“Novel Therapies and New Directions in Pancreas Cancer, 2024”

“Novel Therapies and New Directions in Pancreas Cancer, 2024” (Eileen O’Reilly, MD) [#106] Brad Power July 24, 2024 “It's exciting times in pancreas cancer. Having been in this field for a while and seeing a lot of things sadly not materialize, the field is poised for change.” – Eileen O’Reilly, MD “The way we do genetic testing has really evolved to be practical, feasible, and timely.

We now do what's called ‘point of care’ testing. At the time of diagnosis, and essentially at the first meeting for most of the new people that we will encounter, we will recommend getting germline and somatic testing underway, using a variety of educational tools.

” – Eileen O’Reilly, MD “Traditionally and currently, the main standards of treatment for almost all stages of disease are chemotherapy-based, and that has been improved and refined but imperfect, and multi-agent cytotoxic chemotherapy are in all our guidelines for advanced disease, for post-operative preventive therapy, and for treatment of localized and advanced disease.

But increasingly the focus is shifting to subgroups of patients who can benefit from targeted therapeutics (e.g., KRAS, BRCA).” – Eileen O’Reilly, MD Meeting Summary Patients who are diagnosed with pancreatic cancer and do an online search about their prospects are confronted with a poor prognosis and dire statistics.

If they then search for standard treatment options, they find a limited menu of treatment options that benefit only a small percentage of patients. However, improvements in supportive care, chemotherapy, molecular diagnostics and associated targeted therapies are enabling some patients to live longer and better, while immunotherapies are increasingly making progress.

The pace of change is increasing exponentially. New tests and treatments are being approved and on the horizon which offer new hope for pancreatic cancer patients and caregivers. Eileen O'Reilly, MD, is uniquely qualified to discuss recently announced regulatory approvals and research results in pancreatic cancer.

Her research includes integration of molecular and genetic-based therapies for pancreas cancer along with development of adjuvant and neoadjuvant therapies and identification of biomarkers for therapy selection. Dr. O’Reilly received her medical degree at Trinity College in Ireland.

She completed her postgraduate training in Ireland and subsequent Hematology/Oncology Fellowship training at Memorial Sloan Kettering. Dr. O’Reilly is a clinical scientist whose research focus involves integration of molecular and genetic-based therapies for pancreas cancer along with development of adjuvant and neoadjuvant treatments and identification of biomarkers for therapy selection. Dr.

O’Reilly teaches and mentors junior faculty, oncology fellows, residents and medical/other students and has numerous teaching and other awards. Dr.

adjuvant and neoadjuvant treatments and identification of biomarkers for therapy selection. Dr. O’Reilly teaches and mentors junior faculty, oncology fellows, residents and medical/other students and has numerous teaching and other awards. Dr.

O’Reilly is the principal investigator of multiple phase I, II, and III trials in pancreas cancer and has authored/co-authored about 400 articles, editorials, and book chapters and has an H-index of 93.

“Novel Therapies and New Directions in Pancreas Cancer, 2024” (Eileen O’Reilly, MD) [#106] American Association of Cancer Research (AACR), NIH, DOD, and various international entities. She is the principal investigator of the MSK Pancreas Specialized Program in Oncology Research Excellence (SPORE), an NCI-funded team science grant. Dr.

O’Reilly is the recipient of numerous awards including the Burkitt Medal (TCD) in 2022, and Giants of Cancer Care GI Oncology, 2023. Dr. O’Reilly’s other responsibilities include Chair of the Human Research Protection Program and Institutional Review & Privacy Board (IRB). Nationally, Dr.

O’Reilly is Co-Chair of the NCI Alliance Co-Operative Group Gastrointestinal Cancers Committee and serves on the NCI Gastrointestinal Cancers Steering Committee (GISC) and serves in leadership roles in several advocacy organizations including National Pancreas Foundation, Hirshberg Foundation and Pancreas Cancer Action Network.

Why should you keep up-to-date on the latest treatments for pancreatic cancer? Traditionally and currently, the main standards of treatment for almost all stages of pancreatic cancer are chemotherapy-based. That has been improved and refined, but it is imperfect. However, what was best six months or a year ago may be old news. The pace of change is increasing exponentially.

New tests and treatments are being approved and on the horizon which offer new hope for pancreatic cancer patients and caregivers. Increasingly the focus is shifting to subgroups. What are the latest improvements in testing for pancreatic cancer that are available today and in the near future? ●Genetic testing and liquid biopsies for early detection are improving.

Our ability to detect targets has progressed even from a couple of years ago. One of the greatest uses right now of liquid biopsies (from a blood draw) is being able to understand whether you have a KRAS mutation or not. ●Around 12% of people have a hereditary predisposition to pancreatic cancer, which can be identified through genetic testing.

