Montreal Doctor Leads World First Pancreatic Cancer Treatment

By Joseph Marshall

A Montreal doctor at the Jewish General Hospital is leading an international effort to develop a new treatment for pancreatic cancer, using Israeli technology to deliver radioactive material directly into tumours that cannot be removed surgically. Dr. Corey Miller, Director of Therapeutic Endoscopy at the Jewish General Hospital, performed the world’s first endoscopic ultrasound guided treatment of pancreatic cancer using Alpha DaRT, a technology developed from research at Tel Aviv University.

The initial Montreal study involved 32 patients with advanced pancreatic cancer, including 18 whose cancer had already spread beyond the pancreas. In three patients, the treated pancreatic tumour completely disappeared on imaging, four others had a partial response and 19 had stable disease. Researchers reported disease control in 26 of the 32 patients, results that have since led to larger studies in Canada, Israel, the United States and Europe.

The treatment is delivered from inside the tumour. Miller passes an endoscope through the mouth and into the stomach, uses ultrasound to locate the pancreatic tumour, and then passes a needle through the stomach wall to implant tiny radioactive sources containing radium 224 directly into the cancer. Those sources release alpha radiation over a very short distance, attacking the tumour from inside while reducing the amount of radiation reaching surrounding tissue.

The technology was developed from research by Prof. Itzhak Kelson and Prof. Yona Keisari at Tel Aviv University and is now being developed by Jerusalem based Alpha Tau Medical. Their work eventually led to a treatment platform that had already been studied in other solid tumours, but the Jewish General became the first centre in the world to use it inside the pancreas.

Miller joined the Jewish General’s Division of Gastroenterology in 2020. He received his medical degree from McGill University, completed his internal medicine residency and gastroenterology fellowship at McGill, and later trained in advanced endoscopy at Beth Israel Deaconess Medical Center, a Harvard Medical School teaching hospital in Boston. He is now Director of Therapeutic Endoscopy at the Jewish General, an Assistant Professor of Medicine at McGill and an associate researcher at the Lady Davis Institute, with much of his work focused on advanced procedures involving the pancreas and biliary system.

The first study was conducted at the Jewish General Hospital and CHUM, with the Alpha DaRT sources successfully implanted in all 32 patients. Most of the treatment related complications were mild or moderate. Three Grade 3 events were reported, including biliary obstruction and bacteremia, both of which were resolved, and there were no treatment related deaths.

The research has since expanded well beyond the original Montreal group. Data presented in 2026 combined results from three prospective studies involving 58 pancreatic cancer patients treated in Montreal and Israel. Researchers reported disease control in 87 percent of patients, with three complete responses and nine partial responses. The Jewish General is now part of a larger international study looking at Alpha DaRT together with standard chemotherapy in newly diagnosed patients with unresectable pancreatic cancer, while additional pancreatic cancer programs are underway in the United States, Israel and Europe.

Miller has also travelled to other centres to help physicians learn how to perform the procedure, taking a technique first used at the Jewish General and helping move it into hospitals outside Canada. Work is continuing in Montreal on better imaging and navigation systems to improve placement of the radioactive sources inside tumours, while Miller has also been involved in plans to study Alpha DaRT together with immunotherapy.

Pancreatic cancer remains one of the deadliest cancers in Canada. The Canadian Cancer Society estimates that approximately 7,500 Canadians will be diagnosed with the disease in 2026 and about 6,500 will die from it. Alpha DaRT has already received approval in Japan for certain unresectable head and neck cancers and in Israel for some cancers of the skin and oral cavity, while its use in pancreatic cancer remains under clinical study.

What began with research at Tel Aviv University and the first pancreatic cancer procedures at the Jewish General is now moving through a growing international network of cancer centres. The larger studies will determine where Alpha DaRT ultimately fits in pancreatic cancer treatment, but the work that began in Montreal is no longer a small experimental program involving a handful of patients. It has become an international clinical effort, and the Jewish General remains one of the centres driving it forward.