Pancreatic cancer precision medicine trial aims to be accessible to more patients
Dr Pippa Corrie, consultant medical oncologist, PemOla Trial Lead
18 July 2025
A clinical trial at Addenbrooke’s Hospital, Cambridge is the first to explore using precision immunotherapies to treat pancreatic cancer, one of the hardest to treat forms of cancer. The trial will pilot a new system for running clinical trials in the UK intended to make them faster and more accessible for patients.
Precision medicine has transformed the treatment of many cancers, yet little has changed for people with pancreatic cancer. A new trial led by Dr Pippa Corrie, consultant medical oncologist at Addenbrooke’s Hospital, aims to change this by being the first to trial a precision medicine immunotherapy approach in this challenging cancer.
The trial is the first to pilot a new ‘Just in Time’ scheme run by the National Institute for Health and Care Research (NIHR), which could reduce the time needed for hospitals to join a clinical trial from months to only days. If successful, the scheme could allow more patients to benefit from clinical trials without the need to travel to specialist hospitals. The PemOla trial is funded by the Efficacy and Mechanism Evaluation (EME) Programme, a partnership between the NIHR and the Medical Research Council (MRC), and supported by MSD who are providing the study drug. The trial is being run from the Cambridge Clinical Trials Unit and sponsored by Cambridge University NHS Foundation Trust.
Pancreatic cancer is one of the ten most common forms of cancer, but few weaknesses have yet been found that can be targeted through precision medicine. The PemOla trial will target tumours that have a large number of genetic changes, which makes them susceptible to an immunotherapy that combines the drugs pembrolizumab and olaparib.
Pancreatic cancer continues to be one of the hardest cancers to diagnose and treat and has seen little progress in the last 50 years. Only 1 in 5 patients are diagnosed in the early stages of the disease and only 5% survive more than 10 years beyond diagnosis.
Precision medicine uses scientific analysis of tumours to identify biological weaknesses that can be targeted with specific treatments. For example, breast cancers positive for the HER2 protein are sensitive to treatment with Herceptin. Compared to older methods of treating cancer, these new approaches are more effective and have fewer side-effects.
Immunotherapies for cancer activate the body’s own immune system, causing it to attack and destroy cancer cells. They can be highly effective if given to the right patients. Precision medicine can help to identify those patients.
The development of precision medicines has been driven by advances in our understanding of the underlying biology of disease, revealing weaknesses that can be targeted through specific therapies. The number of precision medicine clinical trials has risen rapidly with fewer than 10 registered per year 20 years ago, to over 200 in recent years.
A key challenge in clinical trials for precision medicines is finding enough patients that have the right cancer subtype to benefit from treatment. This is slowing down the development of new cancer therapies. To realise the benefits of precision medicines we need better clinical trial processes to find the right patients faster.
In many cases, the hospitals where a clinical trial will run are decided at the start of the trial. Setting up each site and preparing to recruit patients can take several months. Once sites are open, participants in the trial need to travel to one of these sites for treatment and monitoring, which often requires a lot of visits.
By simplifying and standardising the process of opening clinical trials at new sites, Just In Time will make it easier for more patients to join clinical trials. It will allow hospitals to join trials when they know they have patients that could benefit from the trial. In turn, this will allow more patients to be treated closer to home rather than needing to travel to participate in a trial.
Just In Time is currently only being piloted with PemOla but it has been designed to provide faster results for all early-stage clinical trials for precision medicines in cancer.
If successful, Just In Time will accelerate patient recruitment and reduce the length of time clinical trials need to run for. At the same time, it will reduce the cost and work involved in setting up a trial. This could be a dramatic leap forward in the development of new precision medicines for cancer.
Improvements to clinical trial processes will be further enabled in Cambridge through the closer working of clinicians and researchers within the Cambridge Cancer Research Hospital, which is being designed to lead the development and delivery of pioneering care and novel precision medicines.
Dr Corrie said:
“Pancreatic cancer remains one of the hardest cancers to treat with very few available treatment options. For the first time we’re taking a precision immunology approach to treatment, which we hope will have a transformative effect for the patients that are able to benefit. With Just in Time we can also make the trial more convenient for participants, by opening sites closer to their homes”
Prof Nick Lemoine, Strategic Development Director at the NIHR Research Delivery Network (RDN), said:
“Pancreatic cancer is one of the most difficult cancers to treat and is often found very late – decreasing the chances of survival. That’s why it’s so important that we find new ways to treat this disease. We hope the Just in Time scheme will help people get the care they need faster and closer to home, so that they are given the best chance to respond to therapies while being surrounded by their loved ones.”
Dr Chris Macdonald, Head of Research at Pancreatic Cancer UK, said: “We desperately need new and more effective treatment options for pancreatic cancer. Immunotherapy has revolutionised the treatment of other forms of cancer, but as yet, has not been successful for pancreatic cancer. We welcome this new trial, which aims to test a personalised approach to immunotherapy for the disease. By using genomics to identify which patients are most likely to benefit from treatment, this study has the potential to increase the effectiveness of treatment, allowing patients to spend more precious time with their loved ones.
“In addition, the Just in Time scheme has the potential to significantly speed up the testing of much-needed new treatment options for pancreatic cancer by accelerating the clinical trials process. This could be a huge step forward for the development of new therapies for this devastating disease.”