●You should get “point of care” genetic testing (hereditary testing on your normal cells and testing on your tumor cells) at your first meeting, accompanied by educational videos to explain the test and its results.

sposition to pancreatic cancer, which can be identified through genetic testing. ●You should get “point of care” genetic testing (hereditary testing on your normal cells and testing on your tumor cells) at your first meeting, accompanied by educational videos to explain the test and its results.

●Although early detection of pancreatic cancer through tests may be expensive or infeasible today, using AI on medical records, and finding patients with certain kinds of diabetes, are identifying selected groups of patients who may benefit from screening tests.

We are on the cusp of identifying pancreatic cancer with a lead time prior to clinical presentation, when, sadly, a lot of people are quite sick. ●Early research suggests immune response may predict outcomes in a pancreatic cancer vaccine trial. What are the challenges in improving tests and treatments for pancreatic cancer?

●It can be difficult to get high-quality tissue from the pancreas for testing.

“Novel Therapies and New Directions in Pancreas Cancer, 2024” (Eileen O’Reilly, MD) [#106] ●It is difficult to detect pancreatic cancer early from a liquid biopsy (blood draw) due to the lack of circulating tumor DNA in the blood. ●Pancreatic cancer has strong immune system suppression. What are the latest improvements in treatments for pancreatic cancer that are available today?

●KRAS inhibitors, including emerging combinations with chemotherapy and immunotherapy ●If you have homologous repair deficiency or have ineffective DNA repair (courtesy of a BRCA1, BRCA2 PALB2, and some other gene alterations), then there are chemotherapeutics, PARP inhibitors, and an emerging role for immunotherapy-based combinations.

What are new treatments for pancreatic cancer that are being studied and may be available in the near future? ●About 15%, maybe 20%, of pancreatic cancer patients have deletion of a gene called “MTAP”, which is associated with other genes, which may have a treatment implication. ●Immunotherapy approaches for pancreatic cancer (e.g.

, personalized neoantigen vaccines, CD40 agonists which activate the immune system, CD73 inhibitors which target immune system suppression) ●Additional RAS-targeted drugs, such as RMC-6236, including in combinations How can you learn more and engage in choosing among the latest pancreatic cancer treatments?

●Get a second opinion from the big academic centers; usually, they will have a good sense of what's happening and where the field is headed and what trials are most relevant, and what might be an approximate horizon for access ●See our discussion with John Strickler, MD, on KRAS treatments .

atments .

●Check out PanCAN and other pancreatic cancer advocacy organizations ●Get a free second opinion from Cancer Commons ●Check out clinical trial resources and search tools at Massive Bio and myTomorrows, free services which review your medical records and make recommendations on suitable clinical trials for you, tailored to specifics, including what might be practical geographically ●Get germline and somatic testing at your diagnosis ●Research the importance of diabetes, weight changes, and other atypical symptoms as potential early warning signs The information and opinions expressed on this website or platform, or during discussions and presentations (both verbal and written) are not intended as health care recommendations or medical advice by Cancer Patient Lab, its principals, presenters, participants, or representatives for any medical treatment, product, or course of action.

You should always consult a doctor about your specific situation before pursuing any health care program, treatment, product or other course of action that might affect your health.

“Novel Therapies and New Directions in Pancreas Cancer, 2024” (Eileen O’Reilly, MD) [#106]

“Novel Therapies and New Directions in Pancreas Cancer, 2024” (Eileen O’Reilly, MD) [#106] Meeting Notes KEYWORDS pancreas cancer, people, disease, k ras, targeting, mutation, treatment, question, immunotherapy, part, pancreas, drugs, setting, chemotherapy, terms, therapeutics, important, tumor, early, field SPEAKERS Eileen O’Reilly (71%), Brad Power (9%), Rick Davis (5%), Gitte Pedersen (5%), Jill Rosen (3%), Roger Royse (3%), Francesca Paradiso (2%), Kathi Peterson (2%), Allen Morris (1%) CHAT CONTRIBUTORS Rick Davis, Robyn Caldwell, Allen Morris, Ellen Miller, Saed Sayad, David Plunkett, Roger Royse, Gitte Pedersen, Rob Weker SUMMARY Pancreatic cancer treatments can be tailored to individual patients based on their unique genetic profiles and immune systems.

Emerging targets and therapies for pancreatic cancer include KRAS inhibitors, vaccines, and small molecule inhibitors. Genetic testing and liquid biopsies for early detection are improving, though there are challenges, such as the need for high-quality tissue and the difficulties in detecting targets due to the lack of circulating tumor DNA in the blood.

Further research is needed to overcome technical challenges and improve early detection and treatment strategies. OUTLINE Pancreatic cancer research and treatment advancements, including targeted therapies and immunotherapies ●Dr. Eileen O'Reilly discusses pancreatic cancer research and future developments.

●There have been recent announcements of targeted therapies for KRAS-mutated tumors and homologous repair deficient subgroups. ●Genetic testing is evolving, including point-of-care testing and timely results.