Neoadjuvant Immunotherapy for Localized Pancreatic Cancer: Challenges and Early Results

Autor: Robert Connor Chick, Andrew J. Gunderson, Shafia Rahman, Jordan M. Cloyd
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Cancers, Vol 15, Iss 15, p 3967 (2023)
Druh dokumentu: article
ISSN: 15153967
2072-6694
DOI: 10.3390/cancers15153967
Popis: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal disease due to its late presentation and tendency to recur early even after optimal surgical resection. Currently, there are limited options for effective systemic therapy. In addition, PDAC typically generates an immune-suppressive tumor microenvironment; trials of immunotherapy in metastatic PDAC have yielded disappointing results. There is considerable interest in using immunotherapy approaches in the neoadjuvant setting in order to prime the immune system to detect and prevent micrometastatic disease and recurrence. A scoping review was conducted to identify published and ongoing trials utilizing preoperative immunotherapy. In total, 9 published trials and 27 ongoing trials were identified. The published trials included neoadjuvant immune checkpoint inhibitors, cancer vaccines, and other immune-modulating agents that target mechanisms distinct from that of immune checkpoint inhibition. Most of these are early phase trials which suggest improvements in disease-free and overall survival when combined with standard neoadjuvant therapy. Ongoing trials are exploring various combinations of these agents with each other and with chemotherapy and/or radiation. Rational combination immunotherapy in addition to standard neoadjuvant therapy has the potential to improve outcomes in PDAC, but further clinical trials are needed, particularly those which utilize an adaptive trial design.
Databáze: Directory of Open Access Journals
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