Presurgical Treatment for Pancreatic Cancer That Is Removable

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Can immunotherapy and vitamin D increase the effectiveness of chemotherapy given before pancreatic cancer surgery?

Researchers are looking at how patients tolerate the combination of immunotherapy and vitamin D and comparing that same combination plus standard chemotherapy. This clinical trial will also compare the effectiveness of the two combinations.

The Importance of Treatment Before Surgery

Some pancreatic cancer patients have tumors that can be removed by surgery. However, when lymph nodes are analyzed after surgery, cancer cells are sometimes found. Giving patients chemotherapy before surgery decreases the size of the tumor and can kill any cancer cells that may have spread.

The combination of gemcitabine and nab-paclitaxel is one of the standard treatments given before surgery. Gemcitabine is converted into two metabolites that cause cell death. One reduces the number of molecules available to make DNA; the other shortens the DNA strands. Nab-paclitaxel inhibits cell division and promotes cell death.

Adding Immunotherapy and Vitamin D

Researchers continue to look for presurgical treatments that will be even more effective against pancreatic cancer. Pembrolizumab (Keytruda) is a monoclonal antibody that is part of a class called “checkpoint” drugs. These drugs help restore the immune functions of cells, allowing the body to recognize the cancer cells as foreign and kill them. Paricalcitol is a vitamin D derivative that has been found to alter the cells that form a barrier around the tumor. With the barrier altered, chemotherapy is better able to reach the tumor and therefore be more effective.

There are two arms in this trial. Some patients will receive pembrolizumab and paricalcitol, while others will receive that combination plus gemcitabine and nab-paclitaxel. After the treatment ends, participants may have surgery to have their tumors removed. The researchers will receive a tumor sample to study, as part of the trial.

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 Trial Finder for a listing of all active pancreatic cancer clinical trials.


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