New Drugs for Pancreatic Cancer Show Remarkable Promise for Deadly Disease

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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.

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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.

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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.

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.

These were early results, meaning additional trials will be needed before the drugs are approved.

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