Pancreatic Cancer Clinical Trials in the UK (2026)
26 May 202612 min readTrialConnect Research Team
Pancreatic cancer remains one of the most challenging cancers to treat, with around 10,500 new cases and 9,600 deaths annually in the UK. However, a wave of innovation is transforming the landscape — KRAS G12C inhibitors targeting the most common driver mutation, novel immunotherapy combinations, and breakthrough early detection programmes are opening doors that were closed for decades. UK centres are at the forefront of this transformation.
UK pancreatic cancer research is led by the NCRI Pancreatic Cancer Subgroup, with world-class trial centres at the Royal Marsden, the Christie, Glasgow Beatson, and Liverpool Cancer Research UK Centre. The UK was pivotal in establishing FOLFIRINOX and nab-paclitaxel + gemcitabine as standards of care, and is now driving the next generation of precision approaches.
The NHS Genomic Medicine Service provides routine molecular profiling for pancreatic cancer patients, identifying actionable mutations like KRAS G12C, BRCA1/2, and microsatellite instability (MSI-H) that unlock access to targeted trials.
There are currently over 50 actively recruiting pancreatic cancer trials in the UK, spanning neoadjuvant, adjuvant, and metastatic settings.
Types of Pancreatic Cancer Trials
Targeted Therapy
KRAS G12C inhibitors, KRAS G12D inhibitors, and other mutation-specific targeted agents for the 90% of pancreatic cancers driven by KRAS mutations.
Immunotherapy
Cancer vaccines, checkpoint inhibitors combined with stroma-modifying agents, and adoptive cell therapies overcoming the immunosuppressive tumour microenvironment.
PARP Inhibitors
Olaparib, niraparib, and other PARP inhibitors for patients with BRCA1/2 mutations or homologous recombination deficiency (HRD).
Surgical & Radiology
Neoadjuvant chemotherapy for borderline resectable disease, HIPEC, stereotactic body radiotherapy (SBRT), and irreversible electroporation (IRE).
KRAS G12C & Targeted Therapy
For decades, KRAS was considered "undruggable" — but that has changed dramatically:
KRAS G12C inhibitors — adagrasib and sotorasib, initially developed for lung cancer, are now in UK pancreatic cancer trials for patients whose tumours carry the KRAS G12C mutation (~2% of pancreatic cancers). Response rates in early studies are encouraging, especially in combination with chemotherapy
KRAS G12D inhibitors — the most common KRAS mutation in pancreatic cancer (around 40% of cases). Several G12D-specific inhibitors are entering UK Phase 1/2 trials, representing the single biggest potential impact on the disease
KRAS wildcard inhibitors — pan-KRAS inhibitors targeting multiple KRAS variants simultaneously, in UK early-phase trials. Could benefit the majority of pancreatic cancer patients
EGFR + chemotherapy combinations — erlotinib remains in combination trials, while newer EGFR/HER3 bispecific antibodies are being tested with gemcitabine and nab-paclitaxel in UK centres
STING agonists — intratumoural or systemic STING pathway activators designed to "heat up" the immunologically cold pancreatic tumour microenvironment, making immunotherapy more effective
Immunotherapy Combinations
Pancreatic cancer has been notoriously resistant to immunotherapy, but combination approaches are changing that:
Checkpoint inhibitors + stromal modifiers — anti-PD-1 combined with agents that break down the dense fibrotic stroma surrounding pancreatic tumours (hyaluronidase, FAK inhibitors, CXCR4 antagonists). UK trials are testing whether stromal depletion allows immune cells to infiltrate the tumour
Personalised cancer vaccines — mRNA-based neoantigen vaccines tailored to each patient's tumour mutation profile, combined with checkpoint inhibitors. UK centres participating in Phase 2 trials showing promising T-cell responses
Adoptive cell therapy — tumour-infiltrating lymphocyte (TIL) therapy and genetically engineered T cells targeting KRAS neoantigens. UK trials at the Royal Marsden exploring TCR-engineered T cells specific for KRAS G12D
GVAX vaccine — whole-cell vaccine approach using irradiated pancreatic cancer cells engineered to secrete GM-CSF, stimulating immune recognition. UK trials combining with anti-PD-1 and anti-CTLA-4 checkpoint blockade
Oncolytic viruses — reovirus and adenovirus-based therapies designed to replicate selectively in pancreatic cancer cells, stimulating local and systemic immune responses. UK trials combining with chemotherapy
PARP Inhibitors & DNA Repair
About 5–10% of pancreatic cancers have defects in DNA repair genes (BRCA1, BRCA2, PALB2, ATM), making them vulnerable to PARP inhibitors:
Olaparib maintenance therapy — following the POLO trial, olaparib is established as maintenance for BRCA-mutated metastatic pancreatic cancer after platinum-based chemotherapy. UK trials now testing: olaparib + immunotherapy combinations, olaparib in earlier disease stages, and as neoadjuvant treatment
Niraparib + immunotherapy — combining PARP inhibition with anti-PD-1 in UK Phase 2 trials, exploiting the increased mutational burden caused by PARP inhibition to enhance immune recognition
