Multidisciplinary approach: surgery, chemotherapy, targeted therapy, and immunotherapy
Pancreatic cancer is one of the most challenging oncological diseases to diagnose and treat. At the Ichilov (Sourasky) Medical Center in Tel Aviv, a multidisciplinary team addresses this pathology: hepatopancreatobiliary oncologists, gastroenterologists, specialists in radiotherapy and chemotherapy, radiologists, pathomorphologists, and geneticists. This approach allows for a quick clarification of the diagnosis, determination of the stage (T, N, M), and biological subtype of the tumor, usually within 3–5 working days, followed by the formation of an individualized treatment protocol.
Diagnosis at Ichilov includes endoscopic ultrasound (EUS) with fine-needle biopsy, PET-CT, MRI with cholangiopancreatography (MRCP), tumor markers (CA 19-9, CEA), and molecular genetic testing of tumor tissue — including mutations in BRCA1/2, KRAS, microsatellite instability (MSI), and NTRK. The obtained data directly influence the choice of treatment: patients with BRCA mutations may receive PARP inhibitors, while those with MSI-high may be eligible for checkpoint immunotherapy.
Surgical treatment is performed through Whipple's procedure (pancreaticoduodenectomy), distal or total pancreatectomy — including vascular reconstruction in cases of locally advanced tumors. Neoadjuvant chemotherapy protocols such as FOLFIRINOX and Gemcitabine + nab-Paclitaxel are actively used, allowing borderline and initially unresectable tumors to be converted to a resectable state. For patients with metastatic forms, targeted therapies, immunotherapy, and phase I–III clinical trials are available, which the Ichilov Oncology Center, as a leading academic center in Israel, has access to.
This subsection combines practical materials for patients and their relatives: how diagnosis is structured, what protocols are applied at each stage, how pancreatic head cancer differs from tumors of the body and tail, what VIPomas and other neuroendocrine tumors are, when a cyst requires monitoring, and when it requires surgery. Below are articles, examination and treatment programs, as well as specialized doctors from Ichilov.