PALACROS – Prioritising multimodal surgical care for patients with locally advanced pancreatic cancer across Europe

Project Summary:

Pancreatic cancer kills faster than almost any other cancer in Europe — only 13% of patients survive five years past diagnosis. For the more than 50,000 Europeans diagnosed every year with locally advanced pancreatic cancer (LAPC), the tumour has grown into the blood vessels surrounding the pancreas, and in most of Europe, that’s treated as a final verdict: fewer than 5 in 100 of these patients ever make it to surgery.

It doesn’t have to be that way. At a handful of expert hospitals, combining the right chemotherapy with highly specialised surgical techniques has pushed resection rates up to 20% — four times the European average — extending and saving lives. The problem isn’t that we don’t know how to help these patients. It’s that almost nobody outside a few elite centres knows how, or has the hard evidence needed to justify trying.

PALACROS exists to close that gap.

Project Coordinator: Amsterdam UMC (The Netherlands)

What PALACROS Will Do

1. Run Europe’s first international randomised controlled trial putting surgery head-to-head against MRI-guided radiotherapy, to finally prove — with real evidence — which approach gives patients the best chance.
2. Put patients at the centre of what “success” means, developing an agreed set of outcomes covering survival, quality of life, mental health, and cost — designed together with patients themselves.
3. Train surgeons across Europe in the advanced techniques currently locked inside a handful of elite hospitals, through hands-on workshops, fellowships, and shared surgical standards.
4. Build and validate an AI tool that helps doctors identify, from CT and MRI scans, which patients are genuinely good candidates for surgery — replacing guesswork with consistent, evidence-based decisions.
5. Design a practical blueprint so what works at expert centres can be adopted by hospitals across Europe, with pilots in real countries to demonstrate it works in practice.
6. Test two additional innovative therapies — OncoSil and ChemoGel — for patients who don’t qualify for the main trial, opening new possibilities to shrink tumours or even make surgery possible later.
7. Build a secure, EU-compliant data and biobank platform, so hospitals across the consortium can safely pool information and samples, both during the project and for years afterward.
8. Turn every result into real change: updated clinical guidelines, new reimbursement policies, and revised national cancer plans — so evidence, not geography, determines who gets access to life-saving treatment.

By the end of the project, PALACROS aims to double LAPC surgery rates — from under 5% to 10% — in at least six countries, extend median survival by six months, and give thousands of patients access to a treatment option that is not yet routinely available across Europe.

Pancreatic Cancer Europe’s Role

PCE is a full partner in PALACROS, leading Work Package 8 (connecting the science to patients, clinicians, and policymakers) and the project’s Patient Advisory Board (giving LAPC patients a say in the trials and outcomes). PALACROS belongs to the EU Cancer Mission’s Innovative Surgery cluster, working with the European Commission to expand access to quality cancer care across Europe.

Diagnosis and Treatment – Innovative Surgery Cluster

PALACROS is part of the “Diagnosis and Treatment – Innovative Surgery” cluster of the EU Cancer Mission — projects funded under Horizon Europe to establish innovative surgery as a cornerstone of affordable, multimodal cancer care. Cluster projects meet annually, in collaboration with the European Commission, to harmonise research methods, exchange strategies for engaging patients and citizens, and tackle one of Europe’s most persistent problems together: unequal access to quality cancer care.

Disclaimer

Funded by the European Union. Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the European Union or the European Health and Digital Executive Agency (HaDEA). Neither the European Union nor HaDEA can be held responsible for them.