Pancreatic cancer is one of the most difficult cancers to treat. Only 12% of diagnosed patients live beyond 5 years, and most therapies – including conventional chemotherapies, targeted therapies and immunotherapies – fail to increase survival. Previous research has studied combinations of chemotherapies and PD1 inhibitors, a type of immunotherapy drug that helps the immune system recognize and destroy cancer cells more effectively, but has so far failed to identify a significant improvement in outcomes in this group of patients. This study brings new hope.
The therapeutic approach specifically combines nivolumab with chemotherapy and surgery in these patients with pancreatic cancer. Nivolumab, releasing the ability of T lymphocytes to fight the tumor.
Immunotherapy, chemotherapy and surgery
The study A pilot study conducted in 28 patients with borderline resectable pancreatic cancer by researchers at UCLA Health Jonsson Comprehensive Cancer Center suggests that for borderline resectable pancreatic cancers, administering this immunotherapy drug in combination with chemotherapy before surgery is safe and improves long-term outcomes. 26 or 93% of participants completed at least 3 cycles of combination therapy and 24 or 86% underwent surgery. Genetic sequencing was performed on 21 tumors resected after treatment, six pre-treatment diagnostic biopsies matched to patients, and nine tumors resected from patients not included in the trial and treated with chemotherapy alone. The experience shows that:
- after a median follow-up of 24 months, the median progression-free survival is 34.8 months and the median overall survival is 35.1 months;
- in patients who have undergone pancreatectomy, the overall survival rate at 18 months is 90%.
- Treating patients with combined immunotherapy before surgery allows
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a higher rate of successful tumor removal,
- an increase in the time before the cancer gets worse,
- an extension of overall survival vs. controls;
- the addition of the immunotherapy drug does not increase adverse side effects and does not result in any significant postoperative complications.
“This is therefore one of the first reported trials with a PD1 inhibitor in pancreatic cancer confirming that the new approach achieves positive results, including improving the function of cytotoxic T lymphocytes, which constitute a key element of immune system for the fight against this cancer”, summarizes one of the lead authors, Dr. Zev Wainberg, an expert and researcher in gastrointestinal oncology at UCLA: “The study also reveals an increase in immunosuppressive adenosine, which indicates a resistance mechanism that we can target to further optimize the body’s ability to fight cancer.”
