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Modern Options, Innovations, and Personalized Treatment
Pancreatic cancer immunotherapy (also called immuno-oncology) is a rapidly developing area of treatment for pancreatic cancer / pancreatic adenocarcinoma in Israel.
The mechanism of action is stimulating the human immune system to fight tumor cells—helping immune cells recognize and attack cancer that would otherwise “hide” from the immune response.
Traditional pancreatic cancer treatments still play a central role and may include surgical resection, radiotherapy, ablative treatments, and chemotherapy.
For today, the most important update is this: immunotherapy can be very effective for a small, biologically defined group of patients, and Israel’s leading oncology teams focus on identifying those patients quickly through molecular testing—and offering clinical trials when standard options are limited.
Immunotherapy for Pancreatic Cancer: Who Can Benefit
Currently, studies are underway on several immunotherapy drugs to treat pancreatic carcinoma / adenocarcinoma, and some approaches show impressive results in selected patients.
The key point: most pancreatic cancers do not respond strongly to checkpoint inhibitor immunotherapy, but a small subgroup can respond effectively—especially tumors that are MMR-D (dMMR) or MSI-H. The prevalence of MSI-H/dMMR in pancreatic ductal adenocarcinoma is around ~1% (roughly 0.8–1.3% in many reports).
That is why in Israel as in leading global centers, a “best practice” step is tumor profiling early in the process—so rare but highly actionable biomarkers are not missed.
Pembrolizumab (Keytruda®) for MSI-H/dMMR Pancreatic Cancer
Pembrolizumab (Keytruda®) is an immune checkpoint inhibitor that helps activate the body’s immune response against cancer. It works by blocking the PD-1 pathway, which can restore T cells’ ability to recognize and destroy cancer cells.
This treatment is only suitable for patients whose tumor is MMR-D (dMMR) or MSI-H (and is used as a tissue-agnostic option for MSI-H/dMMR solid tumors).
The drug is commonly given every three weeks (some protocols use different schedules) by intravenous infusion, usually over about 30 minutes, depending on the regimen.
Possible side effects can include exhaustion and fatigue, nausea and vomiting, bruising and bleeding, diarrhea, headache, and joint pain (your oncologist will explain what is most likely for your situation and how to prevent/monitor complications).
New Immunotherapeutic Updates
- Another option for dMMR tumors: Dostarlimab (Jemperli®). In addition to pembrolizumab, dostarlimab received FDA accelerated approval for dMMR recurrent or advanced solid tumors (after progression and when there are no satisfactory alternatives). This matters for the rare pancreatic cancer patients with dMMR biology.
- Tumor mutational burden-high (TMB-H) immunotherapy pathway. For some solid tumors that are TMB-H (≥10 mutations/megabase), pembrolizumab has an accelerated approval pathway after prior treatment and when alternatives are limited. This is less common in pancreatic cancer but may be relevant for a subset identified via NGS testing.
- Vaccine-based immunotherapy: a major innovation in pancreatic cancer. One of the most exciting innovations is personalized mRNA neoantigen vaccination strategies designed to “teach” the immune system to recognize a patient’s specific tumor targets. A notable study in resected pancreatic cancer reported that an investigational personalized mRNA vaccine strategy (with immunotherapy and chemotherapy) induced strong T-cell activity that may correlate with delayed recurrence in responders.
Newer research continues to explore mRNA vaccine platforms that generate long-lived tumor-specific T cells in pancreatic cancer.
Important: these vaccine approaches are generally available through clinical trials in specialized centers.
Immunotherapy in Israel as Part of a Personalized Treatment Plan
Immunotherapy drugs are also used in Israel as part of a personalized treatment strategy for each patient—especially when standard protocols have limited effect or when biomarkers suggest a immune targeted approach.
Personalized treatment can be prescribed based on the results of new molecular genetic tests (NGS) that compile the genomic profile of the tumor. These tests help predict which treatments are most likely to work—whether immunotherapy (MSI-H/dMMR, sometimes TMB-H), targeted therapy options, or clinical trials.
Examples of “innovation beyond immunotherapy” that can matter after tumor profiling:
- Tumor-agnostic HER2-positive solid tumor treatment options (in eligible patients, after prior therapy)
- New targeted options for rare gene fusions (for example, an FDA approval reported for NRG1 fusion pancreatic adenocarcinoma)
Leading Doctors for Pancreatic Cancer – Consultation Online
If you’ve received a diagnosis of pancreatic cancer and want the most up-to-date options in Israel, the best first step is often an online expert consultation with an Israeli oncologist who specializes in pancreatic cancer.
⇒ Leading Doctors for Pancreatic Cancer – Consultation Online
A structured second opinion can include:
- Review of your biopsy/pathology and staging
- Review of CT/MRI/PET-CT imaging
- Biomarker testing strategy (MSI/MMR, TMB, HER2, gene fusions, BRCA/PALB2 and more when appropriate)
- Clear plan: standard care + immunotherapy eligibility + clinical trials
What to Send Before the Consultation
- Pathology report (biopsy or surgery)
- Imaging reports (CT/MRI/PET-CT) + DICOM files if available
- Blood tests (including liver function, CA19-9 if done)
- Treatment history (chemotherapy regimens, responses, side effects)
- Current medications and key medical history
Want to check whether immunotherapy is relevant for your pancreatic cancer?
Send your medical documents for a professional review and we will help arrange a consultation in Israel—online or in person—with the right pancreatic cancer specialist and discuss:
- Whether your tumor may be MSI-H/dMMR (Keytruda/Jemperli pathway)
- Whether advanced tumor profiling suggests clinical trials, vaccine studies, or targeted options
Traditional (Conservative) Pancreatic Cancer Treatments in Israel
Even when immunotherapy is being considered, most patients will also need a “conservative foundation” of evidence-based care, such as:
- Surgery (when the tumor is resectable or borderline resectable)
- Chemotherapy (commonly used regimens include modern multi-drug protocols, chosen based on fitness and disease stage)
- Radiation / chemoradiation in selected scenarios (locally advanced disease, symptom control, or specific treatment plans)
- Ablative approaches in selected cases (used in specialized centers and individualized plans)
- Supportive (palliative) care for symptom relief and quality of life—at any stage, alongside active treatment
