Aotearoa Australia Pancreatic Enzyme Replacement Therapy (ASPERT)

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. 

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.

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.

• Professor Meera Agar, IMPACCT Director and CST Chair
• Dr Chris Baggoley, Consumer Representative
• Linda Brown, PaCCSC/CST National Manager
• John Clements, Consumer Representative
• Professor David Goldstein, Prince of Wales Clinical School, UNSW Medicine
• 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
• Selena (Yue-Xian) Ooi, Senior Clinical Dietitian, Nutrition Services, Royal North Shore Hospital
• 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 

• Dr Juhaina Al Ruheili, GP Registrar and Medical Officer, Te Omanga Hospice
• 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
• Hinetewai, Māori liaison, Nurse Maude 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
• Louise Daly, Summer Student
• Dr Niamh Fanning, Research Fellow
• Fong Fu, Medical Student

Dana Lewis, Researcher and Consumer Representative