appreciate seeing a patient the day after surgery walking in the hall saying, 'This isn't so bad,' or 'I thought it would be worse.' That is a nice thing to hear when you're facing pancreas cancer," said Nicholas N. Nissen, MD, FACS, PanCAN's Scientific & Medical Advisory Board member, and Director, Hepatobiliary and Pancreatic Surgery, Cedars-Sinai."

Robotic Whipple surgery represents a promising innovation that is being adapted by surgical oncologists but is not available everywhere. And whether a patient is a candidate for it will depend on the location and extent of the tumor. If you were recently diagnosed with localized pancreatic cancer, contact PanCAN's Patient Services to learn more. Patient Services can provide lists of specialists, including surgeons.

KRAS Mutations: Know Your RAS

Understanding KRAS mutations matters for patients diagnosed with pancreatic cancer. KRAS is a protein that helps regulate cell growth and mutations in KRAS are found in over 90% of pancreatic ductal adenocarcinomas (PDAC), the most common type of pancreatic cancer. The information that comes from these mutations can impact treatment plans, clinical trial options, and overall care strategies.

Identifying and understanding KRAS mutations through biomarker testing is vital for personalized treatment planning. Some KRAS mutations are now being targeted by new drugs in clinical trials. Knowing which KRAS mutation your tumor has can help determine which clinical trials you may be eligible for. And, new and ongoing research suggests that cancer cells may behave differently based on the specific type of KRAS mutation that is present - this information will become even more important as investigational therapies and novel combinations are developed to target KRAS mutations.

Since the launch of our Research Grants Program, PanCAN has invested more than $17 million toward 45 grants to 39 investigators to better understand the cellular functions of KRAS mutations and devise strategies to directly or indirectly target mutant KRAS signaling. After decades of being considered "undruggable," KRAS is now "druggable" - two mutation-specific KRAS drugs (targeting KRAS G12C, which is rare in pancreatic cancer) are already approved by the U.S. FDA for lung and colorectal cancer. The first phase 3 trial of a KRAS inhibitor (RMC6236, daraxonrasib) in pancreatic cancer is enrolling now, along with other earlier phase trials of KRAS inhibitors in pancreatic cancer.

PanCAN strongly recommends that all patients with pancreatic cancer undergo biomarker testing to determine their tumor's KRAS status and other relevant biomarkers. This information can guide eligibility for clinical trials and emerging targeted therapies. Biomarker testing is a process that uses a sample from your biopsy or surgery to look for key mutations, like KRAS. PanCAN suggests that you ask your doctor about biomarker testing to fully understand your tumor and empower you to take control of your treatment options.

For patients that are interested in connecting with a community of survivorship and peers, visit KRAS KICKERS, which was founded by patients for patients with any KRAS oncogene or cancer type. They empower patients through support groups to offer hope and knowledge. Their aim is to kick cancer's KRAS!

Advances in surgical techniques like the robotic Whipple procedure and a deeper understanding of mutations such as KRAS are shaping the future of pancreatic cancer treatment. Patients and caregivers are encouraged to discuss these options with their healthcare team and consider participation in clinical trials to access innovative therapies.

PanCAN Patient Services is here to help at every step. Learn more about targeting mutant RAS, or contact Patient Services by calling 877-272-6226, or visit: pancan.org.