Clinical Trial Uses Precision Medicine for Pancreatic Cancer Drugs

The Pancreatic Cancer Action Network (PanCAN) has launched Precision Promise, a precision medicine clinical trial that will aim to improve pancreatic cancer drugs.

Moores Cancer Center at UC San Diego Health is among the few clinical trial sites for the effort.

Pancreatic cancer is one of the world’s most deadly cancers, with a five-year survival rate of just ten percent. Effective treatments for pancreatic cancer are limited, and the National Comprehensive Cancer Network’s guidelines cite clinical trials as the best option for treatment.

“This clinical trial is different than standard clinical trials in that it has an adaptive design, meaning if a drug is not working, it can be pulled from the trial and another treatment can take its place. And if a drug is working, it can move more quickly through the trial and to the FDA for potential approval,” said Aaron Miller MD, PhD, medical oncologist and principal investigator of the trial at Moores Cancer Center.

Each participant in a Precision Promise clinical trial undergoes advanced molecular profiling and receives state-of-the-art supportive care during their treatment. Precision Promise is currently open at Moores Cancer Center, the only NCI-designated comprehensive cancer center in San Diego.

Patients with metastatic pancreatic cancer who have not yet had treatment, or who have received only first-line treatment, may be eligible to enroll in PanCAN’s Precision Promise.

“Precision Promise is a clinical trial that will provide patients with access to therapies rooted in science,” said Andrew Lowy, MD, chief of the Division of Surgical Oncology at Moores Cancer Center at UC San Diego Health.

“Every possible patient with pancreatic cancer should be enrolled in a clinical trial because standard treatments are not enough. Precision Promise will offer options for patients with advanced pancreatic cancer including those who are untreated and those who have received prior therapies.”

Precision Promise investigates multiple treatment options, called sub-studies, under one clinical trial design. Patients can receive both first- and second-line treatment within this trial, allowing patients that enter Precision Promise in first line to quickly shift to a second line therapy within the same trial if necessary.

The network of Precision Promise sites allows researchers at all 15 clinical trial sites to evaluate the success of all patients as they progress through treatment. Researchers will collect tissue samples on each patient, which may help researchers better understand why some patients respond better to specific treatments and not others.

“In some trials, when the results are not what we expected from our initial hypothesis, there are no samples to inform research on why it was unsuccessful,” said Lowy, who was selected as part of a Stand Up To Cancer dream team of investigators working on developing new treatments for pancreatic cancer patients.

“Was the drug ineffective? Did it not reach its target? Was there a mutation we were unaware of? In order to improve upon therapies, we must understand what is happening in each patient. Precision Promise offers a collaborative network in which researchers can help each other answer these questions leading to better, faster FDA approval of new therapies in the clinic.”

This effort will add to PanCAN’s work in applying precision medicine to pancreatic cancer. In March 2020, the network published data showing that a precision medicine service designed to understand differences in patients’ tumors could help people with pancreatic cancer live longer.

The service determines whether tumor differences can impact which treatment options may work best for each patient. Researchers showed that patients who are able to go on therapies that match their tumor biology live an average of one year longer than patients who don’t.

“Looking at reports from 1,082 patients with pancreatic cancer, we found that one of every four tumors had a change that indicates certain treatment options may work particularly well for that patient,” said Lynn Matrisian, PhD, MBA, PanCAN’s chief science officer and co-author of the study, published in partnership with Perthera, Inc., and other collaborators.