"The most exciting thing that's going on right now, is that some of the most common genetic mutations we know of in pancreatic cancer, are finally having drugs that seem to work against them," says Robert McWilliams, MD, a medical oncologist and the Deputy Director of OSF HealthCare Cancer Institute. "They're in clinical trials right now, but we may see drug approvals as early as this year for these new therapies called KRAS inhibitors. Almost all pancreatic cancer tumors have those mutations. If these drugs are as promising and work as well as we hope, it should make a tremendous difference for pancreatic cancer."

Why this moment matters in pancreatic cancer treatment

Historically, treatment options for pancreatic cancer have advanced slowly compared to other cancers.

"Pancreatic cancer treatment hasn't evolved as quickly as I'd like. We've had more complex chemotherapy regimens that work incrementally better," Dr. McWilliams says. "Trying to put those together into a plan for patients using more neoadjuvant therapies (giving chemotherapy to shrink a tumor before surgery) is something we've done a lot more of in the last few years."

Even with incremental improvements, outcomes have remained challenging – largely because of how pancreatic cancer behaves.

The challenge of a “silent” disease

Pancreatic cancer, one of the deadliest forms of gastrointestinal cancer, is often diagnosed late, when treatment options are more limited. According to 2015-2021 data from the National Cancer Institute, only 13.3% of people survived five or more years after being diagnosed with pancreatic cancer. Nearly 68,000 people were diagnosed with pancreatic cancer in 2025, almost 52,000 of them died from the disease.

"One of the things that's most challenging about pancreatic cancer, is that it can be there without causing specific symptoms. Even though a lot of people with advanced pancreatic cancer do have symptoms commonly, it is a very difficult cancer to detect early," Dr. McWilliams says. "Because of that, oftentimes people present with advanced or metastatic disease.”

Therapeutic cancer vaccines are also in development right now. Promising results from post-operative mRNA-based vaccines have suggested an immune response is possible, and patients may have better outcomes. More trials are in progress to evaluate this further.  

Targeting KRAS: A long-standing goal

According to the Lustgarten Foundation, the largest private funder of pancreatic cancer research in the world, KRAS mutations are central to the disease.

KRAS is a gene that helps control when cells grow and divide. Normally, it works like a switch, turning growth on when the body needs it, and off when it doesn’t. But when KRAS mutates, that switch can get stuck in the “on” position, causing cells to grow nonstop and eventually form cancer.

While KRAS mutations are found in about 11% of all cancers, pancreatic cancer depends on it more than almost any other. In fact, more than 90% of pancreatic ductal adenocarcinomas – the most common type of pancreatic cancer – have a KRAS mutation. That’s why researchers see KRAS as one of the most important and promising targets in the fight against pancreatic cancer.

One of the biggest challenges right now is creating drugs that can shut down the KRAS mutations most seen in pancreatic cancer, especially KRAS-G12D, which shows up in nearly half of all cases. Another key goal is developing treatments that can target several KRAS mutations at the same time. The good news: researchers are actively working on it, with more than 60 RAS-focused drugs currently in development.

New drugs moving through late-stage trials

According to Revolution Medicines, Inc., a late-stage clinical oncology company developing targeted therapies for patients with RAS-addicted cancers, the U.S. Food and Drug Administration (FDA) has granted a non-transferrable voucher for its drug daraxonrasib (RMC-6236) under the FDA’s Commissioner’s National Priority Voucher pilot program.

Daraxonrasib is being studied in two global Phase 3 clinical trials: RASolute 302 in patients with previously treated metastatic pancreatic ductal adenocarcinoma and RASolve 301 in patients with previously treated metastatic non-small cell lung cancer.

Symptoms that should not be ignored

Even with promising advances, early detection remains critical.

"One of the things is called painless jaundice. If you turn yellow (jaundice), and you're not having abdominal pain, that is a classical sign for pancreatic cancer," Dr. McWilliams points out. "The most common symptom people notice is weight loss. Most of us are trying to lose weight at any moment in time, but sometimes it's a little too easy and the weight starts dripping off. When that happens, that's something to say 'hey, that's great!' But maybe I should get that checked out."

Reducing cancer risk and improving outcomes

Dr. McWilliams says lifestyle choices can play an important role in reducing cancer risk and improving outcomes after diagnosis:

• Don’t smoke cigarettes
• Don’t vape
• Avoid drinking alcohol
• Maintain a healthy lifestyle, including a healthy weight and regular physical activity

Those diagnosed with cancer tend to do better when they engage in more physical exercise. Regular activity can also help protect against other health concerns, including heart disease, neurological disorders and chronic illness.

