Immunotherapy: Can it change the way pancreatic cancer is treated?

New Delhi: Pancreatic cancer is becoming increasingly common, and some estimates suggest that the number of new cases and fatalities may more than quadruple by 2030. The pancreas, a gland behind the lower section of the stomach, produces enzymes that aid digestion and hormones that regulate blood sugar. Pancreatic cancer is a form of cancer that originates with the proliferation of cells in the pancreas. These cells can invade neighboring tissues and spread to other organs, affecting normal biological activities.

While talking about the role of immunotherapy in pancreatic cancer, Dr. Puneet Gupta, Chairman- Oncology, Asian Hospital, Faridabad, said, “Its symptoms often develop subtly, including persistent abdominal or back pain, unexplained weight loss, jaundice, nausea, fatigue, and appetite loss. In some cases, new-onset diabetes may occur. Detection and diagnosis is challenging in its early stages. It frequently develops without warning signs, there is no widely used method for early detection, and while some risk factors have been identified (such as tobacco use, a family history of pancreatic cancer, and a personal history of diabetes, pancreatitis, or obesity), few patients diagnosed with pancreatic cancer have identifiable risk factors.”

Pancreatic cancer is one of the deadliest malignancies in the world, accounting for the majority of cancer-related deaths. Every year, an estimated 460,000 individuals worldwide are diagnosed with pancreatic cancer, which kills roughly 430,000 people. It is listed as the eleventh most frequent cancer in India. Pancreatic ductal adenocarcinoma (PDA) is extremely fatal; for all stages combined, the 1- and 5-year relative survival rates are 27% and 9%, respectively, making it the only cancer with an overall 5-year survival rate in the single digits.

Role of Immunotherapy in Pancreatic Cancer

There are presently few viable therapies available for individuals with advanced illness who are not surgical candidates, which accounts for the vast majority of pancreatic cancer diagnoses. Pancreatic cancer is relatively more resistant to chemotherapy than other forms of cancer, giving patients fewer treatment choices in the early stages.
Immunotherapy is a treatment that stimulates your immune system to fight cancer cells. Your immune system defends your body against pathogens and illness. However, it frequently does not recognize the danger of cancer cells or is unable to access them. Immunotherapy aids your body’s ability to detect and combat cancer cells, just like it does with other diseases.

The majority of immunotherapy medicines for pancreatic cancer are now in clinical development. In clinical studies, they are typically administered in conjunction with other therapies, such as chemotherapy. For the majority of pancreatic cancer patients, using a single medication for immunotherapy treatment has proven ineffective. As a result, researchers are combining immunotherapies that can target several sections of the immune system.

Additionally, researchers are investigating the potential of cell-based therapy for pancreatic cancer. To eliminate cancer cells, these treatments involve laboratory-altered immune cells such as T cells and natural killer cells. Checkpoint inhibitors are drugs that can be used to treat persons whose pancreatic cancer cells have tested positive for particular gene alterations. They may also be beneficial if the tumor has a high mutation load (TMB-H).
These medications are evaluated for persons who have pancreatic cancer that cannot be removed surgically, has returned (recurred) after therapy, or has spread to other regions of the body (metastasized). They may be prescribed for persons who are physically fragile and cannot handle chemotherapy, or if the cancer recurs after treatment.

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