UCSF Pediatric Focus

Phase I Pancreatic Cancer Immunotherapy Study Shows Promise; Phase II Enrolling

Pancreatic cancer is expected to become the second leading cause of cancer-related death in the United States by 2020 according to a May 2014 paper in Cancer Research, yet only 4 percent of pancreatic cancer patients enroll in clinical trials that could help improve survival.

A multipronged UCSF effort to increase survival rates for pancreatic cancer patients hopes to change those numbers. To that end, a first-line, Phase Ib immunotherapy trial at UCSF’s Pancreas Center has achieved a durable response in some patients with metastatic pancreatic adenocarcinoma. Funded by the Parker Institute for Cancer Immunotherapy, the study is currently in the randomized Phase II portion of its enrollment, which will include 93 patients nationwide.

Improved Patient Survival Tied to Clinical Trials

The Pancreas Center continues to expand its trials, which leverage expertise from across UCSF and from high-profile national partners, including the Parker Institute, the Pancreatic Cancer Action Network’s Precision Promise initiative, Stand Up to Cancer, and multiple industry collaborators.

Many of the new trials focus on immunotherapy. For example, the Parker Institute trial noted above, tests the efficacy of adding an immune checkpoint inhibitor and/or another novel immune-oncology agent (CD40 agonistic antibody) to standard chemotherapy. Other trials of interest include:

  • An industry-funded, second-line, Phase Ib/II, multicenter, randomized study designed to assess the safety, tolerability, pharmacokinetics and preliminary anti-tumor activity of various immunotherapy-based treatment combinations in patients with metastatic pancreatic ductal adenocarcinoma who have previously progressed on standard chemotherapy.
  • Precision Promise, for which UCSF is one of 12 inaugural sites. “The Precision Promise initiative will test new drugs in a more fluid and nimble way that should accelerate and refine our ability to treat patients with pancreatic cancer,” says Andrew Ko, MD, Precision Promise principal investigator for the UCSF site. Extensive molecular profiling of each patient’s cancer informs the platform design. In turn, physicians can offer experimental therapies ranging from novel immuno-oncology agents to molecularly targeted therapies to drugs that target the stromal microenvironment of pancreatic tumors. Physicians can administer these options at the same time or after traditional chemotherapy.

Expert Screening, Imaging, Research Lead to Precision Treatments

The UCSF effort to improve survival extends well beyond clinical trials to more personalized screening, treatments and follow-up care.

A multidisciplinary team delivers care informed by the latest research, including comprehensive management of pancreatic diseases aimed at prevention and early detection. Among the specialized services at the UCSF Pancreas Center are:

  • An in-house, germline molecular profiling platform uncovers tumor-associated mutations and other genetic alterations that inform treatment and familial screening decisions.
  • Expertise in endoscopic ultrasound and endoscopic retrograde cholangiopancreatography gives providers the most advanced tools for detailed imaging and analysis.
  • A pancreatic cyst surveillance program identifies patients who require further diagnostic studies, immediate therapeutic interventions or long-term surveillance.
  • Weekly tumor boards facilitate more personalized treatments.
  • Expert surgeons perform state-of-the-art surgical procedures, including pancreas transplantation.
  • The most advanced radiation modalities, including stereotactic body radiation therapy, enable more precise radiation delivery to tumors at higher doses, with less toxicity.
  • Supportive services include a dedicated nurse navigator, genetic testing and counseling, nutrition, symptom management, exercise counseling, psycho-oncology and integrative medicine.
  • The UCSF Center for BRCA Research, one of only two such centers in the United States, is exploring precision medicine approaches for the approximately ten percent of all pancreatic cancer patients with the BRCA2 mutation.

Learn more about the Pancreas Center
View Dr. Ko’s physician profile