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The Peoria, Illinois-based hospital system has brought surgical oncologist Tamara Floyd, MD, to the care team at OSF HealthCare Saint Francis Medical Center in Peoria. Dr. Floyd performs cytoreductive and HIPEC (hyperthermic intraperitoneal chemotherapy) surgeries in Peoria, while also seeing patients in Bloomington and Galesburg.

HIPEC procedures are mostly for patients who have tumors or cancer spread in the abdominal cavity. 

Cancerous tumors are removed through cytoreductive surgery where the surgeon initially attempts to remove as much of the cancer as possible. Surgery is then followed by HIPEC, which is when a heated chemotherapy – at just over 106 degrees Fahrenheit – is administered into the abdomen. The heated chemo is then circulated around the area inside the abdomen to treat any remaining microscopic tumor cells.

HIPEC can be beneficial for several types of cancer patients. The one it benefits the most is LAMN, or low-grade appendiceal mucinous neoplasm. HIPEC is considered a standard of care for patients who have seen their cancer spread into the space in the abdomen that contains the abdominal organs.

These can be appendix, colorectal, and now more data indicates stomach cancer patients may benefit from HIPEC, Dr. Floyd says.

"Additionally with more data, pancreatic cancer is being looked at as well. Even patients with breast cancer. Another cancer that benefits from HIPEC is peritoneal mesothelioma." 

HIPEC can be a viable treatment option at any stage, Dr. Floyd says. But as some people are diagnosed with later stage disease, it can feel like no options are possible. HIPEC changes that.

"It's beneficial to have the option of doing HIPEC, or cytoreductive surgeries, for patients who have peritoneal spread of disease, which for most cancers means it is a stage 4 disease," Dr. Floyd says. "In a lot of instances, if you're talking about stage 4 disease, there aren't a lot of other options."

While HIPEC is a viable option for low-grade cancers, it's also a helpful option for later stage, more aggressive cancers. Patients with signet ring or goblet cell features, which are more aggressive subtypes, can also be treated with HIPEC. 

"Signet ring is one of the subtypes of appendiceal, colon or rectal that can be treated. There are even some subtypes of gastric or stomach cancer that are considered a signet ring or have signet ring features," Dr. Floyd says. "Cytoreductive and HIPEC can be considered for those patients."

Throughout a cancer journey, combining traditional chemotherapy that is administered through IV with HIPEC provides a "synergistic effect" Dr. Floyd says. HIPEC allows the chemotherapy to be administered directly to the cancer cells and kill them that way. 

Dr. Floyd has done one HIPEC at OSF Saint Francis so far and has another planned soon. It's anticipated that within the next year, Dr. Floyd and her team will start to do three to four HIPEC surgeries a month as OSF HealthCare Cancer Institute continues to grow as a destination center.

Patient recovery times can be one to two weeks in the hospital after HIPEC surgery, which is why having this option for Central Illinois patients is so important. It allows the patient and their families to stay close to home, instead of having to travel hours away. Dr. Floyd says the longer travel times can turn patients and their families away from pursuing care. 

Heated chemotherapy can also be used in thoracic cavities. This would then be called HITEC or HITOC, Heated IntraThoracic Chemotherapy. This is for patients who have disease spreading in the pulmonary area. 

Types of cancers that can be treated by HIPEC: 

-          LAMN (Low-grade appendiceal mucinous neoplasm)

-          Appendiceal

-          Colon

-          Rectal

-          Gastric

-          Stomach

-          Pancreatic

-          Breast

-          Mesothelioma

-          Ovarian

For more information on cancer treatment options at OSF, visit the OSF HealthCare Cancer Institute website.

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Innovative Technologies at the Forefront

Leading-edge cancer treatments like proton beam therapy, brachytherapy, genetic counseling and dietetics are all offered within the OSF Cancer Institute, providing patients with a one-stop-shop during their cancer journey.  

Proton therapy

Proton therapy was first offered on April 1, 2024.

"Proton therapy lets us offer radiation therapy to patients that maybe wouldn't have been able to tolerate side effects due to tumor location, or factors such as prior radiation treatment to the same area," says Tom Cox, the vice president of operations at OSF Cancer Institute. " This is possible because protons stop after passing through a tumor, eliminating the radiation effects on tissue often treated incidentally to photon (X-ray) therapy. The OSF Cancer Institute is on track to have treated 180 patients by April 1, 2025 – which far exceeded the original first-year target of 130 patients.

