Despite the fact that exocrine pancreatic cancer ranks as one of the most lethal forms of neoplasm, with a mortality/incidence rate nearing 98% in both industrialized and developing countries, little improvements has been made in recent decades by means of standard cytotoxic treatment. New effective and non-toxic methods are badly needed. Objective: To further evaluate the therapeutic impact of the method of competitive inhibition of tumor enzymatic activity by means of structural analogs (CISA

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... protocol) on pancreatic cancer patients, and to assess the robustness of our previous conclusions considering an improved N value. Methods: The clinical outcome of 27 pancreatic cancer patients undergoing the CISA protocol (Competitive Inhibition with Structural Analogs), with no other concomitant therapy, were tabulated to determine overall survival and one-year survival rates. Tumor remission and progression-free survival were also evaluated. Measurements of the effect size were chosen over statistical significance as a means of evaluation of relevant data. Results: Following up on a previous Randomized Controlled Clinical Trial on the metabolic therapy of exocrine pancreatic cancer, these authors have found that the one-Year Survival rate (YS) of our study (N=27) has remained above 70%, while overall survival (OS) increased to 27,82 (4-76) months. The YS of the subset of patients with no metastasis at the time of diagnosis stayed at 100%. It has become apparent that OS of the treated group has come to be 5.6 times the OS reported worldwide, which stands at 4,5 (3-6) months. Conclusion: The magnitude of the observed effects suggests that the metabolic therapy of pancreatic cancer allows for a substantial increase in both parameters of survival, particularly in patients with no metastatic lesions at T 0 . Prieto Gratacós E (2019) Impact of non-toxic metabolic disruptors on overall survival and one-year survival rate in exocrine pancreatic cancer. Update and observations on early intervention Prieto Gratacós E (2019) Impact of non-toxic metabolic disruptors on overall survival and one-year survival rate in exocrine pancreatic cancer. Update and observations on early intervention