Clinician-to-Clinician Update Clinician-to-Clinician Update

Cancer Care Specialty Updates

February 2016

Greeno-Edward-2010
— Edward Greeno, MD

Pancreatic clinical trials now enrolling

In addition to the Minnelide trial, 3 clinical trials for patients with metastatic pancreatic cancer are now enrolling, and the primary investigator of each is Edward Greeno, MD. For more information, please contact Klaudija Dragicevic at 612-626-4495 or kdragice@umn.edu.

Phase II Trial of Recombinant Human Hyaluronidase. Patients with previously untreated stage IV pancreatic cancer are currently being enrolled in a phase II clinical trial comparing the efficacy and safety of treatment with an experimental PEGylated recombinant human hyaluronidase (rHuPH20) plus chemotherapy to that of chemotherapy alone. The high levels of hyaluronan found in pancreatic cancers support a protective network around the tumor, which acts as a barrier to chemotherapy drug delivery. rHuPH20 might dismantle the hyaluronan network component of pancreatic tumors and increase the efficacy of concomitant chemotherapy. Interim analysis presented at ASCO this year suggests improved outcomes with this approach, and a phase III trial will begin as this trial is completed.

Phase III Trial of Ruxolitinib. In this phase III study for safety and efficacy, patients with advanced or metastatic adenocarcinoma of the pancreas who have failed or were intolerant to first-line chemotherapy will be randomized to receive either ruxolitinib plus capecitabine or a placebo plus capecitabine. The treatment will be administered in repeating 21-day cycles for as long as the regimen is tolerated and discontinuation criteria are not met. Ruxolitinib is a JAK inhibitor approved for use in certain patients with polycythemia vera or myelofibrosis, now being studied as a treatment for those with advanced pancreatic cancer. A previous phase II trial with this agent suggests a significant survival benefit to inhibition of this pathway.

Phase III Trial of Radioimmunotherapy. Patients are currently being enrolled in a double-blind, randomized study of treatment safety and efficacy that compares patients receiving 90Y-clivatuzumab tetraxetan plus lowdose gemcitabine to those receiving a placebo plus low-dose gemcitabine. 90Y-clivatuzumab tetraxetan is a radioimmunotherapy agent under study for patients with metastatic pancreatic cancer who have progressed on at least 2 prior therapies.

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