TidalHealth Peninsula Regional, Salisbury, MD
Adeel Masood , Hamid Ehsan , Qamar Iqbal , Saher Nasir Amin , Melissa Wilson
Background: Pancreatic cancer is the 11th most common cancer and represents 3.2% of all new cancer cases. But it is the third leading cause of cancer-related deaths with a five-year relative survival of only 10.8%. More than 50% of patients diagnosed with metastatic disease at initial presentation have 5-year relative survival of only 3.0%. Here, we explore the recent literature for the emerging role of immunotherapies and their outcomes for advanced pancreatic cancer. Methods: The literature search was conducted on PubMed, Embase, Cochrane, and ClinicalTrials.gov from inception to January 2022 using MeSH terms' pancreatic neoplasms', 'immunotherapy,' and 'therapeutics'. The final analysis includes nine clinical trials that meet the inclusion criteria regarding immunotherapy for metastatic pancreatic cancer. Results: The combination of pembrolizumab and trametinib with stereotactic radiotherapy (SBRT) reported a median progression-free survival (PFS) and overall survival (OS) of 25 and 18 months compared to gemcitabine and SBRT combination of 22 and 16 months, respectively. Another study reported a median OS of 18 months with nivolumab along with operative irreversible electroporation to increase the bioavailability of nivolumab in the cancer cells. The EGFR targeted CAR T cells therapy was evaluated in 14 patients with advanced pancreatic cancer with a median OS of five months and an overall response rate (ORR) of 29%. Sotigalimab, an agonistic CD40 antibody combined with nivolumab, was found to have an ORR of 58%, PFS of 12 months, and OS of 20 months after a follow-up of almost 18 months. On the contrary, Bruton's tyrosine kinase inhibitors such as Acalabrutinib and Ibrutinib were found to have no OS benefit (median OS 3.8 and 5.3 months, respectively). Conclusions: Due to the high mortality associated with advanced pancreatic cancer, there is increasing interest in Novel immunotherapies-based approaches, with some showing promising results.
Author, Yr. | Immunotherapy | ORR % | Median PFS (Months) | Median Survival (Months) | Comments |
---|---|---|---|---|---|
Kamath 2020 | Ipilimumab | 14 | 2.8 | 6.9 | |
Kumai 2020 | αβ T cells | 14 | 18.7 | ||
Liu 2020 | CAR-T EGFR | 29 | 3 | 4.9 | |
Melisi 2020 | Galunisertib with durvalumab | 3 | 1.9 | 5.77 | No OS benefit |
Tempero 2021 | Arm A: Ibrutinib Arm B: Placebo | Arm A: 29, Arm B: 42 | Arm A:5.3, Arm B: 6 | Arm A:9.7, Arm B: 10.8 after median f/u 25 Mo | No OS benefit |
Ohara 2021 | Sotigalimab + nivolumab | 58 | 11.7 | 20.1 after median f/u 17.8 Mo | |
O'Neill 2020 | Nivolumab | 6.8 | 18 | ||
Overman 2020 | Arm A: Acalabrutinib Arm B: Acalabrutinib + pembrolizumab | Arm A:None, Arm B: 21 | 1.4 | Arm A: 3.6, Arm B: 3.8 | No OS benefit |
Zhu 2021 | Arm A: Pembrolizumab and Trametinib Arm B: GEM | Arm A: 18.3 Arm B:15.6 | Arm A: 24.9 Arm B: 22.4 after median f/u 23 Mo |
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Abstract Disclosures
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