Treatment and Survivorship

New preclinical and clinical studies investigating treatment options for pancreatic cancer patients.

FDA Approves New Treatment for Certain Digestive Tract Cancers
PanCAN articles: Lutathera® Drug Approved for Pancreatic Neuroendocrine Tumors and 5 Key Facts about PNETs
The U.S. Food and Drug Administration approved Lutathera (lutetium Lu 177 dotatate) for the treatment of a type of cancer that affects the pancreas or gastrointestinal tract called gastroenteropancreatic neuroendocrine tumors (GEP-NETs). This is the first time a radioactive drug, or radiopharmaceutical, has been approved for the treatment of GEP-NETs. Lutathera is indicated for adult patients with somatostatin receptor-positive GEP-NETs.

PanCAN’s Precision Medicine Results Featured at Major Meeting
GI Cancers Symposium abstracts: Multiomic molecular comparison of primary versus metastatic pancreatic tumors; Molecular and clinical characterization of BRAF mutations in pancreatic ductal adenocarcinomas (PDACs) and Introduction of #PancChat: A novel Twitter platform to inform and engage the pancreatic cancer community
Two of the PanCAN-affiliated posters presented at the GI Cancers Symposium relate to the organization’s Know Your Tumor® precision medicine service, prepared in collaboration with the precision medicine company Perthera and research partners at several major institutions. The final poster involving PanCAN that will be presented at this year’s GI Cancers Symposium switches gears to social media – and how Twitter can facilitate disease-specific conversations.

Consensus Statement on Mandatory Measurements in Pancreatic Cancer Trials (COMM-PACT) for Systemic Treatment of Unresectable Disease
Journal: The Lancet Oncology
Institution(s): Cancer Center Amsterdam, Academic Medical Center, Amsterdam, Netherlands, and others
Corresponding author(s): Hanneke W M van Laarhoven
PanCAN-affiliated authors: Jordan Berlin, Eileen O’Reilly, Philip Philip
Major finding: The COnsensus statement on Mandatory Measurements in unresectable PAncreatic Cancer Trials (COMM-PACT) identifies a mandatory set of baseline and prognostic characteristics to allow adequate comparison of outcomes between pancreatic cancer studies.

Determinants and Prognostic Value of Quality of Life in Patients with Pancreatic Ductal Adenocarcinoma
PanCAN article: Study Shows Quality of Life Impacts Survival
Journal: European Journal of Cancer
Institution(s): The University of Texas MD Anderson Cancer Center, Houston, TX, and others
Corresponding author(s): Xifeng Wu
PanCAN-affiliated author: Alison Klein
Major finding: Quality of life (QOL) after diagnosis is a significant prognostic indicator for patients with pancreatic ductal adenocarcinoma (PDAC). Multiple factors determine QOL, suggesting possible means of intervention to improve QOL and outcomes of PDAC patients.

Efficacy of Larotrectinib in TRK Fusion-Positive Cancers in Adults and Children
Journal: New England Journal of Medicine
Institution(s): Memorial Sloan Kettering Cancer Center, New York, NY, and others
Corresponding author(s): David Hyman
PanCAN-affiliated author: Jordan Berlin
Major finding: Larotrectinib had marked and durable antitumor activity in patients with tropomyosin receptor kinases (TRK) fusion-positive cancer, regardless of the age of the patient or of the tumor type.

Activity of Mesothelin-specific Chimeric Antigen Receptor T cells Against Pancreatic Carcinoma Metastases in a Phase 1 Trial
Journal: Gastroenterology
Institution(s): University of Pennsylvania, Philadelphia, PA
Corresponding author(s): Gregory Beatty
PanCAN-affiliated author: Gregory Beatty
Major finding: The authors engineered T cells to transiently express an mRNA encoding a chimeric antigen receptor (CAR) specific for mesothelin-a protein that is over-expressed by pancreatic ductal adenocarcinoma (PDAC) cells. Their results provide evidence for the potential anti-tumor activity of mRNA mesothelin-specific CAR T cells (CARTmeso cells) cells, as well as PDAC resistance to the immune response.

Genomics-Driven Precision Medicine for Advanced Pancreatic Cancer: Early Results from the COMPASS Trial
Journal: Clinical Cancer Research
Institution(s): Princess Margaret Cancer Centre, Toronto, ON, Canada, and others
Corresponding author(s): Xifeng Wu
Major finding: Prospective genomic profiling of advanced pancreatic ductal adenocarcinoma is feasible and the authors’ early data indicate that chemotherapy response differs among patients with different genomic/transcriptomic subtypes.

