Nab-paclitaxel/Gemcitabine/Cisplatin for Previously Untreated, Advanced Pancreatic Cancer
In a phase Ib/II pilot study reported in JAMA Oncology, Jameson et al found that treatment with nab-paclitaxel, gemcitabine, and cisplatin was active in patients with previously untreated metastatic pancreatic ductal adenocarcinoma. Study Details In the study, 25 patients were enrolled between...
2019 Supportive Care: Racial Disparities in Use of Hospice Care Near Death Among Patients With Pancreatic Cancer
A study investigating the utilization of hospice care among racial/ethnic minority patients following treatment for pancreatic cancer has found that African American and Hispanic patients who underwent surgical removal of the pancreas were less likely than white patients to use hospice services at...
New Results From the TAPUR Study Reported in JCO Precision Oncology
New results from ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) Study demonstrated that single-agent palbociclib has no meaningful clinical activity in patients with CDKN2A-mutated or -deleted advanced pancreatic adenocarcinoma and cholangiocarcinoma. The results, based on data...
ESMO 2019: High Conversion Rate With Certain Induction Chemotherapy Regimens Is Associated With Improved Overall Survival in Locally Advanced Pancreatic Cancer
Induction chemotherapy with nab-paclitaxel plus gemcitabine or sequential FOLFIRINOX (fluorouracil, leucovorin, oxaliplatin, and irinotecan) followed by surgical exploration induced high conversion rates in patients with locally advanced pancreatic cancer, and conversion was associated with...
Volker Kunzmann, MD, on Advanced Pancreatic Cancer: Findings on nab-Paclitaxel/Gemcitabine and FOLFIRINOX
Volker Kunzmann, MD, of the University of Würzburg/Comprehensive Cancer Center Mainfranken, discusses the final results of a phase II multicenter trial on the conversion rate in locally advanced pancreatic cancer after nab-paclitaxel/gemcitabine- or FOLFIRINOX-based induction chemotherapy (Abstract 671O).
Sita Kugel, PhD, Receives Grant to Study Aggressive Type of Pancreatic Cancer
The deadly nature of most pancreatic tumors is well known, with less than 10% of patients with pancreatic ductal adenocarcinoma estimated to survive 5 years after diagnosis. Recent molecular analyses of pancreatic ductal adenocarcinoma have shown that a patient’s prognosis changes depending on the...
ASTRO Guideline on Use of Radiation Therapy for Patients With Pancreatic Cancer
A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides recommendations on the use of radiation therapy to treat patients diagnosed with pancreatic cancer, including when radiation treatments are appropriate, as well as the optimal dosing, timing, and...
Results From the TAPUR Study on Palbociclib for Pancreatic Cancer and Cholangiocarcinoma
New results from ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) study have demonstrated that single-agent palbociclib has no meaningful clinical activity in patients with CDKN2A-mutated or -deleted advanced pancreatic adenocarcinoma and cholangiocarcinoma. These findings were...
Role of the YAP Regulatory Network in Pancreatic Ductal Adenocarcinoma
Researchers have decoded a chain of molecules that are critical for the growth and survival of pancreatic ductal adenocarcinoma. They say their findings, published by Murakami et al in Developmental Cell, suggest that inhibiting the YAP biologic network may effectively regress early-stage...
USPSTF Recommendation on Screening for Pancreatic Cancer in Asymptomatic Adults
As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF), in a reaffirmation of its 2004 recommendation, has recommended against screening for pancreatic cancer in asymptomatic adults (a grade D recommendation).1 In developing the current recommendation, the USPSTF reviewed evidence on ...
Adavosertib Plus Gemcitabine and Radiotherapy in Locally Advanced Pancreatic Cancer
In a phase I dose-escalation trial reported in the Journal of Clinical Oncology, Cuneo et al established the phase II dose of the Wee1 kinase inhibitor adavosertib in combination with gemcitabine and radiotherapy in locally advanced pancreatic cancer. Wee1 inhibition impedes DNA damage response and ...
Surgical Resection Among Patients Receiving Primary Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer
In an Italian prospective cohort study reported in JAMA Surgery, Maggino et al found that among patients receiving primary chemotherapy for newly diagnosed pancreatic ductal adenocarcinoma, conversion to surgical resection was achieved in 24% of those with borderline resectable disease and 9% of...
