Vincent J. Picozzi Jr, MD, director, Pancreas Center of Excellence, physician, Division of Hematology-Oncology, Virginia Mason Medical Center, discusses the prognostic value of pathologic response to neoadjuvant chemotherapy in patients with resected pancreatic cancer.

The goal of treatment in localized pancreatic cancer is cure, says Picozzi. As such, implementing chemotherapy and chemoradiation in conjunction with surgery is necessary to maximize the chance of cure for patients.

However, the use of chemotherapy and chemoradiation in the neoadjuvant setting can make it difficult to determine optimal adjuvant therapy, explains Picozzi.

At the 2020 Gastrointestinal Cancers Symposium, a poster was presented on the impact of neoadjuvant chemotherapy on treatment outcomes in patients with resected pancreatic cancer.

A univariate analysis of 134 eligible patients confirmed that many variables, including pathologic response to neoadjuvant chemotherapy, have prognostic significance for overall survival. However, a multivariate analysis revealed that other factors such as tumor size, nodal involvement >20%, and tumor differentiation were independent variables that did not have prognostic value.

As such, building upon these data may shed light on how to optimize clinical decisions regarding adjuvant therapy for patients with pancreatic cancer, concludes Picozzi.

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Vincent J. Picozzi Jr, MD, discusses the prognostic value of pathologic response to neoadjuvant chemotherapy in patients with resected pancreatic cancer. 


Dr. Picozzi on Prognostic Value of Pathologic Response to Chemo in Pancreatic Cancer

Vincent J. Picozzi, MD, director, Pancreatic Center of Excellence, Virginia Mason Medical Center, discusses the use of SM-88 in pancreatic cancer.

SM-88 is an oral therapy, and unlike traditional therapies in pancreatic, it is not a chemotherapy. The novel anticancer regimen is comprised of a tyrosine derivative (D,L-alpha-metyrosine), an mTOR inhibitor (sirolimus), a CYP3a4 inducer (phenytoin), and an oxidative stress catalyst (methoxsalen). The agent has shown promising activity with little toxicity for patients with metastatic pancreatic cancer who have progressed on at least 1 prior line of therapy. Due to the agent’s tolerability, elderly and frail patients are also able to receive the treatment. Physicians and patients alike are eagerly awaiting more data to further prove the agent’s efficacy, says Picozzi.

A physicist came up with the construction of SM-88, adds Picozzi. The agent uses a derivative of an immunoacid tyrosine as a “poisonous pill” to cancer cells. By redirecting the mTOR inhibitor, CYP3a4 inducer, and oxidative stress catalyst, the agent is able to enhance the effect of the altered tyrosine, explains Picozzi.

Vincent J. Picozzi, MD

Articles

Dr. Picozzi on Prognostic Value of Pathologic Response to Chemo in Pancreatic Cancer

Dr. Picozzi on the Use of SM-88 in Pancreatic Cancer