Pancreatic Cancer x Dr. Michael Pishvaian 2026 UPDATE Part 3
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In this final installment of their 2026 update series, Sam and Kareen of Two Onc Docs welcome back Dr. Michael Pishvaian to discuss the critical role of supportive care in pancreatic cancer, emphasizing symptom management for pain, gastrointestinal issues, and appetite loss. Dr. Pishvaian highlights the underutilized but vital benefits of palliative care, celiac plexus blocks, stenting for biliary and intestinal obstructions, and the nuanced use of pancreatic enzyme supplements and medical marijuana—particularly THC-based formulations—for symptom relief. He then shifts to promising emerging therapies, spotlighting MTAP-deleted tumors as a target for PRMT5 and MAT2A inhibitors with favorable side effect profiles, the potential of anti-CLDN18.2 therapies despite past trial setbacks, and the future of MDM2 inhibitors. Vaccines targeting KRAS in the adjuvant setting show early immunological promise, with a pivotal phase 2 trial from Elysio awaited. Dr. Pishvaian also shares career advice for early oncologists, urging specialization in disease types and deep engagement with molecular oncology, while affirming oncology’s enduring relevance amid AI advancements. Finally, he introduces Tumor Board Tuesday—a monthly online educational forum on Twitter X that dives into molecular aspects of cancer care across tumor types, fostering interdisciplinary learning. Key takeaways include: 1) Supportive care is as critical as treatment in pancreatic cancer; 2) MTAP-deleted tumors offer a promising new therapeutic avenue with less toxicity than RAS inhibitors; 3) Medical marijuana (THC-based) is a clinically effective symptom reliever; 4) Vaccines may soon play a role in preventing recurrence after surgery; 5) Specialization and deep scientific literacy are essential for future oncologists; 6) Tumor Board Tuesday is a valuable resource for staying updated on cutting-edge oncology topics. The episode concludes with a strong, hopeful tone about the future of pancreatic cancer care and professional development in oncology.
Supportive care—including pain management, stenting, and pancreatic enzyme replacement—is as vital as cancer treatment in pancreatic cancer.
MTAP-deleted pancreatic tumors are a promising target for PRMT5 and MAT2A inhibitors, offering potentially safer alternatives to RAS inhibitors.
THC-based medical marijuana is highly effective for symptom relief in pancreatic cancer patients and should be considered when legal.
KRAS-targeting vaccines in the adjuvant setting show strong immune activation and may soon enter phase three trials.
Early-career oncologists should specialize early and develop deep expertise in molecular and translational oncology.
…and 1 more takeaway available in PodZeus
Supportive Care in Pancreatic Cancer: Managing Symptoms from Diagnosis
“For all of us across the United States, access to palliative care and those kinds of supportive services are very, very limited, which is unfortunate because there's really proof of benefit in pancreatic cancer for patients to be able to see a palliative care team and get their symptoms managed.”
Promising New Therapies: MTAP, CLDN18.2, and MDM2 Targets
“There's a number of companies that have PRMT5 inhibitors right now in phase three trials, in some cases in combination with chemotherapy.”
Vaccines, Career Advice, and Tumor Board Tuesday
The episode concludes with discussion on KRAS-targeting vaccines in the adjuvant setting, career guidance for early oncologists to specialize and master molecular oncology, and an introduction to Tumor Board Tuesday—a monthly Twitter X forum for deep dives into cancer biology and treatment innovation.
“I don't think it's a career that's going to be pushed out by AI. So I think we will have a clear role and an important career for many years to come.”
“For all of us across the United States, access to palliative care and those kinds of supportive services are very, very limited, which is unfortunate because there's really proof of benefit in pancreatic cancer for patients to be able to see a palliative care team and get their symptoms managed.”
“There's a number of companies that have PRMT5 inhibitors right now in phase three trials, in some cases in combination with chemotherapy.”
Hosts
Guest
Dr. Michael Pishvaian
person
Tumor Board Tuesday
other
MTAP
other
Palliative Care
other
KRAS
other
Two Onc Docs
media
Medical Marijuana
product
PRMT5 Inhibitors
product
CLDN18.2
other
THC
other
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