Improving the Treatment of Locally Advanced Pancreatic Cancer - Episode 4
John Marshall, MD:A new study has just been doneit’s now published—taking patients with locally advanced pancreas cancer, and instead of using the sort of biased FOLFIRINOX frontline, it’s using gemcitabine/nab-paclitaxel with traditional dosing and the like. About 100 patients was the number. In fact, they were able to show not only responses in these patients but also a decent percentage of patients who were in fact converted to being resectable. This opens up, really, a new option for us. We can hold off the 3-drug regimen in the right patient by using the 2-drug regimen in locally advanced pancreas cancer, now with prospective data saying that that 2-drug regimen will convert some patients to being resectable.
Specifically, this study enrolled a little over 100 patients in the trial. Everybody had locally advanced pancreas cancer as defined by traditional imaging measures. They were treated with gemcitabine/nab-paclitaxel using traditional doses. Traditional side effects were observed in the study, with no new signals there. But I think the really important part of this study is not the disease control rate. We’re expecting all of that. It’s that 15% of patients were able to undergo surgical resection. I think what this gives us is a new appropriate option for some patients: maybe those who can’t tolerate FOLFIRINOX, maybe more than that. But this is an appropriate choice in locally advanced pancreas cancer as a preoperative strategy in order to try to get some patients to surgery.
This is not something that’s new to us. They’re data that support what we’ve been doing anyway. There are a lot of patients who present with this kind of problem who would never be candidates for FOLFIRINOX, where it’s too spicy, too complicated, or there’s not enough support at home to manage a FOLFIRINOX regimen. Gemcitabine/nab-paclitaxel is a pretty easy regimen to give, particularly in the older population. We have seen patients with nice responses in this space who then become candidates for surgery.
Transcript edited for clarity.