Germline RABL3 Mutation May Increase Risk of Pancreatic Cancer Development
Scientists who studied a highly cancer-prone single family have identified a rare, inherited gene mutation that may raise the lifetime risk of pancreatic and other cancers. Their findings were published by Nissim et al in Nature Genetics. The discovery of the previously unknown mutation could lead ...
USPSTF Recommendation on Screening for Pancreatic Cancer in Asymptomatic Adults
As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF), in a reaffirmation of its 2004 recommendation, has recommended against screening for pancreatic cancer in asymptomatic adults (a grade D recommendation). In developing the current recommendation, the USPSTF reviewed...
Durvalumab With or Without Tremelimumab in Metastatic Pancreatic Cancer
In the first stage of a phase II trial reported in JAMA Oncology, O’Reilly et al found poor activity of durvalumab with or without tremelimumab in metastatic pancreatic ductal adenocarcinoma. Owing to the lack of efficacy, study expansion was not pursued. The lead-in open-label safety ...
Artificial Intelligence to Guide Management of Pancreatic Cysts
In a proof-of-concept study, an international scientific team has shown that a laboratory test using artificial intelligence tools has the potential to more accurately sort out which people with pancreatic cysts will eventually develop pancreatic cancers. Their findings were published by Springer...
AACR Immune Cell Therapies: Early Study Results Suggest Activity of Multiantigen T-Cell Therapy in Patients With Pancreatic Cancer
Findings from a small phase I study investigating a nonengineered, multiantigen-specific T-cell therapy for the treatment of pancreatic cancer has found that the therapy had clinical activity and was safe and well tolerated. The early results suggest that the immune cell therapy may provide a...
Does the Association Between Diet and Colonic Mucosa–Associated Microbiota Affect Cancer Risk?
A report published by Liu et al in The American Journal of Clinical Nutrition found an association between diet quality and microbiome composition in human colonic mucosa. The researchers found that a high-quality diet is linked to more potentially beneficial bacteria, whereas a...
Biliary Microbiome Altered in Patients Undergoing Surgery After Neoadjuvant Therapy for Pancreatic Cancer
The biliary microbiome was altered in patients who received neoadjuvant therapy prior to undergoing surgery for pancreatic cancer, according to a study published by Goel et al in HPB. Additionally, more bacteria in patients who underwent surgery after neoadjuvant therapy were resistant to...
APACT Trial: Nab-paclitaxel/Gemcitabine vs Gemcitabine Alone in Adjuvant Treatment of Pancreatic Cancer
The largest adjuvant trial in pancreatic adenocarcinoma, the global phase III APACT trial, evaluated the combination of adjuvant nab-paclitaxel/gemcitabine vs gemcitabine monotherapy in patients with resected pancreatic cancer. Results of the study were reported by Margaret A. Tempero, MD, of the...
Expert Point of View: Wells Messersmith, MD, and Allyson Ocean, MD
“THE RATIONALE for the POLO study is sound,” said invited study discussant Wells Messersmith, MD. “There’s clearly an unmet need in pancreatic cancer, and there are promising data for poly (ADP-ribose) polymerase (PARP) inhibitors in other BRCA-mutated tumors.” Dr. Messersmith is Professor and Head ...
POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer
In patients with metastatic pancreatic cancer and germline mutations in BRCA1 or BRCA2, maintenance therapy with olaparib doubled the time to disease progression and the proportion of patients who were progression-free at 2 years, in the phase III POLO trial.1 “Maintenance olaparib provided a...
Serum MicroRNAs for the Diagnosis of Pancreatic and Biliary Tract Cancers
Diagnosis of pancreatic and biliary tract cancers is complex and challenging due to the lack of symptoms and/or the difficulty of direct, invasive, and imaging-based methods of diagnosis. In an effort to develop better diagnostic markers for these diseases, Kim et al analyzed the genome-wide...
Margaret A. Tempero, MD, on Pancreatic Cancer: Adjuvant Nab-paclitaxel and Gemcitabine
Margaret A. Tempero, MD, discusses phase III results from the multicenter APACT trial, which showed that adjuvant nab-paclitaxel plus gemcitabine may be an option for patients who are ineligible for treatment with FOLFIRINOX (Abstract 4000).
2019 ASCO: POLO: Maintenance Olaparib in Germline BRCA-Mutated Pancreatic Cancer
The randomized phase III POLO trial found that maintenance therapy with the poly (ADP-ribose) polymerase inhibitor olaparib significantly delayed the progression of metastatic pancreatic cancer in patients with germline BRCA gene mutations compared with placebo (median...
