Predicting treatment response in pancreatic and biliary tract cancers
Research type
Research Study
Full title
Predictors of REsponse to neoaDjuvant treatment In Cancers of the pancreas and biliary Tract (PREDICT study)
IRAS ID
368986
Contact name
Anita Balakrishnan
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust
Duration of Study in the UK
9 years, 0 months, 1 days
Research summary
Pancreatic cancer and cancers of the bile ducts and gallbladder are among the most aggressive cancers, with survival rates that remain poor despite improvements in surgery and drug treatments. Only a small proportion of patients are suitable for surgery when they are first diagnosed. Many have tumours that lie close to major blood vessels, making surgery unsafe at the outset. These patients are usually given chemotherapy first to shrink or stabilise the tumour and increase the chance of successful surgery. Unfortunately, nearly half do not benefit from this treatment and their cancer continues to grow, exposing them to side effects without clear benefit. At present, doctors have no reliable way of knowing in advance who will respond well to treatment.
This study aims to change that by identifying biological markers that predict whether a patient’s cancer is likely to respond to chemotherapy or immunotherapy. We will analyse cancer tissue and blood samples taken before, during, and after treatment to understand how individual tumours behave. Using advanced laboratory techniques, we will study the genetic makeup of the cancer, how genes are switched on and off, how cancer cells interact with surrounding support cells and the immune system, and how these features are arranged within the tumour itself. We will also analyse circulating tumour DNA from blood samples, which allows cancer activity to be monitored using simple blood tests.
By comparing patients who respond well to treatment with those who do not, we aim to identify patterns that predict treatment success or resistance. We will also study samples from patients whose cancer comes back after surgery, as well as from people with early or pre-cancerous conditions, to see whether signs of resistance are present even before cancer fully develops.
The long-term goal is to help doctors personalise treatment for pancreatic and bile duct cancers. Being able to identify, early on, which treatments are most likely to work for each patient could reduce unnecessary side effects, improve the chances of successful surgery, detect relapse earlier, and ultimately improve survival and quality of life.
REC name
Wales REC 2
REC reference
26/WA/0075
Date of REC Opinion
10 Apr 2026
REC opinion
Further Information Favourable Opinion