When Roxane Isal, a 43-year-old mother of two from west London, was diagnosed with stage 4 pancreatic cancer that had spread to her liver, her prognosis was bleak. Pancreatic cancer is known for its poor survival rates, with about half of patients dying within three months of diagnosis. In the United Kingdom, around 10,500 people receive this diagnosis annually, and approximately 70% of cases are so advanced at detection that only palliative care is offered, according to Pancreatic Cancer UK. Yet, two years after her diagnosis, Isal remains cancer-free, a testament to recent advances in treatment and targeted therapies.

Isal’s case was complicated by her status as a carrier of the BRCA gene mutation, which is often associated with breast and ovarian cancers but also increases the risk for pancreatic cancer. Paradoxically, this mutation has been found to enhance the responsiveness of tumors to certain chemotherapy agents and targeted therapies known as PARP inhibitors. These drugs exploit the tumor’s defective DNA repair mechanism, effectively halting disease progression and promoting cancer cell death.

Isal underwent ten sessions of platinum-based chemotherapy from May to October 2024, followed by ablation treatment targeting metastatic lesions in her liver, and radiotherapy. Since January 2025, she has been on a combination of the PARP inhibitor olaparib and an oral chemotherapy agent, which has kept her in remission. Her treating oncologist, Professor Naureen Starling of the Institute of Cancer Research and the NHS, noted that patients with BRCA mutations often demonstrate significantly improved outcomes with this approach, sometimes surviving many years beyond typical expectations.

Despite these advances, broader treatment access remains limited. Olaparib is not routinely available through the NHS for pancreatic cancer, gaining use primarily via individual compassionate access requests. Pancreatic Cancer UK highlights the chronic underinvestment in research and the low proportion of patients participating in clinical trials—only 12% according to a recent survey of more than 1,100 patients. Most patients are diagnosed late due to the pancreas’s deep location and the disease’s subtle early symptoms, such as indigestion, back pain, and weight loss, which often lead to misdiagnosis or delayed investigation.

Apart from targeted treatments for BRCA carriers, recent clinical research has shown promise with a new oral medication, daraxonrasib, which inhibits the KRAS protein that drives most pancreatic cancers. A trial published earlier this year reported that daraxonrasib nearly doubled median survival in advanced pancreatic cancer patients compared with standard chemotherapy—from seven to 13 months—while maintaining manageable side effects. The drug, recently approved by the US Food and Drug Administration but not yet available on the NHS, represents a major breakthrough for a patient population where around 90% have KRAS gene mutations.

Researchers are also developing new diagnostic tools aimed at earlier detection. Teams at Imperial College London are working on a breath test to identify cancer-related compounds, while scientists at the University of Essex are investigating blood biomarkers for pancreatic cancer. However, experts emphasize the need for greater funding and expanded clinical trial opportunities to facilitate further discoveries.

Isal’s experience underscores both the challenges and the potential new pathways in pancreatic cancer care. While she acknowledges the uncertainty that remains for her future, she stresses the importance of ongoing research and expanded treatment access. “Who knows what other discoveries may be just around the corner if only scientists can get the funding?” she said.