Alok A. Khorana, MD, and Hedy L. Kindler, MD, on Metastatic Pancreatic Cancer: POLO Trial on Olaparib as Maintenance Therapy
Alok A. Khorana, MD, of the Cleveland Clinic, and Hedy L. Kindler, MD, of The University of Chicago, discuss phase III findings on olaparib as maintenance treatment following first-line platinum-based chemotherapy in patients with metastatic pancreatic cancer and a germline BRCA mutation (Abstract LBA4).
Expect Questions About Screening for Pancreatic Cancer
Although the detection of pancreatic cancer at early stages would offer an improved chance for successful treatment and survival, symptoms of pancreatic cancer are usually vague or absent, and screening to detect pancreatic cancer earlier is not recommended for average-risk asymptomatic patients....
Lifestyle Modifications and Screening of Patients at High Risk Can Reduce Deaths From Pancreatic Cancer
After disclosing that he had been diagnosed with stage IV pancreatic cancer, Alex Trebek, longtime host of the popular television game show Jeopardy!, vowed that he would beat the disease despite the low associated survival rate. His statement has brought pancreatic cancer back into the public...
Study Shows Rucaparib Active as Maintenance Therapy in Pancreatic Cancer
The poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib holds promise as maintenance therapy for advanced, platinum-sensitive, BRCA- or PALB2-mutated pancreatic cancer, according to an interim analysis of an ongoing phase II clinical trial presented at the 2019 Annual Meeting of the American...
ASCO Clinical Opinion Recommends Germline Testing for All Patients With Pancreatic Cancer
The recently released ASCO Clinical Practice Provisional Clinical Opinion on Evaluating Susceptibility to Pancreatic Cancer highlights the importance of emerging data indicating a relatively high rate of germline mutations in pancreatic cancer.1 Recent studies have demonstrated that up to 1 in 10...
NCCN Clinical Practice Guidelines in Oncology: 2019 Updates
In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®), covering eight tumor types. NCCN Guidelines are now published for more than 70 tumor types and topics. Some of the key updates for 2019 were presented...
Study Finds Immune Enrichment Improves Outcomes in Pancreatic Cancer With Activated but Not Normal Stroma
ALTHOUGH IMMUNOTHERAPIES have had limited success in pancreatic cancer to date, findings from a molecular analysis of the tumor microenvironment suggest that certain subtypes may be more responsive to treatment. According to data presented at the 2019 Society of Surgical Oncology Annual Cancer...
AACR Study Presentations Include New Data in Breast and Prostate Cancers, Sarcoma, and High-Risk Individuals
THE 2019 American Association for Cancer Research (AACR) Annual Meeting was held March 29 to April 3 in Atlanta. In addition to our regular coverage of news stories from the meeting, here are some brief highlights of additional noteworthy studies. Stage IV HER2-Positive Breast Cancer: Surgery or No ...
Single Nucleotide Polymorphisms and Survival After Pancreatic Cancer Resection
In a study reported in JAMA Surgery, Dimitrakopoulos et al found two single nucleotide polymorphisms (SNPs) in noncoding, functional regions of genes that regulate cancer progression. They were associated with survival after resection of pancreatic ductal adenocarcinoma. The study involved...
Factors Contributing to Improved Survival Following Total Neoadjuvant Therapy for Borderline/Locally Advanced Pancreatic Cancer
A newly published Mayo Clinic study has found that a presurgery treatment plan for patients with borderline/locally advanced pancreatic cancer undergoing total neoadjuvant therapy may improve outcomes. The findings were published by Truty et al in Annals of Surgery. The study followed 194...
VISTA Checkpoint Implicated in Pancreatic Cancer Immunotherapy Resistance
Researchers have identified a new potential immunotherapy target in pancreatic cancer, which so far has been notoriously resistant to treatment with immune checkpoint blockade drugs effective against a variety of other cancers. A research team from The University of Texas MD Anderson Cancer Center...
Trends in Neoadjuvant Therapy for Resectable Pancreatic Cancer
SEVERAL STUDIES at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...
AACR 2019: Maintenance Rucaparib Treatment in BRCA- or PALB2-Mutated Pancreatic Cancer
Maintenance treatment with the PARP inhibitor rucaparib was well tolerated and showed activity among patients with advanced BRCA- or PALB2-mutated pancreatic cancer sensitive to platinum-based chemotherapy, according to results from an interim analysis of an ongoing phase II clinical...
