Dr Weinberg on the Implications of Data With BXCL701 Plus Pembrolizumab in mPDAC

“This [approach] represents an important chemotherapy-free treatment [regimen] for patients with this disease who are often fairly [exhausted] from prior lines of chemotherapy. We hope that it offers an opportunity to make the immune system work against pancreatic cancer.”

Benjamin A. Weinberg, MD, FACP, an associate professor of medicine in the Division of Hematology and Oncology of the Lombardi Comprehensive Cancer Center at Georgetown University, discussed the potential clinical implications of the phase 2 EXPEL-PANC trial (NCT05558982) of BXCL701 plus pembrolizumab (Keytruda) in patients with metastatic pancreatic ductal adenocarcinoma (PDAC) after disease progression on frontline chemotherapy.

Findings from EXPEL PANC presented during the 2025 ESMO Gastrointestinal Cancers Congress demonstrated that patients who received the combination (n = 18) achieved an overall response rate of 17% and a disease control rate of 39%. The median progression-free survival was 2.3 months (95% CI, 1.58-5.29) and the median overall survival was not reached (NR; 95% CI, 4.54-NR). In terms of safety, no new signals were reported.

Weinberg noted that pembrolizumab monotherapy and single-agent immune checkpoint inhibitors have largely not been effective to date for the treatment of patients with pancreatic cancer. The approach used in EXPEL PANC is an attempt to modify the stroma and allow an influx of T cells and natural killer cells to enter the tumor microenvironment, he added. The findings showed that BXCL701 was synergistic with PD-1 inhibition, he noted.

In the future, investigators hope to move these types of approaches into earlier lines of therapy, such as the frontline maintenance setting, or [use them] in combination with other novel agents such as KRAS inhibitors, Weinberg explained. The regimen used in EXPEL PANC represents a chemotherapy-free treatment option for patients, he said. Patients with PDAC who experience disease progression following chemotherapy often experience substantial adverse effects after initial treatment; accordingly, investigators hope that BXCL701 plus pembrolizumab represents an opportunity to activate patients’ own immune systems to work against their disease, he concluded.