Renuka Iyer with Patient

Medical Therapy for Pancreatic Cancer

Medical therapies use drugs or other substances to kill cancer cells or slow their growth. These are called systemic therapies, because the medications travel throughout the body to find and attack cancer cells. Chemotherapy, targeted therapy, and immunotherapy are types of medical treatment used for pancreatic cancer and these approaches use drugs that work in different ways.

Targeted therapy and immunotherapy are treatment approaches that only benefit patients whose tumors show specific characteristics. The National Comprehensive Cancer Network (NCCN) recommends that patients with advanced pancreatic cancer who are healthy enough to receive cancer therapy should have their tumors profiled to see if a targeted agent or immunotherapy might work for their cancer.

Roswell Park’s Innovation — OmniSeqSM Precision Medical Technology

Roswell Park developed several of the most comprehensive diagnostic tests for genetic profiling and immune analysis so that your care team can customize your treatment precisely for your tumor. OmniSeq ComprehensiveSM looks for mutations within 144 of the most relevant genes and OmniSeq Immune Report Card® analyzes your body’s immune response to your cancer. With these tests, your tumor can be matched with the specific targeted drug, immunotherapy or new agent in a clinical trial that will best fight it. Learn more about this latest innovation born out of Roswell Park’s research laboratories.

Chemotherapy for pancreatic cancer

Chemotherapy is a class of drugs that fights cancer by interrupting the life cycle of cells that grow and multiply rapidly — like cancer cells. In this way, chemotherapy kills cancer cells, slows their growth and/or prevents the formation of new ones.

In pancreatic cancer, chemotherapy is often part of the treatment at every stage of the disease, including:

  • Before surgery (called neoadjuvant) for resectable or borderline resectable tumors to shrink the tumor
  • Combined with surgery or radiation (called adjuvant) to improve cancer control
  • As a primary treatment for patients with unresectable or metastatic disease

Chemotherapy drugs that are used for pancreatic cancer may be delivered in various ways, including:

  • Orally, as a pill you swallow
  • Infusion into your bloodstream (most common)

The pancreatic cancer care team will develop your personalized treatment plan, including whether or how to use chemotherapy, and which drugs to use, based on your cancer’s stage and other characteristics specific to your cancer. For pancreatic cancer, chemotherapy drugs are often given in a combination (using two or more drugs together) to improve the effectiveness of the treatment.

Targeted therapy for pancreatic cancer

Targeted therapies use drugs that affect specific, unique feature of the cancer cell (such as a gene mutation or protein) that isn’t found with normal, non-cancerous cells.

These drugs focus on certain targets (genes, proteins or microenvironment) of the cancer cells that keep the cell working, growing and living. Targeted therapy fights cancer in various ways such as blocking signals within the cancer cell that instructs it to grow or multiply, or to live longer than it should, or affect cells that are needed for the cancer to grow, such as blood vessels. Currently, the targeted drug Erlotinib is used with chemotherapy to treat some patients with pancreatic cancer.

Targeted therapy is a type of personalized medicine in that the drugs used are chosen specifically for that patient, based on that tumor’s genetic profile. For example, one patient may have a pancreatic tumor that has a specific gene characteristic that a targeted drug can affect, while another patient’s pancreatic tumor does not, even if they have the same cancer type and stage. Targeted therapies for pancreatic cancer include:

  • Olaparib is an oral drug that targets a protein called PARP. It can be used in patients with advanced pancreatic cancer and germline BRCA1 or 2 mutations after initial successful therapy with platinum-based chemotherapy.
  • Larotrectinib may be an option for patients whose tumors have an NTKR mutation.

Researchers at Roswell Park are actively searching for new targets within cancer cells and developing new agents to affect them.

Immunotherapy for pancreatic cancer

Immunotherapy is a treatment approach that harnesses your immune system to fight cancer. Immunotherapy can use your own immune system in two ways:

  • Power up your immune system so it is stronger and better able to fight cancer
  • Enhance or alter your immune cells to target and attack cancer cells

Immunotherapy drugs used for pancreatic cancer include pembrolizumab or nivolumab. These drugs work only for patients with tumors that have a unique characteristic called microsatellite instability or are deficient in mismatch repair proteins.