Pancreatic Cancer Surgery Q&A w/ Dr. Stauffer on September 4

I read that rmc6236 which is named as ras solute 302 in phase 3 was given the designation of FDA breakthrough therapy in late June of this year. All trials will be completed by the end of this year. FDA approval to occur in 2026. Do you have any idea when in 2026 this approval should be given?

Correction: enrollment in phase 3 will be completed by the end of this year. So if trials are still going on in 2026, and since this drug (6236) has the FDA designation of breakthrough therapy, what is the likelihood FDA will approve it in 2026?

I am a 75 year old female diagnosed Sept. 3, 2024, a year a go. I have adnocarcinoma 7 cm long. My Dr. considers me stage 4 with no cancer anywhere else but in the celiac axis, the body and tail. With the 3 scans the tumor has shrunk .5 inches. Dr. said inoperable and I will not servive this. I was on Gemsar and Abraxane but am now off the Abraxane because of side effects. I am now on Gemsar and nothing else. As of right now I am the same as I was a year ago. Dr. said eventually the tumor may reject the chemo. I was told I was getting chemo only for quality time. I am in Palliative Care. (I am hoping this is where you post for Dr. Stauffer)

Stage IV with Mets to liver considering histotripsy or nanoknife. Since oligometastaic, would surgery be better option? I am progressing (shrinking) with chemo at 4months of Flu.

Hello, can you please explain the enuculation(sp?) procedure that actor, Pauly Shore, recently had in Los Angeles. Is this procedure available through you and can it be performed on IPMN’s? Can this procedure be done robotically?

Wondering if pancreatic cancer is ever NED and also how to tell if cancer is worse when can 19-9 has been negative all along. Is there another blood test? Or just another scan?

In general, if recurrent cancer does not appear within five years of the initial diagnosis, the patient is often considered to be in long-term remission or potentially cured, depending on the cancer type. For pancreatic and other gastrointestinal cancers, CA 19-9 has been a standard biomarker used alongside surveillance imaging (such as CT or MRI) to monitor for recurrence.

Emerging technologies like circulating tumor DNA (ctDNA) analysis offer the potential for more sensitive and earlier detection of recurrence by identifying tumor-specific genetic material in the blood. However, while promising, ctDNA is not yet a standard of care, and its role in routine surveillance is still being determined through ongoing clinical trials and research.

Hi there, we have performed enucleation for appropriate lesions. However, IPMNs are generally not suitable candidates for enucleation. Even when IPMNs appear benign, they are better monitored with serial MRI rather than resected. This is because IPMNs typically communicate with the pancreatic duct, and enucleation in such cases would likely lead to a pancreatic duct leak, given the disruption of the ductal system.

I wish I could provide an answer, but this is a question more appropriate for a bariatric physician or a plastic surgeon.

Yes, we use NanoKnife for a very select group of patients. However, this is uncommon, as we prefer an aggressive, margin-negative resection when technically feasible.

Sometimes we offer novel techniques such as irreversible electroporation (IRE) and intraoperative radiation therapy (IORT) as complements to resection.

Both IRE and IORT target cancer cells after the tumor removal and require a radiation oncologist to be in the operating room, something unique to Mayo Clinic.