Immunotherapy has revolutionised cancer treatment over the last few years . But, sadly, not all cancer patients derive benefit from the costly immunotherapy drugs. 

For instance, almost, all advanced kidney or skin melanoma cancer patients are eligible to try immunotherapy. But only about 1% of patients with pancreatic cancer are at present eligible for immunotherapy .

A new study suggests more people with pancreatic cancer may be eligible for immunotherapy. 

The preliminary data from a good quality early study (randomized phase II trial) is interesting.

The study compared treatment with gemcitabine (G) and nab-paclitaxel (N) with and without dual immunotherapy treatment with durvalumab (D) and tremelimumab (T) as 1st-line therapy in patients with advanced pancreatic cancer. 

In this study, only a subset of patients derived benefit from the dual combination therapy. 

Subsequent molecular and genetic analysis showed that the presence of certain gene mutations (≥2 DDR) was strongly associated with benefit from the combination of chemotherapy with dual immune checkpoint inhibitor therapy. 

These intriguing exploratory data analysis needs confirmatory data before the combination therapy become the standard of care for advanced pancreatic cancer patients.

The study data was presented at the prestigious annual meeting of the American Society of Clinical Oncology (ASCO) hosted at Chicago.

Dr Sundar is a member of American Society of Clinical Oncology (ASCO) and has been a member for more than 25 years.

References

American Society of Clinical Oncology (ASCO) 2025: Concurrent mutations in DNA damage repair genes BRCA1, POLE, ATM and FANCA to predict overall and progression-free survival for patients (pts) with metastatic pancreatic ductal adenocarcinoma (mPDAC) treated with chemotherapy in combination with dual checkpoint inhibition in the CCTG randomized PA.7 trial.

Evaluating Mismatch Repair Deficiency in Pancreatic Adenocarcinoma: Challenges and Recommendations. Clin Cancer Res (2018) 24 (6): 1326–1336.

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