The Growing Challenge of Pancreatic Cancer in Brazil

Pancreatic cancer remains one of the most formidable challenges in oncology worldwide, and Brazil is no exception. According to data from the Instituto Nacional de Câncer (INCA), Brazil sees approximately 11,000 new cases annually, with mortality rates climbing steadily over the past decade. The disease's aggressiveness stems from its late diagnosis—often at advanced stages—and limited effective treatments, resulting in a five-year survival rate of around 10%. In Brazil, incidence has risen by over 50% in recent years, particularly among those over 70, highlighting the urgent need for innovative research led by the country's universities.

Brazilian institutions like the Universidade de São Paulo (USP) and Universidade Federal de São Paulo (UNIFESP) are at the forefront, conducting pivotal studies on genetic variants and tumor biology. These efforts not only address local epidemiology but also contribute to global knowledge, positioning Brazilian higher education as a key player in combating this silent killer.

Global Breakthrough: Elraglusib Study in Nature Medicine

A landmark phase 2 trial published in Nature Medicine on April 14, 2026, has ignited hope with elraglusib (9-ING-41), a GSK-3β inhibitor combined with standard gemcitabine/nab-paclitaxel chemotherapy. In the study involving 233 patients with metastatic pancreatic ductal adenocarcinoma (mPDAC), median overall survival reached 10.1 months versus 7.2 months for chemotherapy alone—a 38% reduction in death risk. One-year survival doubled to 44%, with benefits across subgroups, including those with liver metastases.

The drug disrupts tumor proliferation, fibrosis, and immune evasion by boosting CD8+ T cells and natural killer cells. While developed by Actuate Therapeutics in the US, its implications resonate in Brazil, where mPDAC accounts for most cases. Brazilian oncologists view it as a model for targeted therapies tailored to local genetics.

USP's Pioneering Genetic Mapping of Pancreatic Cancer

At USP's Instituto de Ciências Biomédicas, researchers have mapped germline pathogenic variants (PGVs) in Brazilian pancreatic cancer patients, filling a critical gap. A 2024 FAPESP-funded study sequenced 50 patients, identifying PGVs in 12%, including BRCA2 mutations more common than in global cohorts. This work, led by Professor Maria Isabel Achatz, underscores Brazil's unique genetic landscape influenced by diverse ancestry.

These findings enable precision medicine, screening high-risk families, and inform clinical trials. USP's efforts exemplify how Brazilian universities drive actionable research amid rising incidence.

Periostin Protein: USP Discovery on Nerve Invasion

Another USP breakthrough reveals periostin, produced by pancreatic stellate cells, facilitates cancer spread along nerves—a perineural invasion path in 80-100% of cases. Published in Molecular and Cellular Endocrinology (2026), the study shows periostin activates cancer cell migration via integrins, offering a target for inhibitors. This could revolutionize treatment for Brazil's aggressive cases.

Led by Professor José Xavier-Neto, the research integrates animal models and patient samples, highlighting higher education's role in mechanistic insights.

Photo by Darwin Boaventura on Unsplash

UNIFESP and INCA: Epidemiological and Clinical Advances

UNIFESP's studies on neuroendocrine pancreatic tumors identify prognostic markers, while INCA reports 17.4% of cancer deaths from pancreas, with mortality rising from 5.0 to 5.5/100,000 (1990-2015). Recent INCA data projects continued increase, urging expanded screening.

• UNIFESP: Better outcomes for localized tumors via multidisciplinary care.
• INCA: National registry improvements for better statistics.
• Collaborations with Fiocruz on vaccine trials.

These institutions train next-gen researchers, fostering oncology expertise.

Challenges in Brazilian Pancreatic Cancer Research

Funding constraints, low incidence (2% of cancers), and late diagnoses hinder progress. Only 20% operable at diagnosis. Yet, universities like UFRJ explore AI for early detection, reducing retention issues in models.

Cultural factors, like fad diets, complicate prevention. Solutions include CAPES/FAPESP grants boosting PhDs in oncology.

Clinical Trials and Treatment Innovations in Brazil

Brazil hosts trials for irinotecan lipossomal (Onivyde), approved 2025, extending survival in metastatic cases. USP's 2022 study halted progression using molecular inhibitors. Ongoing NCT trials at A.C. Camargo Cancer Center test immunotherapies.

Universities partner with pharma for phase II/III, training residents.

Higher Education's Role in Oncology Workforce Development

Brazilian universities produce oncologists via residencies at USP, UNIFESP. Programs emphasize research, with 1,015 neuroendocrine cases analyzed for subtypes. Career paths include postdocs at INCA.

Photo by Lucas Vasques on Unsplash

International Collaborations and Future Outlook

Brazilian researchers collaborate via BRICS, FAPESP-INCA exchanges. The Nature Medicine study inspires local GSK-3β trials. Projections: AI diagnostics by 2030 could double early detections.

Optimism grows with genomic mapping, targeting 20% hereditary cases.

Implications for Patients, Policy, and Academia

For patients, genetic screening via SUS integration. Policy: Boost MEC funding for cancer centers. Academia: More faculty in oncology research positions.

Brazil's universities are pivotal, blending local data with global advances for better outcomes.