Davendra Sohal, MD, MPH, oncologist, Cleveland Clinic, discusses the SWOG S1505 trial, which looks at initial findings on eligibility and neoadjuvant chemotherapy experience with mFOLFIRINOX versus gemcitabine/nab-paclitaxel (Abraxane) for resectable pancreatic adenocarcinoma.

Current standard of care for pancreatic cancer is taking the patient to surgery followed by chemotherapy. According to Sohal, this is the first study in the United States that gives patients with pancreatic cancer chemotherapy. Sohal hopes that using chemotherapy upfront will better control systemic disease more aggressively with better outcomes.

In a retrospective study, Sohal and researchers looked at 150 patients to see eligibility. Of the 147 patients, 29% were ineligible due to tumors that were more than resectable disease, per protocol criteria. That was significant in ineligibility rate, according to Sohal, and highlights the need for more objective evaluations of scans before enrolling patients in trials.

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Davendra Sohal, MD, MPH, discusses the SWOG S1505 trial, which looks at initial findings on eligibility and neoadjuvant chemotherapy experience with mFOLFIRINOX versus gemcitabine/nab-paclitaxel for resectable pancreatic adenocarcinoma.

Dr. Sohal on Eligibility of Patients with Pancreatic Cancer for Clinical Trials

Davendra Sohal, MD, MPH, Department of Hematology and Medical Oncology, Cleveland Clinic, discusses an ongoing study exploring mFOLFIRINOX versus gemcitabine and nab-paclitaxel (Abraxane) in patients with resectable pancreatic adenocarcinoma.

SWOG S1505 is one of the first cooperative group studies exploring this treatment in pancreatic cancer, Sohal explains. It is a shift from the standard of care for these patients, which is surgery followed by adjuvant chemotherapy with or without radiation therapy. However, research now shows that pancreatic cancer is a systemic disease and it should be targeted with aggressive systemic chemotherapy regimens upfront.

This is what this study is testing, Sohal adds—the efficacy, safety, and feasibility of this approach.

Dr. Sohal on Perioperative mFOLFIRINOX in Pancreatic Adenocarcinoma

Davendra Sohal, MD, MPH, oncologist and Director of the Clinical Genomics Program at the Cleveland Clinic Taussig Cancer Institute, discusses the feasibility of standardizing genomic profiling and apply precision medicine techniques.

His team conducted a prospective trial which included 250 patients with incurable, solid tumor cancers. All patients received genomic profiling for up to 350 cancer-related genes. Most of the results were available within a medium of 26 days after informed consent and 63% of patients were determined to have a biologically actionable alteration within their tumors.

However, due to a lack of available targeted therapies and clinical trials, only 11% of the patients with biologically actionable alterations within their tumors were able to receive specifically targeted treatment, said Sohal.

In order for precision medicine to become more commonplace, clinical trials of novel targeted therapies needs to be increased and made more accessible, he said.

Davendra Sohal, MD, MPH, oncologist and Director of the Clinical Genomics Program at the Cleveland Clinic Taussig Cancer Institute, discusses the feasibility of standardizing genomic profiling and apply precision medicine techniques. 


Davendra Sohal, MD, MPH

Articles

Dr. Sohal on Eligibility of Patients with Pancreatic Cancer for Clinical Trials

Dr. Sohal on Perioperative mFOLFIRINOX in Pancreatic Adenocarcinoma

Dr. Sohal on the Challenges of Standardizing Genomic Profiling and Precision Medicine