Dr. Choti Discusses Immunotherapy in Pancreatic Cancer

Michael A. Choti, MD, chief of surgery, Banner MD Anderson Cancer Center, discusses the role of immunotherapy in the treatment of patients with pancreatic cancer.

Immunotherapy has made virtually no impact in this space for the time being, but there are ongoing trials testing its role in patients with advanced disease. Choti says it seems as though pancreatic cancer is not an immunogenic disease and that these patients are not appropriate candidates for this class of agents. Therefore, it is not amenable for immunotherapy. However, there is a very small subset of patients with microsatellite instability-high tumors where this type of treatment has potential.

A phase IIa trial presented at the 2018 ESMO Congress indicated that pembrolizumab (Keytruda) may have an impact in combination with the CXCR4 antagonist BL-8040 for patients with metastatic pancreatic adenocarcinoma. Patients received 5 days of BL-8040 monotherapy followed by repeated 3-week cycles of pembrolizumab combined with BL-8040 every 3 weeks. The median overall survival with this treatment was 3.4 months in the 29 evaluable patients.