The ASPERT Research Group is a collaborative of researchers working to address the lack of access to Pancreatic Enzyme Replacement Therapy (PERT) by people with pancreatic cancer in Aotearoa New Zealand and Australia.
Cancer Symptom Trials (CST), the University of Otago Department of Medicine and Nurse Maude Hospice are working in collaboration as the ASPERT Research Group to address the perceived lack of access of Pancreatic Enzyme Replacement Therapy (PERT) by people with pancreatic cancer in Aotearoa New Zealand and Australia.
We want to understand the prescribing of and compliance with PERT by investigating current practices in both countries with a view to highlighting the current gaps.
The problem
Pancreatic cancer has a poor prognosis, with a survival rate of five years for only 5% of people diagnosed. In addition, people with pancreatic cancer face symptoms that reduce their quality of life.
The pancreas secretes enzymes that enable the body to digest proteins, fats and carbohydrates. For people with pancreatic cancer, the amount of enzymes secreted is often insufficient for normal digestion. This is called pancreatic exocrine insufficiency (PEI).
PEI can occur as a result of the disease and/or the treatments including surgery. It leads to malabsorption and poor digestion with symptoms that include diarrhoea, excessive flatulence, cramping, fatty stools, abdominal bloating and weight loss.
PERT
PEI can be treated with Pancreatic Enzyme Replacement Therapy (PERT), which improves fat, protein and carbohydrate digestion as well as symptoms of malabsorption.
PERT may slow down the rate of weight loss, improve quality of life and allow people with pancreatic cancer to better tolerate chemotherapy.
Our literature review indicates that PERT may help increase survival rates and we hope our research will provide more data to improve the evidence of PERT’s effectiveness.
The challenge
Our systematic literature review has shown a lack of good quality evidence in the use of PERT for people with advanced pancreatic cancer.
There are international guidelines that outline the use of PERT in this population but research shows poor adherence globally.
It is vital that we investigate current practices in Aotearoa New Zealand and Australia to understand the frequency, dose range and circumstances in which PERT is being prescribed for people with advanced pancreatic cancer.
Pancreatic cancer treatment survey – Australia and Aotearoa New Zealand
We are currently conducting a survey of people with pancreatic cancer in Australia and Aotearoa New Zealand. The goal of the survey is to help us identify better access to treatments for all Australians and New Zealanders with pancreatic cancer.
If you live in Australia or Aotearoa New Zealand and have a diagnosis of pancreatic cancer, you can complete a short (7 minute) survey to help identify how access to PERT might be improved for those who need it.
Find out more and access the survey
If you would like to be notified of the survey outcomes, please sign up to receive our bulletin by email to: aspert@otago.ac.nz.
PERT information for people with pancreatic cancer
pert information brochure - aotearoa new Zealand (pdf, 585kb)
pert information pankind [opens external site]
In the media
August 2024 1News [opens external site]
Otago Daily Times – Registry launched to improve access July 2024 [opens external site]
New Zealand Doctor – Registry launched to improve patient access to pancreatic cancer therapy [opens external site]
RNZ interview – helping cancer patients get the therapy they need July 2024 [opens external site]
calls to improve pancreatic cancer care - otago daily times [opens external site]
a new research team wants to ensure pancreatic cancer patients have a better quality of life - NZcity [opens external site]
Publications
- Amanda Landers, Helen Brown, Kylie Russell, Niamh Fanning, Fong Fu, Clare McKenzie, Meera R. Agar, Vanessa M. Yenson, Kate Clarke, and John Windsor. "Prescribing of pancreatic enzyme therapy for malabsorption in unresectable pancreatic cancer: Cross-sectional survey across New Zealand and Australia." Pancreatology 24, no. 8 (2024): 1288-1293.
- Amanda Landers, Charlotte Cahill, Poppy McCall et al. Helping the voices of people with pancreatic cancer to be heard: a mixed media methodology to optimise recruitment for an international survey of pancreatic enzyme replacement, 01 June 2023, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-3007373/v1]
- Amanda Landers, Helen Brown, Juhaina Al Ruheili, Kylie Russell, Clare McKenzie, Meera R. Agar, Vanessa M. Yenson, Kate Clarke, and John Windsor. "Patient-reported use of pancreatic enzyme replacement treatment (PERT) in pancreatic cancer in New Zealand and Australia: a cross-sectional survey study." Supportive care in cancer 32, no. 6 (2024): 402.
