Next Steps for Novel Treatment Combination in Pancreatic Cancer

Tara Seery, MD, a physician at the Hoag Cancer Center, discussed the next steps for the novel treatment of combination immunotherapy protocol of low-dose chemoradiation, N-803, and PD-L1 t-haNK therapy, for patients with metastatic pancreatic cancer center.

Use of this combination was looked at in the multi-center, randomized, phase 2 QUILT 88 study (NCT03563144) that gave patients 100 mg/m2 via IV infusion chemoradiation nab-paclitaxel, 600 mg/m2 IV of gemcitabine, twice daily cyclophosphamide at 50 mg, and low dose stereotactic body radiation therapy. Seery explains that this method is to address that treatment with just chemotherapy may not be enough in this patient population.

These data were presented at the 2023 ASCO Gastrointestinal Cancers Symposium, which showed median overall survival (OS) at 5.7 months (95% CI, 4.9-6.4) with 37% of patients having achieved stable disease at 8 weeks or longer. Median OS in the third-line setting, which included 38 patients, was 6.3 months, whereas 40 patients in the fourth line setting had a median OS of 5.0 months.

Seery also explains what these results mean for the future of this treatment and where she believes this treatment combination can benefit this patient population.

Transcript:

0:08 | We still have an ongoing second-line trial. So, when we opened the third line, people from all over the world flocked in. Now that that is full, we really want to get the second-line filled. So second-line is for patients who have had only 1 prior line of therapy, and we are randomizing patients 50/50 to either our experimental arm vs what is approved as our standard of care 5-FU and irinotecan liposome injection [Onivyde].

0:39 | Now, we know that might be a little issue with [the irinotecan liposome injection] in the first-line setting, but still, 50% of patients receive first-line gemcitabine [and paclitaxel]. Some people might say they had gemcitabine and [paclitaxel], so why would they want to go into this experimental arm that does use gemcitabine and [paclitaxel]. We have seen people respond even if they've received gemcitabine and [paclitaxel] before, so that's not an issue in our minds.