Why Does Pancreatic Cancer Spread So Early and How to Stop It

Pancreatic cancer remains one of the deadliest due to its ability to spread long before the first symptoms appear. Unlike other cancers, it often progresses silently, making surgical interventions and standard treatments ineffective. Researchers are now focusing on the early mechanisms that transform benign lesions into malignant cells capable of traveling throughout the body.

From the earliest stages, genetic mutations such as those in the KRAS gene alter the behavior of pancreatic cells. These cells acquire plasticity, allowing them to change shape and function, thus promoting their migration to other organs. This phenomenon, known as epithelial-mesenchymal transition, grants them resistance to therapies and the ability to survive in hostile environments. Precancerous lesions, common in adults over 30, sometimes develop into aggressive tumors without visible signs.

Recent analyses reveal that these cancer cells can leave the pancreas long before a detectable tumor forms. They move alone or in groups, adapting to the tissues they invade, such as the liver or lungs. Their discreet presence explains why surgical procedures often fail to prevent recurrence.

The challenge lies in identifying these disseminated cells. Current markers, such as KRAS mutations, are insufficient because they are also present in benign lesions. Scientists are therefore exploring new methods to detect these cells early, before they become incurable.

Two tumor subtypes have been identified: one classical and the other more aggressive, associated with increased resistance to treatments. Understanding how these cells evolve and interact with their environment could enable the development of targeted therapies. The goal is to block their plasticity to prevent their spread and improve patient survival. Experimental models, such as organoids, help study these mechanisms, but their complexity remains a challenge.

Hope lies in a better understanding of the molecular signals that trigger this early dissemination. By targeting these processes, it may be possible to intervene earlier and prevent the formation of metastases, thus offering a real chance of cure.

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Official Study Source

DOI: https://doi.org/10.1007/s10555-026-10326-1

Title: Early cellular plasticity promotes progression and dissemination in pancreatic adenocarcinoma

Journal: Cancer and Metastasis Reviews

Publisher: Springer Science and Business Media LLC

Authors: Giulio Innamorati; Giorgio Malpeli; Luca Giacomello; Roberto Salvia; Thomas M. Wilkie