Immunotherapy Before Surgery Shows Promise for Pancreatic Cancer.
A pilot study from UCLA Jonsson Comprehensive Cancer Center offers promising results for a new approach to treating pancreatic cancer. The study investigated the use of immunotherapy combined with chemotherapy before surgery (neoadjuvant therapy) for patients with borderline resectable pancreatic cancer.
Improved Outcomes with Combination Therapy
The findings suggest that administering an immunotherapy drug along with chemotherapy prior to surgery may lead to better long-term outcomes for these patients. Compared to historical controls, the combination therapy resulted in:
- Higher rate of successful tumor removal
- Increased progression-free survival (time before the cancer worsens)
- Extended overall survival
Safety and Side Effects
The study also found that adding immunotherapy did not cause significant additional side effects or post-operative complications.
Enhanced Immune Response
Researchers observed an increase in the activity of cytolytic T cells, immune system cells that attack cancer cells. This indicates that the immunotherapy component helped activate the immune system against the tumor.
Resistance Mechanism Identified
The study also identified a potential resistance mechanism involving the molecule adenosine. This finding paves the way for future research aimed at overcoming this resistance and further enhancing the body’s ability to fight the cancer.
Unique Collaboration
The study benefited from collaboration between UCLA research teams with expertise in pancreatic cancer. This collaboration allowed for detailed analysis of changes in the patients’ immune response, potentially contributing to the positive outcomes.
A Difficult Disease
Pancreatic cancer is a highly aggressive disease with a poor prognosis. Most current therapies are not very effective. This study explored a new approach that holds promise for improving treatment outcomes.
Previous Immunotherapy Trials
Prior studies combining chemotherapy and immunotherapy drugs have not shown significant improvement in pancreatic cancer treatment. However, this is the first study to investigate this combination in the neoadjuvant setting (before surgery).
Study Details
The pilot study included 28 patients with borderline resectable pancreatic cancer. Most patients completed the combination therapy, and a majority underwent surgery. Genetic analysis was performed on tumor tissues to understand the therapy’s effects.
Encouraging Survival Rates
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. Patients who underwent surgery had a particularly high 18-month overall survival rate of 90%.
Markers of Improved Immune Response
Analysis of resected tumors revealed increased expression of genes associated with immune cell activity compared to pre-treatment biopsies. This suggests that the therapy stimulated the immune system to attack the cancer cells.
Future Research
This research opens new avenues for exploring the use of immunotherapy in earlier stages of pancreatic cancer. The promising results of this Phase II trial warrant further investigation in larger studies.
Conclusion
This study demonstrates the potential of combining immunotherapy with chemotherapy before surgery to improve outcomes for patients with borderline resectable pancreatic cancer. The research team plans to build on these findings in future studies to potentially redefine the standard of care for this challenging disease.