Potential new treatment for pancreatic cancer

Johns Hopkins Kimmel Cancer Center researchers are encouraged by early results of a treatment vaccine for pancreatic cancer, a disease with few options and low odds for long-term survival.

At about two years into a study of 60 patients, the researchers report that 88 percent survived one year and 76 percent are alive after two years.

"Even though our results are preliminary, the survival rates are an improvement over most published results of pancreatic cancer treatment studies," says Daniel Laheru, assistant professor at the Johns Hopkins Kimmel Cancer Center.

Until recently, most studies have shown pancreatic cancer survival rates at about 63 percent one year after diagnosis and 42 percent at two years. The long-term outlook is more grim - only 15 to 20 percent of patients with local disease are alive at five years. One 2003 study raised the survival bar higher, but with a chemotherapy and radiation regimen that Laheru describes as tough, with many side effects. "Since there is no universal standard for treating pancreatic cancer, it is difficult to make direct comparisons between all the studies," says Laheru.

In the current study, his team combined an immune-boosting vaccine with surgery and conventional postoperative chemotherapy and radiation. The vaccine, originally developed at Johns Hopkins, uses irradiated pancreatic cancer cells incapable of growing, but genetically altered to secrete a molecule called GM-CSF. The molecule acts as a lure to attract immune system cells to the site of the tumor vaccine where they encounter antigens on the surface of the irradiated cells. Then, these newly armed immune cells patrol the rest of the patient's body to destroy remaining circulating pancreatic cancer cells with the same antigen profile.

Patients get one vaccine injection eight to ten weeks after surgery, then four booster shots after chemotherapy and radiation. Laheru and his team completed enrolling patients in the study this past January. The average follow-up time is 32 months.

"It is important that we continue to follow these patients to know how the treatment will work in the long-term," says Elizabeth Jaffee, M.D., the Dana and Albert "Cubby" Broccoli Professor in Oncology and Pathology. "We're hopeful that these early results will hold true."

Jaffee and Laheru hope to begin multi-institutional studies in about a year. They are working with Hopkins pathologists from the Sol Goldman Pancreatic Cancer Research Center to analyze proteins from pancreatic cancer cells that may help them refine the vaccine's targets.

Pancreatic cancer strikes more than 30,000 Americans annually, and about the same number will die each year.

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