This issue features several noteworthy contributions on pancreatic cancer. Despite curative-intent surgery, pancreatic cancer continues to be diagnosed (too) late and five-year survival rates remain poor due to the limited efficacy of chemotherapy. Early detection therefore remains paramount. Newly diagnosed diabetes represents an important clinical warning sign. In a prospective cohort study, 0.6% of patients with new-onset diabetes subsequently developed pancreatic cancer, with a median latency of 8 months (Chari et al.). Conversely, sustained glycemic control in patients with longstanding diabetes was associated with a significant long-term reduction in pancreatic cancer risk (Tan et al.). In populations at risk, serum-based protein signatures may also facilitate detection of early-stage ductal pancreatic cancer (Lucas et al.). Improved radiologic imaging may further enhance early detection: In a comparative study, AI-based analysis of standard abdominal CT scans outperformed radiologists in identifying early-stage tumors (Alves et al.). We are also seeing advances in oncologic therapy. The Italian CASSANDRA trial demonstrated that neoadjuvant treatment with the PAXG protocol (capecitabine, cisplatin, nab-paclitaxel, and gemcitabine) extended median event-free survival from 10.2 to 16 months compared with mFOLFIRINOX (Reni et al.). Looking ahead, we hope that even more effective treatment options for pancreatic cancer will become available. Highly promising preclinical results in mouse models offer hope for new targeted and highly effective therapies, though the translational path from bench to bedside is expected to be lengthy (Liaki et al.). In any case, this remains an exciting and rapidly evolving field.

Yours sincerely,

Peter Hasselblatt and Tobias Böttler
Department of Internal Medicine II, University Medical Center Freiburg (Germany)