Dr. Bekaii-Saab on Napabucasin in Patients With Pancreatic Cancer

Tanios Bekaii-Saab, MD, professor of medicine, Mayo Clinic, discusses the potential of napabucasin, previously known as BBI-608, in patients with pancreatic cancer.

Napabucasin is a stemness inhibitor. Pancreatic cancer cells tend to have stem cells that are hard to kill with chemotherapy and radiation. When physicians use chemotherapy, the sensitive cancer cells will die off, but some of them will revert to a stemless phenotype.

Napabucasin seems to inhibit and facilitate killing by lowering the chemosensitizing capacity against these cancer cells. If it is given with chemotherapy and gemcitabine, nab-paclitaxel (Abraxane), or paclitaxel, the cancer cells are killed more efficiently and are prevented from reverting to the stemless phenotype, says Bekaii-Saab.

This was done in a phase Ib study of around 67 patients with an objective response rate of 55% and 2 complete responses. That has taken napabucasin to the phase III CanStem111P trial, which is randomizing patients to gemcitabine and nab-paclitaxel versus gemcitabine and nab-paclitaxel plus napabucasin. This trial is currently accruing.