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Adjuvant Treatment Strategy Shows Promise in Pancreatic Cancer

Kristi Rosa
Published: Monday, Mar 11, 2019

Autumn McRee, MD

Autumn McRee, MD

Some of the most encouraging data to be read out in the pancreatic cancer space within the last decade came from the PRODIGE 24/CCTG PA.6 trial, said Autumn McRee, MD, as this was the first trial to demonstrate an overall survival (OS) benefit with an adjuvant strategy of intense chemotherapy combinations often used in the metastatic setting.

State of the Science Summit™ on Gastrointestinal Malignancies, McRee highlighted promising adjuvant/neoadjuvant strategies under investigation in the pancreatic cancer space and stressed the importance of using a multidisciplinary treatment approach to improve patient outcomes.

OncLive®: What therapies are being explored in the neoadjuvant or adjuvant setting?

McRee: One of the more promising studies that we saw come out of the pancreas space in the last decade was the PRODIGE 24/CCTG PA.6 study, data from which were reported at the 2018 ASCO Annual Meeting. This was, for the first time, an adjuvant strategy comprised of more aggressive chemotherapy combinations that we typically use in the metastatic setting. For this study, [investigators] randomized patients who had been resected to receive either gemcitabine, which is an old standard, to the 3-drug combination FOLFIRINOX. That study followed on the heels of the ESPAC-4 study, which combined gemcitabine with capecitabine.

However, there are now studies looking to bring those treatments to the neoadjuvant space; [for example, work by] Matthew H.G. Katz, MD, from the Alliance for Clinical Trials in Oncology and The University of Texas MD Anderson Cancer Center.

Could you expand on these studies?

The study that Dr Katz is leading is looking at patients who are borderline resectable, meaning that we are optimistic that they are resectable, but they have certain features of their cancer that make them unlikely to have a complete resection; that is usually intimate involvement of certain blood vessels.
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