AACR 2019: Higher BMI Before Age 50 May Increase Risk of Pancreatic Cancer
A higher body mass index (BMI) before age 50 may be more strongly associated with pancreatic cancer mortality risk than excess weight at older age, according to the results of a study presented by Jacobs et al at the American Association for Cancer Research (AACR) Annual Meeting 2019 (Abstract...
Germline Mutations and Risk for Neoplastic Disease Progression During Pancreatic Surveillance
In a study reported in the Journal of Clinical Oncology, Abe et al found previously unidentified deleterious germline mutations in patients with family history as the basis for pancreatic surveillance. Moreover, the study showed the risk of pancreatic cancer was higher in individuals with germline...
AACR 2019: CD40 Antibody Combined With Chemotherapy in Advanced Pancreatic Cancer
An interim analysis of a small phase Ib study by O’Hara et al evaluating the CD40 agonistic monoclonal antibody APX005M in combination with gemcitabine and nab-paclitaxel with or without the programmed cell death protein 1 (PD-1) inhibitor nivolumab in untreated patients with metastatic...
Margaret A. Tempero, MD, on Pancreatic Cancer: NCCN Guidelines Updates
Margaret A. Tempero, MD, of the UCSF Helen Diller Family Comprehensive Cancer Center, discusses new adjuvant therapy options for patients with pancreatic cancer, and germline testing, including testing for microsatellite instability/mismatch repair genes as well as molecular analysis of all tumors.
Addition of Pegylated Recombinant Human Hyaluronidase to FOLFIRINOX in Metastatic Pancreatic Adenocarcinoma
In the phase I/II SWOG S1313 trial, which was reported in the Journal of Clinical Oncology by Ramanathan et al, researchers found that the addition of pegylated recombinant human hyaluronidase (PEGPH20) to modified (m) FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) worsened...
The Pancreatic Cancer Collective Awards $7 Million to Teams of Researchers in Pancreatic Cancer
The Pancreatic Cancer Collective—the strategic partner of the Lustgarten Foundation and Stand Up To Cancer (SU2C)—has awarded a total of $7 million in first-round New Therapies Challenge grants to 7 teams of top cancer researchers to explore new pancreatic cancer treatments. Each team will receive...
Mutations in DNA Damage Repair Predict Benefit With Platinum Agents in Pancreatic Cancer
Patients with advanced pancreatic cancer who have homologous repair damage response mutations may derive considerable benefit from treatment with platinum agents, according to an analysis of patients in the Know Your Tumor Program presented by Michael Pishvaian, MD, PhD, of Georgetown University,...
Expert Point of View: Andrew X. Zhu, MD, PhD
ANDREW X. ZHU, MD, PhD, of Massachusetts General Hospital Cancer Center and Harvard Medical School, noted that Prep-02/ JSAP-05 is the first study to show the value of neoadjuvant chemotherapy in patients with resectable pancreatic adenocarcinoma. However, the findings are applicable only to Asian ...
Emerging Role for Neoadjuvant Treatment of Resectable Pancreatic Cancer
SEVERAL STUDIES presented at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...
FDA Pipeline: Treatments for Tenosynovial Giant Cell Tumor and Pancreatic Cancer, Plus a Statement on Breast Implant–Associated Lymphoma
The U.S. Food and Drug Administration (FDA) recently granted the following designations and applications and also issued a statement: Priority Review for Pexidartinib in Tenosynovial Giant Cell Tumor The FDA has accepted a new drug application (NDA) and granted Priority Review for pexidartinib...
Enhancing Patient Outcomes After Whipple Procedure
Pancreaticoduodenectomy, or the Whipple procedure, is one of the most complex abdominal surgeries, and is commonly prescribed as a first line of therapy for cancer located within the pancreatic head. Investigators reported that following a 5-day accelerated recovery pathway after surgery helped to...
Andrew X. Zhu, MD, PhD, on Pancreatic Cancer: Results From the Prep-02/JSAP-05 Trial
Andrew X. Zhu, MD, PhD, of the Massachusetts General Hospital Cancer Center, discusses phase II/III study findings on neoadjuvant chemotherapy with gemcitabine and S-1 vs upfront surgery for resectable pancreatic cancer (Abstract 189).
