Pancreatic cancer is one of the deadliest cancers. It killed nearly 52,000 Americans last year, many within a year of diagnosis. Now, there are some new experimental medicines with the potential to change that. undefined undefined New data from two drugs showed it might be possible to keep the disease in check for longer than ever before. One drug, developed by Revolution Medicines , shrank tumors in roughly half of people who used it as a first treatment. And an mRNA vaccine made by Germany-based BioNTech and Genentech kept most patients who responded to it alive six years—an unusually long stretch for a cancer that normally leaves only around one in eight people alive five years after diagnosis. undefined undefined “This is a pivotal point in time for this disease, there’s no question,” said Dr. Eileen O’Reilly , a gastrointestinal oncologist at Memorial Sloan Kettering Cancer Center in New York City who led one of the RevMed-funded trials.
Pancreatic cancer is hard to detect and aggressive; most people aren’t diagnosed until they are far along. Standard chemotherapy works for few patients. The disease is hard to treat for two distinct reasons. More than 90% of pancreatic tumors carry a mutation called RAS, which accelerates tumor growth and historically has been nearly impossible to treat with drugs. Many pancreatic tumors also carry relatively few mutations overall, which makes them harder for the immune system to detect and attack.
RevMed’s drug, called daraxonrasib, targets RAS mutations. Results of a nearly 40-person study of people with late-stage pancreatic cancer showed that the drug, when used as the first treatment, shrank tumors in nearly half of the people treated. The results, announced Tuesday at the American Association of Cancer Research annual meeting, led some researchers to wonder whether the drug might eventually replace chemo.
“This is going to be a paradigm-shifting outcome,” said Dr. Andrew Coveler , director of the pancreatic cancer specialty clinic at Fred Hutch Cancer Center in Seattle, who wasn’t involved in any of the studies. “In 15 years, this is probably the first real big change or anticipated change in pancreas cancer.”
The results come days after RevMed reported that daraxonrasib, its RAS-targeting pill, nearly doubled overall survival for people with advanced pancreatic cancer compared with chemotherapy in a larger, later-stage trial.
“We have enormous momentum now toward our goal of changing the treatment landscape for patients” with RAS mutations, RevMed Chief Executive Mark Goldsmith said in an interview. Shares of RevMed have surged more than 50% since the company announced the late-stage results last week. undefined undefined A completely different experimental treatment from BioNTech targeted tumors with low mutations that were diagnosed earlier in the course of the disease. Of the 16 patients in BioNTech’s trial of its mRNA vaccine, eight responded to the vaccine and seven of those people are still alive six years later.
Moderna is also developing an mRNA cancer vaccine through a partnership with Merck , and the companies expect to release data potentially later this year about its effectiveness in melanoma. undefined undefined These mRNA vaccines are custom-built for each patient. After surgery to remove part of a tumor in New York, doctors ship the tissue to BioNTech’s laboratories in Germany. Scientists there analyze it to identify genetic mutations unique to that patient’s cancer, encode them into an mRNA vaccine and return the vaccine to New York in about nine weeks.
If successful, the vaccine trains immune cells to recognize and destroy any remaining cancer cells carrying those mutations before they can form new tumors. undefined undefined “If we can do it here, maybe we can do this in many other cancers,” said lead researcher Dr. Vinod Balachandran , director of the Olayan Center for Cancer Vaccines at Memorial Sloan Kettering.
These were early results, meaning additional trials will be needed before the drugs are approved.
Write to Xavier Martinez at xavier.martinez@wsj.com
