• Posted April 8, 2024

Immunotherapy Before Surgery Might Boost Pancreatic Cancer Survival

Pancreatic cancer patients may do better if they receive an immunotherapy drug as well as chemotherapy in preparation for surgery, new research suggests.

Pancreatic cancer is one of the toughest to treat. Only 12% of patients live more than five years after diagnosis. Most therapies -- including chemo, targeted therapies and immunotherapies -- are unsuccessful.

For this study, researchers at UCLA Health Jonsson Comprehensive Cancer Center found three benefits from the pre-surgery regimen: a higher rate of successful tumor removal; a longer time before the cancer worsened; and longer survival compared to a comparison group that previously received traditional treatment.

"By treating patients before surgery, not only were we able to see whether the drug combination worked but by collecting surgical resection tissues, we went back to the lab to study why this combination does not always work," said senior study author Dr. Timothy Donohue, chief of surgical oncology at UCLA's David Geffen School of Medicine.

First study author Dr. Zev Wainberg, co-director of the UCLA Health GI Oncology Program, noted that this is among the first trials reported using a PD1-inhibitor drug before pancreatic cancer surgery.

Researchers didn't say which PD1-inhibitor was used, but this class of drugs includes Keytruda and Opdivo. They work with the patient's immune system to thwart the growth and spread of cancer cells.

The new study included 28 pancreatic cancer patients with what doctors call borderline resectable tumors. That means their tumor may have grown into neighboring tissues or organs. It may be removable, but some cancer may remain.

For the study, 26 patients completed at least three cycles of the chemo/immunotherapy. All but two then had surgery. 

Researchers compared results of genetic sequencing on 21 surgically removed tumors, six pre-treatment biopsies and nine tumors removed from patients not in the trial treated with chemotherapy alone.

At a median follow-up of 24 months, the median progression-free survival was 34.8 months, and the median overall survival was 35.1 months.

For patients whose pancreas was removed, the 18-month survival rate was 90%. Two patients had no signs of cancer in tissue samples removed after treatment and two had near complete responses to treatment.

Researchers said the findings point to the possibility of more effective treatment options for pancreatic cancer patients. The phase 2 trial is ongoing.

"We've identified some leads that will be the basis for subsequent studies, again in the preoperative setting," Donohue said in a UCLA news release. "Through these efforts, we are working to redefine the standard of care for pancreatic cancer."

Wainberg presented the findings Monday at the American Association for Cancer Research annual meeting in San Diego. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

More information

The American Cancer Society has more about immunotherapy.

SOURCE: UCLA Health Sciences, news release, April 5, 2024