Expression of Dihydropyrimidine Dehydrogenase (DPD) and hENT1 Predicts Survival in Pancreatic Cancer
Journal: British Journal of Cancer
Institution(s): University of Liverpool, Liverpool, UK, and others
Corresponding author(s): William Greenhalf
Major finding: Dihydropyrimidine dehydrogenase (DPD) tumor expression was a negative prognostic biomarker. Together with tumor expression of human equilibrative nucleoside transporter-1 (hENT1), DPD tumor expression defined patient subgroups that might benefit from either postoperative 5-fluorouracil/folinic acid (5FU/FA) or gemcitabine.

Dynamic Changes During the Treatment of Pancreatic Cancer
Journal: Oncotarget
Institution(s): MD Anderson Cancer Center, Houston, TX, and others
Corresponding author(s): Arnold Levine
PanCAN-affiliated authors: Andrea Wang-Gillam, Anirban Maitra and David Tuveson
Major finding: This detailed analysis of the clinical descriptions, imaging, pathology, molecular and cellular evolution of the tumors, treatments, and responses to chemotherapy, targeted therapies, and immunotherapies, as well as attempts at the development of personalized medical treatments for a single patient should provide a valuable guide to future directions in cancer treatment.

Neoadjuvant Therapy Affects Margins and Margins Affect All: Perioperative and Survival Outcomes in Resected Pancreatic Adenocarcinoma
Journal: HPB
Institution(s): Boston University School of Medicine, Boston, MA, and others
Corresponding author(s): Jennifer Tseng
PanCAN-affiliated author: Jennifer Tseng
Major finding: While neoadjuvant therapy is associated with decreased R1/R2-resection rates after pancreaticoduodenectomy, the poor prognostic impact of positive margins is not abrogated by neoadjuvant therapy, stressing the need for complete tumor clearance and postoperative treatment even after neoadjuvant therapy.

Gemcitabine and Taxane Adjuvant Therapy with Chemoradiation in Resected Pancreatic Cancer: A Novel Strategy for Improved Survival?
Journal: Annals of Surgical Oncology
Institution(s): Virginia Mason Medical Center, Seattle, WA
Corresponding author(s): Flavio Rocha
PanCAN-affiliated author: Vincent Picozzi
Major finding: Adjuvant gemcitabine-taxane combination chemotherapy (gem/ax) with or without chemoradiation is feasible, with a favorable overall survival. Future prospective studies of gem/tax-based adjuvant treatment for pancreatic cancer are warranted.

Evaluating Mismatch Repair Deficiency in Pancreatic Adenocarcinoma: Challenges and Recommendations
Journal: Clinical Cancer Research
Institution(s): Memorial Sloan Kettering Cancer Center, New York, NY, and others
Corresponding author(s): Eileen O’Reilly
PanCAN-affiliated author: Christine Iacobuzio-Donahue and Eileen O’Reilly
Major finding: An integrated approach of germline testing and somatic analyses of tumor tissues in advanced pancreatic ductal adenocarcinoma (PDAC) using next-generation sequencing (NGS) may help guide future development of immune and molecularly directed therapies in PDAC patients.

Imaging-Based Biomarkers: Changes in the Tumor Interface of Pancreatic Ductal Adenocarcinoma on Computed Tomography Scans Indicate Response to Cytotoxic Therapy
Journal: Cancer
Institution(s): The University of Texas MD Anderson Cancer Center, Houston, TX, and others
Corresponding author(s): Eugene Koay
PanCAN-affiliated authors: Huamin Wang, Anirban Maitra, Jason Fleming, Joseph Herman, Eugene Koay
Major finding: Changes at the pancreatic ductal adenocarcinoma (PDAC)/parenchyma interface may serve as an early predictor of response to therapy.

Analyzing the Impact of Compliance with National Guidelines for Pancreatic Cancer Care Using the National Cancer Database
Journal: Journal of Gastrointestinal Surgery
Institution(s): Geisinger Medical Center, Danville, PA
Corresponding author(s): Kathryn Jaap
Major finding: Adherence to National Comprehensive Cancer Network guidelines for pancreatic cancer patients improves survival. Compliance nationwide is low, especially for older patients and minorities and those treated outside academic centers. More studies will need to be performed to identify factors that hinder compliance.

