Kenneth Yu, MD, MSc, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, called investigational ­PEGPH20 “a very promising tumor microenvironment-targeted approach” that appears to be well tolerated. “The results are preliminary but there appears to be a biomarker to predict response—high [hyaluronan] expression.”

Dr. Yu reiterated that PEGPH20 is a pegylated enzyme that hydrolyzes molecular hyaluronic acid, which is a major component of pancreatic tumors. Preclinical data suggest that it can improve the delivery of chemotherapy by creating holes within the tumor vasculature.

Based on the data, he said, a number of research questions can be raised: Why are some tumors hyaluronan-high or hyaluronan-low? How reliable is hyaluronan testing? How heterogeneous is hyaluronan level among tumors of individual patients? Is biopsy of the primary tumor more predictive?

“This study highlights the potential that we may be entering an era when pancreatic cancer is a biomarker-directed disease,” he said. “We eagerly await results of a prospective validation randomized phase III trial.” ■

Disclosure: Dr. Yu reported no potential conflicts of interest.