Brachytherapy

The brachytherapy suite offers a more patient-friendly way for mostly prostate and gynecological (cervical, endometrial) cancer patients to receive treatment. This option involves placement of applicators or needles directly into tumors so that very controlled, effective radiation can be delivered in discrete volumes. Since the radiation is delivered from within the tumor, there is a dramatic reduction of the dose to normal tissue, even those near the tumor itself. The dose is delivered with high-dose rate techniques so the therapy is delivered in just a few minutes time.

"Being able to bring the introduction of the applicators into the body, the treatment planning CT and the treatment all in one room, has created a much better experience. We're having some really good outcomes there, and we think we can expand what we're able to do there,” Cox says.

Intuitive Ion robot 

The OSF Cancer Institute’s pulmonology team offers state-of-the-art diagnostic tools and treatments, including minimally invasive, robotic surgeries and robotic assistive bronchoscopy. This includes the Intuitive Ion Robot, which allows care teams to get early answers and advance care for lung cancer patients.

"We're going to leverage the ability of an ion robot in the interventional pulmonary lab to really upend how we do the front end of lung cancer care," Cox says. "That robot is going to enable us to biopsy smaller lesions. It has fewer side effects than when you're getting a lung biopsy that's CT-guided. You can also do a staged EBUS (endobronchial ultrasound) exam, so you can diagnosis and stage at the same time."

Rachael Davis, MD, a pulmonologist at OSF Cancer Institute, and her team have been using the ion robot weekly. Dr. Davis and her team are training more providers, and by this summer they’re expecting to quadruple – or more – how often it’s used. 

HIPEC procedures

Hyperthermic intraperitoneal chemotherapy (HIPEC) surgeries are now offered at the OSF Cancer Institute. Tamara Floyd, MD, a surgical oncologist with OSF performs the open surgery and removes tumors from the abdomen. In the HIPEC procedure, heated chemotherapy is circulated through the body for a period of time. The first case went extremely well, and Dr. Floyd is planning her second case for mid-March. 

In addition to treatment options, the OSF Cancer Institute is increasing cancer supportive services in the Peoria region as well.

• Cancer navigation - 13% increase (Specially trained OSF Mission Partners walking you through the process of cancer care) 
• Dietetics - 64% increase
• Palliative medicine - 213% increase (Helps control symptoms, augments treatment from physicians) 
• Genetic counseling - 20% increase

Nutrition journey during cancer

Part of the dietary benefits OSF Cancer Institute offers is in the CEFCU Teaching Kitchen. Oncology dietitians work with patients on recipes to cook and are there with them step-by-step during their cancer journeys. Cox says 50% of people who come in for cancer treatment have dietary risks, while 80% of those people suffer malnutrition during treatment. Having a trained, professional dietary team walking alongside you helps fight those negative complications.

OSF Cancer Institute Culture

Cox credits the Institute’s first-year success to the culture of those who work there. The goal, he says, is to offer cancer support services across the entire spectrum of life. 

"The Mission Partners that work in this building have completely bought in to the idea that we all are advocates for cancer patients. We're always asking patients what they need, to see if we can help them," Cox says. "If we hear there's an issue with travel, or they're having trouble keeping food down, or if their children are not coping very well (with a loved one's cancer diagnosis), we know there are resources in the building, and we try very hard to line up those resources. You can feel it when you walk through the building."

Support services after cancer treatment 

"We can get you with a nurse, an exercise specialist and a dietitian to get back to your best life after cancer. Maybe you like to run a lot and ran half marathons, and you think you'll never be able to do it again. We have rehab and exercise specialists here and nutritionists. Who says you can't do that again? We're going to work with you to see you can get to the life after cancer you want to get to,” Cox says.

Services and medical professionals continue to grow

Building off the first year of OSF Cancer Institute, the administrative team continues to hire world-class medical professionals to offer cancer care in Peoria. A breast surgeon was recently brought onto the team, and a colorectal surgeon will be starting soon.

Additionally, the fourth floor of the building will be built out soon. Cox says this will give much-needed space for the surgical oncology and medical research teams. Research-focused medical oncologists are currently being recruited as well.

Leaving OSF Cancer Institute healthier, and more aware

Patients who leave OSF Cancer Institute don't just leave the building as healthier people; their awareness continues and will benefit other people. Cox admits a cancer diagnosis is not an easy thing to go through, and that the support from the OSF care team doesn’t stop when you walk out the door.

Grateful for community support

Cox says he’s been humbled throughout the years of working in oncology by the incredible commitment of the community and region to the OSF Cancer Institute.

"It is overwhelming to me, the philanthropic spirit of our community and extended community," Cox says. "I take that as, they've made a big commitment to us, and we're making a big commitment back. We're going to bring things to central Illinois that have not been here before. We are going to support you and your family members throughout your life and keep you as healthy, relative to cancer, as we possibly can."