Amphiphilic Nanocarrier-induced Modulation of PLK1 and miR-34a Leads to Improved Therapeutic Response in Pancreatic Cancer
Journal: Nature Communications
Institution(s): Tel Aviv University, Tel Aviv, Israel, and others
Corresponding author(s): Ronit Satchi-Fainaro
Major finding: Here the authors show a potent combination of microRNA and siRNA delivered by an efficient nanocarrier to pancreatic ductal adenocarcinoma (PDAC) tumors. Taken together, their findings warrant this unique combined polyplex’s potential as a novel nanotherapeutic for PDAC.

Personalized RNA Medicine for Pancreatic Cancer
Journal: Clinical Cancer Research
Institution(s): Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, and others
Corresponding author(s): Frank Slack
PanCAN-affiliated author: Manuel Hidalgo
Major finding: In this study, the authors tested whether RNA-based therapeutics were suitable for personalized medicine by using patient-derived-organoid (PDO) and patient-derived-xenograft (PDX) models. This general approach appears suitable for co-clinical validation of personalized RNA medicine and paves the way to prospectively identify patients with eligible miRNA profiles for personalized RNA-based therapy.

Global Surveillance of Trends in Cancer Survival 2000-14 (CONCORD-3): Analysis of Individual Records for 37 513 025 Patients Diagnosed with One of 18 Cancers from 322 Population-based Registries in 71 Countries
Journal: The Lancet
Institution(s): London School of Hygiene & Tropical Medicine, London, UK, and others
Corresponding author(s): Claudia Allemani
Major finding: The CONCORD program enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. Governments must recognize population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer.

Pancreatic Cancer Subtypes: A Roadmap for Precision Medicine
Journal: Annals of Medicine
Institution(s): University of Illinois at Chicago, Chicago, IL
Corresponding author(s): Carolina Torres
PanCAN-affiliated author: Paul Grippo
Major finding: The ultimate goal of this review is to identify current challenges in this area and summarize current efforts in developing clinical modalities that can effectively identify these subtypes in order to advance Precision Medicine.

ChemoCentryx Announces Positive Overall Survival Results with CCR2 Inhibitor CCX872 for Locally Advanced/Metastatic Pancreatic Cancer
Company: ChemoCentryx, Inc., Mountain View, CA
Major finding: ChemoCentryx, Inc., announced positive overall survival (OS) results from an ongoing Phase Ib clinical trial of the Company’s second CCR2 inhibitor -- CCX872 -- in the treatment of locally advanced/metastatic pancreatic cancer.

FibroGen Granted Fast Track Designation by U.S. FDA for Pamrevlumab Treatment of Patients with Locally Advanced Unresectable Pancreatic Cancer
Company: FibroGen, Inc., San Francisco, CA
Major finding: FibroGen, Inc., announced that the U.S. Food and Drug Administration (FDA) has granted Fast Track designation for the company’s anti-CTGF antibody, pamrevlumab, for the treatment of patients with locally advanced unresectable pancreatic cancer. This follows review of the Phase 2 clinical trial evaluating pamrevlumab in combination with gemcitabine and nab-paclitaxel and represents recognition by the FDA that pamrevlumab has the potential to address an unmet medical need for this disease.

BERG Announces FDA Orphan-Drug Designation of BPM31510 for the Treatment of Pancreatic Cancer
Company: BERG, Boston, MA
Major finding: BERG, a Boston-based biopharmaceutical company that merges biology with technology to map the nature of diseases, announced the U.S. Food and Drug Administration (FDA) has granted orphan-drug designation to the Company’s leading product candidate BPM31510, for the treatment of pancreatic cancer. BPM31510 is a first in class molecule that specifically targets the dysregulated metabolism observed in cancer.

The US FDA Granted Orphan Drug Designation to Yisheng Biopharma’s Biological Product for Pancreatic Cancer Treatment
Company: Yisheng Biopharma Co., Ltd., Beijing, China
Major finding: Yisheng Biopharma, a biopharmaceutical company focusing on research, development, manufacturing, sales and marketing of immunological biologics and vaccines, announced that the U.S. Food and Drug Administration (FDA) has granted orphan drug designation (ODD) for its lead immuno-oncology candidate, YS-ON-001, for the treatment of pancreatic cancer. YS-ON-001 is a multi-component complex with broad immunomodulating properties, such as promoting Th1-biased immunity, inducing the activation and proliferation of dendritic cell (DC), B and natural killer cells (NK cells), promoting macrophage M1 polarization and downregulating regulatory T cells.