On April 22, 2026, a titanium rod carrying radioactive iridium-192 was implanted directly into a pancreatic tumor at Grenoble Alpes University Hospital, marking Europe’s first human test of intratumoral brachytherapy for this lethal cancer.
The procedure, led by gastroenterologist Pierre-Yves Eyraud, involved placing 80 radioactive seeds — each about the size of a grain of rice — through an endoscopic ultrasound probe into the core of the tumor. Each seed emits radiation over a 2-millimeter radius, designed to deliver a high, localized dose while sparing surrounding organs like the duodenum and spleen.
This approach builds on decades of failed attempts to treat pancreatic cancer, a disease where five-year survival remains below 13% nationally in France. Unlike systemic chemotherapy, which attacks both cancerous and healthy cells, this method aims to concentrate radiation precisely where it’s needed.
Early imaging after the procedure showed signs of tumor stabilization, according to Gaël Roth, professor of digestive oncology at Grenoble Alpes University and trial coordinator. “We’re not claiming shrinkage yet,” Roth said in a follow-up interview, “but the lack of growth in such an aggressive cancer is itself a signal.”
The Grenoble trial is one of three parallel advances emerging in pancreatic cancer therapy. In Lyon, researchers from CNRS and the Léon-Bérard Center identified a protein called netrin-1 that shields tumor cells from chemotherapy. Their antibody, NP137, blocks this protection, making tumors more vulnerable to standard drugs. In a phase II trial at Grenoble Alpes, patients receiving NP137 alongside chemotherapy saw a median progression-free survival increase of over five months compared to historical controls.
Meanwhile, oral KRAS inhibitors like daraxonrasib — already approved for lung cancer in 2021 — are being repurposed for pancreatic cancer, which depends more intensely on mutant KRAS signaling. Early trial data showed a median overall survival of 13.2 months versus 6.7 months in the control group, a gain described by MD Anderson’s Matthew Katz as “enormous” in this context.
More than seventy KRAS-targeting drugs are currently in development worldwide, according to Olatunji Alese, with daraxonrasib now designated a high-priority review candidate by the U.S. FDA, potentially shortening approval timelines.
Despite these advances, chemotherapy remains the backbone of treatment while new therapies await regulatory clearance. The Grenoble brachytherapy trial plans to enroll 40 patients total, with the goal of determining whether tumor reduction could eventually make surgery — currently an option for fewer than 20% of patients — a viable next step.
How does the radioactive seed procedure differ from external beam radiation?
Unlike external beam radiation, which passes through healthy tissue to reach the tumor, the implanted seeds deliver radiation from inside the tumor, minimizing exposure to nearby organs.
Is the netrin-1 antibody (NP137) available outside clinical trials?
No, NP137 is still investigational; researchers are seeking to confirm results in larger trials before pursuing regulatory approval.
Why is pancreatic cancer so hard to treat with targeted drugs?
Pancreatic tumors create a dense stromal barrier that limits drug penetration, and they often harbor multiple genetic mutations that drive resistance, requiring combination approaches rather than single-agent solutions.