Looking to the future

Cox says the OSF Cancer Institute is looking to bring more pediatric cancer support services to the building, the work collaboratively alongside the adult services.

The team is creating both a lung lesion clinic and a lung multidisciplinary clinic, which aims to reduce the time from finding a cancerous lesion to treatment. The lesion clinic is expected to open in late spring.

The OSF Cancer Institute intake team has been created with oncology nurses who will answer patients’ questions on the very same day, to see if services are right for you.

Cox adds that OSF is planning to put together an early detection hotline as a resource for the community to know if or when they should be screened for cancer.

To learn more about the OSF HealthCare Cancer Institute, visit its website to view the services offered and find contact information to get connected.

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Peoria, Illinois-based OSF HealthCare is partnering with the University of Illinois Chicago (UIC) to award six grants totally more than $460,000 to support projects funded through the Community Health Advocacy program, with a goal to improve outcomes and reduce health care disparities. The latest grants seek to generate solutions focused on new models of care that improve access and reduce barriers for individuals from all racial and ethnic backgrounds. The projects also explore prototypes that can transform care and community-based initiatives that address the social determinants of health. The CHA program is also aimed at improving outcomes and reducing health care disparities.

The CHA program is a partnership between OSF HealthCare and The University of Illinois Chicago (UIC).

The funding supports research involving clinicians, engineers and social scientists to rapidly develop technologies and devices that could revolutionize medical training and health care delivery. A requirement of the grant applications was for solutions that could be deployed quickly, within four to six weeks.

Spring 2023 CHA Grant Projects

Automated Seizure Detection in Ambulatory EEG

• Huan Huynh, MD, OSF HealthCare
• Biswajit Maharathi, PhD, University of Illinois Chicago

Ambulatory EEG is a powerful tool to evaluate seizure propensity in patients with epilepsy within natural community settings and residential environments. This goal of this pilot project is to build a semi-automated seizure screening system using modern machine learning-based computational approaches to significantly reduce the physician’s time evaluating these events by providing faster and more accurate screening methods and improving the patient care experience.

BRIDGeS (Building Resourceful Interactions Despite Grief and Stress)

• Eileen Knightly, MHA, RN, BSN, OSF HealthCare
• Carolyn Dickens, PhD, APRN, ACNP-BC, University of Illinois Chicago

This project addresses the growing issue of violence and incivility in the community and its impact on patient care in hospitals. It utilizes findings from a 2022 community health needs assessment to address cultural and communication barriers affecting nursing staff and patients. Nurse burnout, caused by prolonged stress, has worsened due to staffing shortages, documentation burden and increased violence.

Developing Tools to Empower Patient Understanding, Management and Communication of Condition

• Jonathan Handler, MD, OSF HealthCare
• Michael J. Scott, PhD, University of Illinois Chicago

This project will focus on social determinants of health (SDoH) and consider solutions that empower the patient to more accurately track and communicate their conditions before they reach the reactive state. The approach is to change the way patients engage with their health-related data and provide better tools to convey this information to their care provider.

Harnessing Mobile Technology to Diagnose Migraines in Rural Communities

• Hrachya Nersesyan, MD, PhD, OSF HealthCare
• Yelena Nersesyan, MD, PhD, University of Illinois Chicago

The goal of this project is to test and improve the MiGRO app that enables providers to quickly and accurately diagnose and treat migraines, resulting in better health outcomes and improved patient satisfaction. The app also streamlines the referral process, allowing providers to quickly refer patients to migraine specialists, reducing medical costs and improving access to care in rural areas.

Improving Cancer Screening in Underserved High-Risk Populations

• Lisa Barker, MD, FACEP, OSF HealthCare
• Elizabeth Papautsky, PhD, MS, University of Illinois Chicago

This project seeks to characterize the current barriers to completion of screening recommendations among patients at high risk for breast cancer, then use that data to create and pilot test an “intervention bundle” to optimize rates of breast MRI completion for eligible high-risk patients. With attention to the underserved communities within the OSF service population, this project will contribute to reduced health disparities by reducing barriers to care in the context of timely breast cancer diagnosis.

UI Health Pancreatic Cancer Screening Initiative

• Jason Bill, MD, OSF HealthCare
• Paul Grippo, PhD, University of Illinois Chicago

The project aims to develop an infrastructure of early community engagement with clinical trials for all types of cancer. The goal is to address the increasing technological development in screening modalities without simultaneously widening the gap in morbidity rates of cancer within underserved communities. With this health care protocol in place, the team hopes to increase accessibility of clinical trials using methods that are showing promising results in pancreatic cancer detection.