Pancreatic adenocarcinoma is a malignancy with a relatively static incidence of around 12 to 13 per 100,000 during the past several decades. For meaningful progress to be effected in this disease, the maximal gain is anticipated to accrue from a focus on screening, early detection, and diagnosis of early-stage pancreatic adenocarcinoma, opportunities that, previously, have not yet been fully capitalized on.

Aune et al., in a meta-analysis of 23 prospective cohort studies, concluded that each five-unit increment in body mass index was related to a 10% increase in pancreatic adenocarcinoma risk, and the greatest risk was in those who had a body mass index greater than 35 kg/m2. In contrast, the early evaluation of hyaluronan degradation using a pegylated-hyaluronidase enzyme (PEGPH20), combined with gemcitabine and nab-paclitaxel, has potential utility in a subset of patients with high levels of hyaluronan, leading to increased thrombotic events. A phase III evaluation of strategy in previously untreated metastatic pancreatic adenocarcinoma as a front-line therapy is planned in a carefully selected patient population, with no patients with thrombosis or at high risk of thrombosis.

Mettu and Abbruzzese commented on the emerging opportunity for immune therapy intervention. They explained why the initial endeavors yielded a modest impact but provided support for combination immunotherapy approaches in the clinic. For the greatest gains in this disease, public health measures of lifestyle alterations may collectively contribute to modulating the risks for developing this disease.