Dr. Pishvaian on Molecular Alteration in Pancreatic Cancer

Michael Pishvaian, MD, PhD, director, Phase I Clinical Program, co-director of the Ruesch Center Pancreatic Cancer Program Medical Oncology, Otto J. Ruesch Center for the Cure of Gastrointestinal Cancer, Georgetown-Lombardi Comprehensive Cancer Center, discusses the background of a study investigating molecular alterations for patients with pancreatic cancer.

Patients with pancreatic cancer have limited therapeutic options. Chemotherapy is beneficial and is used regularly but physicians are still looking for something better, Pishvaian says. There is a relatively small population of patients who have defined molecular actionable alterations, although that number of patients is increasing.

There are no approved therapies that are targeted to metastatic pancreatic cancer, except for the small subgroup of patients who are known to have microsatellite instability-high pancreatic cancer, for which pembrolizumab (Keytruda) may be of benefit.

This study was done for a very small population of patients who have an NTRK fusion, which accounts for less than 1% of all patients with cancer across the board. However, some patients with pancreatic cancer who have this fusion were found, explains Pishvaian, leading to this study. In this disease type, and other disease types, when a NTRK fusion is identified, there is potential for significant benefit from single-agent therapy. It suggests that this was a sort of a driving mutation of the cancer.