HRD-guided treatment — expanding beyond BRCA to identify all patients with homologous recombination deficiency using genomic scar assays. UK trials testing whether HRD-positive patients benefit from platinum chemotherapy + PARP inhibitor combinations regardless of specific gene mutation
Rucaparib and talazoparib — alternative PARP inhibitors in UK comparative trials, exploring different potency and toxicity profiles
Surgical Innovation & HIPEC
Surgery remains the only curative option for pancreatic cancer, and trials are pushing the boundaries of who can have it:
Neoadjuvant chemotherapy for borderline resectable disease — UK trials (including ESPAC-5) showing that giving FOLFIRINOX or gemcitabine + nab-paclitaxel before surgery improves survival for borderline resectable tumours compared to surgery first
Hyperthermic intraperitoneal chemotherapy (HIPEC) — heated chemotherapy delivered directly into the abdominal cavity during surgery to treat microscopic peritoneal disease. UK trials at the Christie and Royal Marsden for selected patients with limited peritoneal spread
Irreversible electroporation (IRE/NanoKnife) — non-thermal ablation using electrical pulses to destroy tumour cells while preserving blood vessels and ducts. UK trials for locally advanced, unresectable pancreatic cancer where surgery isn't possible
Stereotactic body radiotherapy (SBRT) — highly targeted, high-dose radiation in fewer sessions. UK trials for locally advanced disease, sometimes combined with immunotherapy to exploit the "abscopal effect" (immune-mediated tumour shrinkage at distant sites)
Enhanced recovery after surgery (ERAS) — UK-led trials optimising post-operative recovery protocols to reduce complications and get patients to adjuvant treatment faster
Early Detection & Screening
Catching pancreatic cancer earlier is the single biggest opportunity to improve survival:
High-risk screening programmes — UK trials enrolling individuals with BRCA2 mutations, Peutz-Jeghers syndrome, familial pancreatic cancer kindreds, and hereditary pancreatitis for annual MRI/EUS surveillance. The EUROPAC study, based in Liverpool, is the longest-running pancreatic screening trial in Europe
Liquid biopsy for early detection — circulating tumour DNA (ctDNA), exosomes, and protein biomarker panels being tested in UK trials for detecting pancreatic cancer at a resectable stage. The goal is a blood test that identifies high-risk individuals before symptoms appear
AI-enhanced imaging — machine learning algorithms analysing CT scans, MRI, and EUS images to detect subtle early pancreatic lesions missed by human readers. UK trials integrating AI into NHS diagnostic pathways
Symptom awareness studies — research into using new-onset diabetes, weight loss, and other "red flag" symptoms to trigger earlier pancreatic cancer investigation in primary care
💡 Tip: Ask About Genomic Testing
Every pancreatic cancer patient should request comprehensive genomic profiling at diagnosis. Testing for KRAS mutation type, BRCA1/2, PALB2, ATM, MSI-H, and NTRK fusions is now available on the NHS and directly determines which clinical trials and targeted therapies you can access. Don't assume your oncologist has ordered it — ask specifically. Keep copies of your molecular reports.
Who Can Participate?
Pancreatic cancer trial eligibility depends on stage, mutation status, and prior treatment:
KRAS-targeted trials — require confirmed KRAS mutation type (G12C, G12D, etc.) from tumour tissue or liquid biopsy. Treatment history varies: some trials accept treatment-naïve, others require progression after first-line chemotherapy
Immunotherapy trials — most require metastatic or locally advanced disease, adequate organ function, and no active autoimmune disease. MSI-H or high TMB status may be required for some checkpoint inhibitor studies
PARP inhibitor trials — require confirmed BRCA1/2 mutation or HRD-positive status. Most require prior platinum-based chemotherapy
Neoadjuvant/surgical trials — borderline resectable or locally advanced disease, adequate performance status (ECOG 0–1), and no distant metastases
Screening trials — individuals with known genetic predisposition (BRCA2, Peutz-Jeghers, familial pancreatic cancer kindreds with ≥2 affected first-degree relatives), or new-onset diabetes after age 50
UK Pancreatic Cancer Trial Locations
Major UK centres running pancreatic cancer trials include:
London — Royal Marsden Hospital, UCLH, King's College Hospital, Imperial College Healthcare (Hammersmith)
Manchester — The Christie NHS Foundation Trust (major pancreatic and HIPEC centre)
Liverpool — Liverpool Cancer Research UK Centre (EUROPAC screening study, pancreas biology research)
Glasgow — Beatson West of Scotland Cancer Centre
Edinburgh — Western General Hospital (Edinburgh Cancer Centre)
Cambridge — Addenbrooke's Hospital (pancreatic genomics and early detection research)
Southampton — University Hospital Southampton
Leeds — St James's University Hospital (Leeds Cancer Centre)
Oxford — Oxford University Hospitals (Churchill Hospital)
How to Find Your Match
Use our Smart Matcher to find pancreatic cancer trials tailored to your stage, mutation status, and treatment history. Whether you have early-stage disease suitable for neoadjuvant treatment, metastatic cancer needing systemic therapy, or a genetic predisposition qualifying for screening, we can match you to actively recruiting studies.