Pancreatic Cancer: Targeted and Immunotherapies
Targeted and Immunotherapies for Pancreatic Cancer
This section covers the following topics:
What is ?
is a type of cancer treatment designed to attack or kill cancer cells, while sparing normal cells as much as possible. They are designed to target abnormal proteins, receptors or genes that are found in cancer cells or the surrounding tissue. Often times additional testing on the cancer is used to decide if is the best treatment for a person with pancreatic cancer.
PARP inhibitors
PARP inhibitors work by blocking a protein used by cells to repair damaged . They were initially developed to treat cancers in people with an inherited or mutation. For people with pancreatic cancer, the Lynparza () has been approved as in patients with advanced pancreatic cancer whose cancer has stabilized after at least four months of chemotherapy. Approximately 5-8% of people with pancreatic cancers will have a mutation.
Research is ongoing to learn if PARP inhibitors are also affective for treating pancreatic cancer in other situations, including:
- people with an in a different gene that repairs damage (for example: ).
- people who do not have an inherited gene mutation, but their tumor tested positive for an acquired mutation in a gene that repairs damage.
- in combination with or other agents.
Other targeted therapies
Other targeted therapies used to treat pancreatic exocrine cancer include:
- Vitrakvi (larotrectinib) is approved for treatment of of advanced cancers that have a genetic change called an NTRK fusion.
- Enhertu (trastuzumab deruxtecan) is a type of targeted therapy approved for treatment of advanced cancers that have a called .
- Retevmo (selpercatinib) if tumor testing is positive for a called RET gene fusion.
Targeted therapies used to treat pancreatic neuroendocrine tumors include:
- Afinitor (everolimus) is a type of known as an mTOR inhibitor that is approved for treating people with advanced pancreatic neuroendocrine tumors.
- Sutent (sunitinib malate) is a that is approved to treat patients with pancreatic neuroendocrine tumors that cannot be removed by surgery or that have metastasized.
What is ?
Immunotherapies are cancer treatments that help the body’s immune system detect and attack cancer cells. There are several different categories of immunotherapies.
Immune checkpoint inhibitors
Immune checkpoint inhibitors are a type of used to treat several types of cancer, including some pancreatic cancers. Cancer cells can switch off the immune system. Immune checkpoint inhibitors are drugs that prevent this from happening. This allows the immune system to find, unmask and destroy cancer cells.
- Keytruda (pembrolizumab) is known as an immune checkpoint inhibitor. Keytruda is approved for treatment of patients with cancer with a known as microsatellite instability-high (MSI-H) or mismatch repair deficient (). Although this is not common in pancreatic cancer, it is often seen in people with a gene mutation who develop cancer.
Cancer vaccines
Cancer vaccines help the body's immune system recognize and attack cancer cells. Currently, there are no vaccines with approval to treat pancreatic cancer, but several are being studied in clinical trials.
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Name of Drug |
Cancer Stage |
Line of Treatment |
Indication |
Biomarker |
Type of Agent |
Lynparza (olaparib) |
Metastatic pancreatic cancer |
First-line maintenance therapy |
For people whose disease has not progressed on at least 16 weeks of platinum-based chemotherapy |
Inherited mutation in BRCA1 or BRCA2 |
Type of targeted therapy known as a PARP inhibitor |
Enhertu (fam-trastuzumab-deruxtecan-nxki) |
Metastatic or unresectable solid tumors |
Second-line or later |
For adults with unresectable or metastatic, HER2-positive solid tumors who have received prior systemic treatment and have no alternative treatment options |
HER2 overexpression (HER2-positive) |
Antibody-drug conjugate (chemotherapy attached to antibody targeting HER2 receptor) |
Retevmo (Selpercatinib) |
Metastatic solid tumors |
Second-line or later |
For treatment in metastatic solid tumors for which there are no other treatment options |
RET gene fusion |
Targeted therapy known as a kinase inhibitor |
Vitrakvi (larotrectinib) |
Metastatic solid tumors |
Second-line or later |
For treatment in metastatic solid tumors for which there are no other treatment options |
NTRK fusion |
Targeted therapy known as a kinase inhibitor |
Afinitor (everolimus) |
Pancreatic neuro-endocrine tumors (PNET) that have gotten worse |
After progression |
Treatment of pancreatic neuroendocrine tumors that have grown or gotten worse |
No biomarker required |
Type of targeted therapy known as an MTOR inhibitor |
Sutent (sunitinib malate) |
Unresectable, locally advanced or metastatic pancreatic neuro-endocrine tumors (PNET) |
After progression |
For treatment of well-differentiated pancreatic neuroendocrine tumors (pNET) |
No biomarker required |
Type of targeted therapy known as a multi-target kinase inhibitor |
Keytruda (pembrolizumab) |
Metastatic or unresectable cancers |
Second-line or later |
For treatment of solid tumors that have progressed after treatment and for which there are no other treatment options |
|
Type of immunotherapy known as an immune checkpoint inhibitor |
Keytruda (pembrolizumab) |
Metastatic or unresectable cancers |
Second-line or later |
For treatment of solid tumors that have progressed after treatment and for which there are no other treatment options |
TMB-H (tumor mutational burden-high) |
Type of immunotherapy known as an immune checkpoint inhibitor |