A recent study conducted by Johns Hopkins investigators has found that a three-pronged combination immunotherapy treatment for patients with operable pancreatic cancers is safe and appears effective. The treatment consists of the pancreatic cancer vaccine GVAX, the immune checkpoint therapy nivolumab, and urelemab, an anti-CD137 agonist antibody treatment. The study, published in the journal Nature Communications, shows that this combination treatment increases the number of cancer-killing immune system T cells in tumors when given two weeks prior to surgery for cancer removal.
This study is part of an ongoing platform trial that began in 2015 to investigate immunotherapy treatments for pancreatic cancer before and after surgery. The trial, led by researchers at the Johns Hopkins Kimmel Cancer Center, the Bloomberg~Kimmel Institute for Cancer Immunotherapy, and the Johns Hopkins University School of Medicine, aims to advance the development of immunotherapies within the same study by analyzing data generated by the trial.
In this particular part of the trial, 10 participants received the combination treatment. The median disease-free survival was 33.51 months, and the median overall survival was 35.5 months. Although these numbers were higher than previous arms of the trial, which tested the vaccine alone or in combination with nivolumab, the results were not statistically significant due to the small number of patients.
Additionally, the tumor specimens from the recent arm of the trial showed significantly higher levels of cancer-killing immune cells compared to specimens from patients who received only the vaccine or the vaccine plus nivolumab.
According to senior study author Lei Zheng, M.D., Ph.D., the co-director of the Pancreatic Cancer Precision Medicine Center of Excellence and professor of oncology at the Johns Hopkins University School of Medicine, these results indicate that further study of this therapy combination is warranted in a larger clinical trial.
The platform trial also serves two purposes regarding pancreatic cancer treatments given prior to surgery. Firstly, it allows the immunotherapies to educate the patient’s immune cells on how to respond to tumors, offering continued surveillance in case of cancer recurrence. Secondly, it enables investigators to evaluate the response of tumors to the treatment by analyzing the tumors removed during surgery. The trial is currently conducting a fourth arm, which focuses on studying anti-interleukin-8 neutrophil-blocking antibodies in pancreatic tumors.