Study Uses Precision Medicine to Speed Drug Testing for Pancreatic Cancer

Aaron Miller MD, PhD

Pancreatic cancer is among the world’s toughest cancers, with a five-year survival rate of just 10 percent. Effective treatments for pancreatic cancer are limited and the National Comprehensive Cancer Network’s guidelines point to clinical trials as the best option for treatment. Fortunately, Moores Cancer Center at UC San Diego Health is among the few clinical trial sites in the U.S. for the Pancreatic Cancer Action Network’s (PanCAN) newly created Precision Promise, the first large-scale precision medicine trial designed to transform outcomes for patients with pancreatic cancer.

“This clinical trial is different than standard clinical trials in that it has an adaptive design, meaning if a drug is not working, it can be pulled from the trial and another treatment can take its place. And if a drug is working, it can move more quickly through the trial and to the FDA for potential approval,” said Aaron Miller MD, PhD, medical oncologist and principal investigator of the trial at Moores Cancer Center.

Each patient enrolled in a Precision Promise trial undergoes advanced molecular profiling and receives state-of-the-art supportive care during their treatment. Precision Promise is currently open at Moores Cancer Center, the only NCI-designated comprehensive cancer center in San Diego. Patients with metastatic pancreatic cancer who have not yet had treatment, or who have received only first-line treatment, may be eligible to enroll in PanCAN’s Precision Promise.

“Precision Promise is a clinical trial that will provide patients with access to therapies rooted in science,” said Andrew Lowy, MD, chief of the Division of Surgical Oncology at Moores Cancer Center at UC San Diego Health. “Every possible patient with pancreatic cancer should be enrolled in a clinical trial because standard treatments are not enough. Precision Promise will offer options for patients with advanced pancreatic cancer including those who are untreated and those who have received prior therapies.”

Precision Promise investigates multiple treatment options, called sub-studies, under one clinical trial design. Patients have the option to receive both first and second line treatment within this trial, allowing patients that enter Precision Promise in first line to quickly shift to a second line therapy within the same trial if needed.

The network of Precision Promise sites allows researchers at all 15 clinical trial sites to evaluate the success of all patients as they progress through treatment. Tissue samples will be collected on each patient which may help researchers better understand why some patients respond better to specific treatments and not others.

Andrew Lowy, MD

“In some trials, when the results are not what we expected from our initial hypothesis, there are no samples to inform research on why it was unsuccessful,” said Lowy, who was selected as part of a Stand Up To Cancer dream team of investigators working on developing new treatments for pancreatic cancer patients.

“Was the drug ineffective? Did it not reach its target? Was there a mutation we were unaware of? In order to improve upon therapies, we must understand what is happening in each patient. Precision Promise offers a collaborative network in which researchers can help each other answer these questions leading to better, faster FDA approval of new therapies in the clinic.”

Moores Cancer Center is a member of the National Comprehensive Cancer Network and was recently named an NPF Center by the National Pancreas Foundation — a designation reserved for premier health facilities that focus on high-quality, multidisciplinary approaches to pancreatic disease. More patients with pancreatic cancer receive their care at UC San Diego Health than at any other medical center in the region and its surgeons perform the highest volume of complex procedures for this kind of cancer.