Chemotherapy, Immunotherapy, and Radiation for Locally Advanced Pancreatic Cancer

Credit: Marcos Fernandez, Flickr
Credit: marcos Fernandez, Flickr
Can a combination of chemotherapy, two types of immunotherapy, and radiation halt the growth of pancreatic cancer that has spread beyond the borders of the pancreas?

A clinical trial is testing chemotherapy that enhances the action of two immunotherapy drugs, followed by stereotactic body radiation therapy, as a treatment to stop pancreatic cancer that has spread beyond the pancreas but not to other parts of the body. Researchers are looking at the safety of this combination, as well as its effectiveness in stopping the growth of the cancer.

Combining Chemotherapy and Immunotherapy

The chemotherapy and immunotherapy combination focuses on the cells that control the immune system. Cyclophosphamide is a chemotherapy drug that blocks the growth of tumor cells and eventually kills them by interfering with DNA replication. The drug, given at a low dose, targets cells that regulate the immune system function, in this case the ones that suppress immune function.

The two types of immunotherapy are GVAX, a pancreas vaccine that stimulates the immune system to kill the tumor cells, and pembrolizumab (Keytruda), a monoclonal antibody that is part of a class called “checkpoint” drugs. Checkpoint drugs help restore the immune functions of cells, allowing the body to recognize the cancer cells as foreign and kill them.

Focused Radiation Follows

Stereotactic body radiation therapy, known as SBRT, uses multiple beams of high-dose radiation focused on a specified location in the body. The technique enables the radiation oncologist to kill cancer cells and limit the exposure of healthy tissue to radiation. The precise location for the radiation beams is determined using 4-D imaging to map the area that will receive treatment. Metal markers are then implanted to outline the boundaries of that area.

To be eligible for this trial patients must have been recently treated with FOLFIRINOX or the combination of gemcitabine and Abraxane. All participants will receive this experimental combination of therapies.

We encourage you to consult your physicians for clinical trials that may be right for you. The website Clinicaltrials.gov provides more details about this trial as well as many others. You can visit the Clinical Trials Finder for a listing of all active pancreatic cancer clinical trials.

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