New therapy approach for pancreatic cancer: Study shows doubling of survival time

A significant advantage was also seen in disease-free progression: according to the study data, the time during which the disease did not progress further extended from 3.5 months to 6.7 months. Furthermore, the time until disease progression increased on average from 3.5 to 6.7 months, as shown in the publication. The data had previously been presented at a congress of US oncologists (ASCO), where, according to APA, they received "Standing Ovations" from the cancer specialists in attendance.

Active substance Daraxonrasib targets KRAS signaling pathway

In parallel, an international research team reports in the journal "Nature Communications" on a therapeutic vaccine against KRAS mutations called mKRAS-VAX. In an initial Phase I study, 20 people with a hereditary predisposition to pancreatic cancer and notable changes in the pancreas received four doses of the experimental vaccine. 18 of the subjects with precursor stages of such a disease showed a specific immune response against KRAS. The study was small, with 20 participants, and was primarily intended to investigate safety and immune response.

Particularly notable, according to the study authors, is the fact that after a median observation time of 16.5 months, none of the 20 participants developed pancreatic cancer or a high-risk change that required surgery. "The enthusiasm stems of course largely from the dramatic therapeutic successes in a disease that in the past was difficult to respond to treatments," it says in an accompanying statement.

In Austria, nearly 2,000 people develop pancreatic carcinoma each year, with around 1,900 deaths registered per year. The disease is considered particularly difficult to treat: "Pancreatic carcinoma kills the patients and, proverbially, also the treating physicians," a Viennese oncologist formulated it. At the Comprehensive Cancer Center (CCC) of the Medical University of Vienna and the AKH, an "Exact" study with around 50 patients is to establish a system for individualized cancer medicine in Austria for the first time.

Vaccine candidate mKRAS-VAX in high-risk individuals

The editor of the "New England Journal of Medicine," Eric Rubin, put the results in context: "But from a basic research perspective, it is great to see how the decades-long efforts to develop inhibitors for cancer-promoting KRAS proteins are now bearing fruit." The deputy director of the Sidney Kimmel Cancer Center at Johns Hopkins University, Elizabeth Jaffee, also commented to the US cancer information service "Healio" on the future of preventive approaches: "An important question is: Can we prevent it before it even occurs?"

Significance for Austria and outlook

Jaffee was at the same time cautious with regard to the timeline. "I don't think this will be possible next year, but I am confident that it will become a reality in the next five to ten years," the expert was quoted as saying. The study group in "Nature Communications" holds a similar assessment: "Despite enormous efforts, we have so far not succeeded in detecting pancreatic cancer early enough to prevent most deaths."

Further research needed

A prerequisite for preventive use would therefore be better identification of at-risk patients. "If we make progress in screening methods and can better identify at-risk patients, we can hopefully administer a vaccine to them early and trigger an immune response that protects them from pancreatic cancer," the research group said. Furthermore, the Phase III study with Daraxonrasib is designed for patients with already metastasized disease — the question of whether the active substance is also effective in earlier stages of the disease remains open.

The data are considered an important advance in oncology, as pancreatic cancer has for decades been among the tumor types with the lowest five-year survival rate. Both the therapeutic approach with Daraxonrasib and the vaccine candidate mKRAS-VAX will be investigated further in larger studies in the coming years. Daraxonrasib is currently available as a tablet and therefore theoretically usable on an outpatient basis, which could noticeably ease treatment for those affected.