- Pancreatic enzyme replacement therapy (PERT) for the treatment of pancreatic exocrine insufficiency (PEI)
- Landers, Amanda MBChB, FRACP, FaChPM; Donaldson, Francis BHealSc; Brown, Helen NZRD, DipHSc; McKenzie, Clare RN, MNClin; Pendharkar, Sayali PhD. The Impact of Pancreatic Enzyme Replacement Therapy on Patients With Advanced Pancreatic Adenocarcinoma: A Systematic Review and Narrative Synthesis. Pancreas: May 2022 - Volume 51 - Issue 5 - p 405-414 doi: 10.1097/MPA.0000000000002049
Webinars
The power of pert - world pancreatic cancer coaltiions education series (youtube)
Gut Cancer foundation diet and nutrition in pancreatic cancer (youtube)
Conference posters
food, aroha and hope in the face of advanced pancreatic cancer - NZSO 2021 (PDF, 467KB)
the neglected cancer: enzyme replacement in advanced pancreatic cancer - opcc 2021 (pdf, 70kb)
Project bulletin
To subscribe to the ASPERT bulletin, please email aspert@otago.ac.nz.
aspert bulletin - december 2024 (pdf, 1695kb)
Aspert Bulletin - July 2024 (pdf, 748kb)
aspert bulletin - march 2024 (pdf, 688kb)
ASPERT BULLETIN - NOVEMBER 2023 (PDF, 1,275KB)
aspert bulletin - july 2023 (pdf, 1,326kb)
aspert BULLETIN - april 2023 (pdf, 675kb)
aspert bulletin - december 2022 (PDF, 1181kb)
aspert bulletin - SEPTEMBER 2022 (pdf, 659kb)
aspert bulletin - june 2022 (pdf, 604kb)
aspert bulletin - march 2022 (PDF, 2117KB)
aspert bulletin - December 2021 (pdf, 1930kb)
ASPERT bulletin - September 2021 (PDF, 1604kb)
ASPERT Bulletin - May 2021 (pdf, 246kb)
ASPERT Bulletin - February 2021 (pdf, 243kb)
Investigation team
- Dr Amanda Landers, Principal Investigator [opens external site]
Australian team
- Professor Meera Agar, IMPACCT Director and CST Chair
- Dr Chris Baggoley, Consumer Representative
- Associate Professor Savio George A. Da P. Barreto, College of Medicine and Public Health, Flinders University
- John Clements, Consumer Representative
- Dr Jodie Ellis, Department Head, Dietetics, Speech and Psychology, Calvary Health Care Kogarah
- Dr Anubhav Mittal, Hepatobiliary and Pancreatic Surgeon, Faculty of Medicine and Health, The University of Sydney
- Yuexian (Selena) Schultz, Clinical Dietitian, Flinders Medical Centre
- Paris Osborne, Clinical Dietitian, Flinders Medical Centre
- Karen Percy, Nutrition Services, Nutrition Services, Royal North Shore Hospital
- Associate Professor Natalie Taylor, Director of Research, School of Population Health, University of New South Wales
- Dr Vanessa Yenson, CST Research Assistant-Writer
Aotearoa New Zealand team
- Helen Brown, Palliative Care Dietitian, Hospice Palliative Care Service, Nurse Maude Association
- Dr Kate Clarke, Medical Oncologist, Wellington
- Megan Copland, Dietitian, Nurse Maude Palliative Care Association
- Clare McKenzie, Hospice Palliative Care Service, Nurse Maude Association
- Kylie Russell, Specialist Hepatopancreaticobiliary and Gastroenterology Dietitian
- Dr Matthew Strother, Medical Oncologist, Canterbury District Health Board
- Professor John Windsor, Department of Surgery, Auckland District Health Board
- Dr Niamh Fanning, Research Fellow
International team
Dana Lewis, Researcher and Consumer Representative
Email and social
ASPERT Research Group
@aspertstudy [opens external site]
aspertstudy [opens external site]
@aspertstudy [opens external site]
Cancer Symptom Trials (CST)
@UTS_CST [opens external site]