Dr Picozzi on Optimal Candidates for Optune Pax in Pancreatic Cancer

"Number one, the device is approved for locally advanced pancreatic cancer…number two, patients [must be able to] receive gemcitabine and nab-paclitaxel. Third, the patient [must be] willing to use the device for the time required, which…can seem burdensome. In point of fact, in PANOVA-3, the vast majority of [patients] were able to use the device for the requisite time.”

Vincent Picozzi, MD, medical oncologist and director for the Pancreaticobiliary Program at the Floyd & Delores Jones Cancer Institute at Virginia Mason Medical Center, discussed 3 key considerations for the use of Optune Pax for patients with pancreatic cancer.

In February 2026, the FDA approved Optune Pax for concomitant use with gemcitabine and nab-paclitaxel (Abraxane) in adult patients with locally advanced pancreatic cancer based on data from the phase 3 PANOVA-3 study (NCT03377491). Results from the study demonstrated that patients in the combination arm achieved a 2-month survival advantage compared with those receiving gemcitabine plus nab-paclitaxel alone (HR, 0.82; 95% CI 0.68-0.99; P = 0.039). Picozzi emphasized that this survival benefit is a crucial benchmark for patients facing locally advanced disease.

With the integration of this modality into routine clinical practice, Picozzi identified 3 essential factors for identifying optimal candidates: disease stage, chemotherapy compatibility, and practicality of use.

Although the current FDA indication is specifically for locally advanced pancreatic cancer, Picozzi observed that the device’s activity appears to extend beyond the primary tumor site to include metastatic disease. Furthermore, because the efficacy was established in combination with gemcitabine and nab-paclitaxel, patients must be eligible for that specific systemic regimen to align with the trial's evidence.