Promising results for chemo-immunotherapy combination against pancreatic cancer

Medical Xpress / University of Pennsylvania / Nature Medicine ^ | June 4, 2022 | Robert H. Vonderheide, MD, DPhil, et al

[ConservativeMind]

A combination of chemotherapy with an immunotherapy meant to unleash the anticancer capacity of the immune system was effective against one of the hardest targets in cancer care, pancreatic cancer, in a national, randomized clinical trial.

The researchers found that in 34 patients with advanced pancreatic cancer randomized to receive the immunotherapy nivolumab with two chemotherapy drugs, nab-paclitaxel and gemcitabine, had a one-year survival rate of 57.7 percent, significantly greater than the historical average of 35 percent with chemotherapy alone. The findings also included the identification of immune system biomarkers associated with better outcomes.

A ray of hope has come from preclinical experiments in mouse models of PDAC, and an initial small clinical trial reported by Vonderheide's team last year suggested that the addition of chemotherapy can substantially disrupt pancreatic tumors' resistance to immunotherapy.

They randomized a set of more than 100 patients with metastatic PDAC to receive a standard chemotherapy (gemcitabine/nab-paclitaxel) plus one of three immunotherapy regimens: an antibody treatment (nivolumab) targeting the immune "off switch" PD-1, a different antibody treatment (sotigalimab) that activates an immune "on switch," CD40, and a combination of the anti-PD-1 and pro-CD40 treatments. The main goal of the study was to see if any of these combinations could improve the rate of survival over one year for these patients, compared to the historical rate of just 35 percent for patients who receive chemotherapy alone.

The researchers found that all three groups had one-year survival rates higher than 35 percent: 57.7 percent for anti-PD-1 plus chemo, 48.1 percent for pro-CD40 plus chemo, and 41.3 percent for combo immunotherapy plus chemo. Only the first of these results was statistically significant, although in a study with such small patient numbers only the most striking differences will clear the statistical significance barrier.

[ConservativeMind]

To have a 57.7% 1 yr. survival rate with nivolumab a single additional therapy sounds promising, and it appeared another option might help those that exhaust nivolumab.

[ConservativeMind]

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