Pancreatic Cancer Awareness Month: New Trials and Treatments for Pancreatic Cancer, Including NanoKnife Procedure

Pancreatic cancer, a type of cancer that starts in the pancreas, is one of the most difficult types of cancer to detect and treat.

That’s because it has few early signs and symptoms. “We don’t know how to prevent pancreatic cancer, and there is no effective screening for it,” says Hollings oncologist and director of the MUSC Division of Hematology/Oncology Dr. Craig Lockhart. Because the disease is difficult to diagnose early, it often goes undetected until it has advanced and spread to nearby organs.

“Pancreatic cancer remains one of the deadliest cancers we deal with as oncologists,” says Dr. Lockhart. “Most patients who are diagnosed with pancreatic cancer cannot receive curative therapy because the cancer is diagnosed at such an advanced stage.”

Though pancreatic cancer is relatively rare compared to other cancers, its dismal survival rate has catapulted it to the third leading cause of cancer death in the United States. About 90% of people diagnosed with pancreatic cancer will die from it.

Signs of pancreatic cancer include weight loss, jaundice, indigestion, and abdominal pain. Risk factors include tobacco use, obesity, diabetes, age, and hereditary genetic factors.

Surgery, ablation, chemotherapy, radiation, and clinical trials are all treatment options. Often a combination of treatments is most effective.

Dr. Lockhart and Hollings surgeon Dr. Katherine Morgan share how MUSC is at the forefront of the search for better therapies for patients with pancreatic cancer.

Innovative Treatments and Clinical Trials

Patients at the Hollings Cancer Center receive a personalized cancer treatment plan from a multidisciplinary team of pancreatic cancer experts. In addition, MUSC’s Pancreatic Transdisciplinary Cancer team brings together the expertise of different disciplines to advance the understanding of pancreatic cancer and translate that information to clinical trials.

As a result, MUSC offers multiple innovative clinical trials for patients with pancreatic cancer as its researchers strive to find more effective options to improve the odds for a population desperate for better treatments.

Clinical trials at MUSC include the Renovo CATH study, which uses a thin tube called a catheter to deliver chemotherapy drugs directly into the pancreas through a patient’s arteries for a targeted approach to help shrink and stabilize the tumor.

Another ongoing trial uses a novel protein to activate the anti-cancer properties of the immune system and minimize those that are not beneficial.

“We have several upcoming trials that use newer clinical regimens shown to have higher response rates than some of the standardly used regimens,” says Dr. Lockhart. Studies opening in the next few months incorporate cellular therapies, including chimeric antigen receptor (CAR) T-cell therapy, to treat patients with advanced pancreatic cancers.

Genetic testing and immunotherapy clinical studies are helping researchers determine if there are more novel and effective treatments patients could receive, says Dr. Lockhart, who has served as principal investigator on more than100 clinical trials.

“We will be participating in genetic-specific trials, including one that targets the factors that cause the weight loss we frequently see in patients with pancreatic cancer,” he says.

Access to NanoKnife Surgery at MUSC

The nature and location of pancreatic cancer require complicated treatment by skilled experts. MUSC is the only center in the region offering irreversible electroporation (IRE), also known as the NanoKnife procedure, to treat pancreatic cancer. Dr. Morgan, chief of the MUSC Health Division of GI and Laparoscopic Surgery, is the surgeon who performs it.

The NanoKnife procedure uses precisely directed electric shockwaves to kill cancer cells in difficult-to-reach areas without damaging surrounding structures. Probes placed around the tumor send out pulsing shockwaves that disrupt membranes in the cancer cells, weakening them so the immune system can more easily kill them off. The approach is particularly effective in the pancreas because it allows surgeons to maneuver around surrounding large blood vessels, a vulnerable area where traditional ablation techniques often fail.

“NanoKnife can be used during surgery for pancreatic cancer to target tumor cells that are otherwise not easily entirely removable with surgery alone,” explains Dr. Morgan. “It’s most useful in patients with stage 2 or stage 3 pancreatic cancer.”

In trials, patients with stage 3 pancreatic cancer who underwent treatment with NanoKnife surgery had a survival rate that approaches that of patients with earlier stages who are able to have conventional resection surgery, says Dr. Morgan.

“Results are better than anticipated, with patients living twice as long as expected,” says Dr. Lockhart.

Sources

• What Is Pancreatic Cancer?
• Irreversible Electroporation in Pancreatic Cancer—An Evolving Experimental and Clinical Method