Oncology Treatment
Pancreatic Cancer
Clinical Trials
Pancreatic cancer — the 4th most common cause of cancer death in America in both men and women — is notoriously stubborn and resistant to treatment. New therapeutic approaches are required to make progress against this challenging disease. Investigators in Columbia University's Pancreas Center are now conducting multiple clinical trials of innovative therapies for patients with pancreatic cancer, including:
HIPPOCRATES: Identification of Personalized Treatment Utilizing Master Regulator Gene Targets in Pancreatic Cancer
Patient Population: Inoperable or metastatic pancreatic adenocarcinoma with no prior treatment for advanced disease
The goals of this study are to assess safety, feasibility, and efficacy of an RNA-based precision medicine approach. Columbia University researchers have developed a systems biology technique to select the most appropriate therapy for patients with advanced treatment-refractory pancreatic cancer: the OncoTreat algorithm, which evaluates the actual state of a cancer cell and identifies drugs to target the context of that cell. Through the HIPPOCRATES study (High-throughput Pancreas Precision Oncology by Cell Regulatory-network Analysis based Therapy Selection), biopsy samples from each patient’s tumor are transplanted into a laboratory model to test the best therapies as predicted by the OncoTreat algorithm. The top validated agent for each patient’s tumor will then be recommended for treatment in the second- or third-line metastatic setting.
Chemo4METPANC: A Phase II Study of Combination Chemokine Inhibitor, Immunotherapy, and Chemotherapy
Patient Population: Metastatic treatment-naïve pancreatic adenocarcinoma
Investigators are assessing the safety and efficacy of combination treatment with cemiplimab, motixafortide, gemcitabine, and nab-paclitaxel in patients with metastatic treatment-naïve pancreatic cancer. Motixafortide, a CXCR4 inhibitor, is thought to promote the entry of CD8+ T cells into a tumor. Columbia University researchers found in laboratory models that the combination of chemotherapy, immunotherapy, and CXCR4 inhibition allows T cells to come physically closer to cancer cells and boosts treatment efficacy, leading to increased overall survival in preclinical studies. This combination also created a more favorable tumor environment for chemotherapy and immunotherapy to work more effectively.
A Phase I "Window of Opportunity" Study of Presurgical Bethanechol Therapy
Patient Population: Resectable localized pancreatic adenocarcinoma
Bethanechol is a medication that regulates the parasympathetic nervous system and is FDA-approved for treating dry mouth or urinary difficulties. Columbia University scientists recently showed that bethanechol stimulation of nerve receptors slowed tumor growth in cells in a laboratory model. In this study, researchers are assessing the impact of presurgical bethanechol therapy on tumor activity by looking at biomarkers of proliferation, inflammation, and stem cell markers in post-treatment specimens compared to pre-treatment specimens and compared to other patients who were not treated with bethanechol prior to surgery. They hypothesize that bethanechol will alter nerve conduction within tumors by stimulating the parasympathetic nervous system and reduce tumor proliferation, macrophage activation, tumor necrosis factor (TNF) alpha, and human cluster of differentiation 44 (CD44) protein cancer stem cells.