With the lowest survival rate of all major cancers in Australia, a pancreatic cancer diagnosis can be devastating.
A newly opened clinical trial, called PemOla – made possible thanks to community-funded grants and philanthropy – aims to change that.
Sponsored by Cambridge University Hospitals NHS Foundation Trust with support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre in the UK, and AGITG and GI Cancer Institute in Australia, this urgently needed research is investigating a potential treatment combination for people with metastatic pancreatic cancer (cancer that has spread beyond its original site), bringing hope for better survival outcomes.
“A trial like PemOla isn’t just a study. It’s a lifeline,” says hepatobiliary surgeon and leading upper GI cancer researcher, A/Prof Daniel Croagh, who is leading the trial in Australia.
An enormous unmet need
“Pancreatic cancer is a cancer that people don’t think about a lot. But it has one of the highest mortality rates,” says A/Prof Croagh.
There’s been little improvement in survival statistics over the last 50 years, with the disease predicted to become Australia’s second leading cause of cancer death by 2030.
Currently, the five-year survival rate is just 13% – dropping to 6.8% for those living in rural and regional areas.
Like many gastro-intestinal cancers, symptoms are often vague. And for around 80% of people, diagnosis comes too late for surgery.
“Even with the best chemotherapy, the average survival for metastatic pancreatic cancer is less than a year,” explains A/Prof Croagh.
There’s an enormous need for more effective treatments, both in Australia and globally. However, because of the aggressive nature of the disease, conducting trials can be incredibly difficult. As well as there often not being enough time, many patients simply aren’t well enough to participate.
A targeted treatment combination
In the search for more effective treatments, immunotherapy is increasingly being explored as an alternative to chemotherapy. Immunotherapy is a drug that stimulates the patient’s own immune system to identify and target the destruction of their own tumour.
The PemOla trial, sponsored in Australia by AGITG, is testing whether combining an immunotherapy drug with another drug called a ‘PARP inhibitor’ could improve outcomes for those whose tumours contain a high number of mutations, meaning a change in the DNA sequence of a cell.
Mutations can make tumours more visible to the immune system, potentially making them more responsive to this drug combination. The immunotherapy drug works to stimulate the body’s immune system to attack cancer cells, while the PARP inhibitor prevents them from repairing themselves.
While only about 5% of people with metastatic pancreatic cancer have a high tumour mutational burden – a biomarker indicating numerous genetic changes within the tumour – the potential impact of this study is still immense. Targeting only those most likely to benefit ensures they’re able to receive personalised treatment in time.
If successful, PemOla could provide the first evidence that immunotherapy is an effective treatment for metastatic pancreatic cancer, leading to further international research.
Backed by the community
It’s a vital, innovative trial that the pancreatic cancer community has thrown its weight behind, helping to bring the study to Australia though dedicated fundraising and multiple grants.
“I can’t thank the community enough,” says A/Prof Croagh. “PemOla could change the future of treatment for patients who currently have no options left.”
PemOla is led by Dr Pippa Corrie and sponsored by Cambridge University Hospitals NHS Foundation Trust with support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre in the UK. AGITG and GI Cancer Institute is acting as the local sponsor, with the AGITG Clinical Research Centre as the coordinating centre and A/Prof Daniel Croagh as the local Study Chair. This trial is generously funded by a Tour de Cure grant, a PanKind Australian Pancreatic Cancer Foundation Limited Research Grant, an Epworth Medical Foundation Grant and GI Cancer Institute philanthropy.
Please speak to your consulting specialist if you think this trial may be suitable for you.