Two new clinical-trial readouts presented in San Diego this month show measurable survival gains in pancreatic cancer — the first real movement against the disease in decades [1]. The Washington Post reports that researchers gathered at the American Association for Cancer Research meeting are using the word optimism, carefully [1].

One trial tests an mRNA vaccine that primes the immune system against tumor neoantigens after surgery; the other tests a targeted therapy aimed at the KRAS mutations that drive most pancreatic tumors [1]. Both extended survival in the trial arm versus standard-of-care chemotherapy, and both will need confirmation in larger Phase 3 studies before they reach patients off-label [1].

Pancreatic cancer kills roughly 50,000 Americans a year. Five-year survival has hovered around 13% for a generation, in part because most cases are caught after the cancer has spread, and in part because the dense tumor stroma blocks drug delivery. Both approaches in San Diego try to route around the stroma — the vaccine by training T cells, the targeted therapy by binding directly to mutated KRAS proteins [1].

The funding subtext is real. NIH cancer grants have been cut. The trials reading out now were funded years ago. What replaces them, and on what timeline, is the unanswered question for the next cohort of patients.

-- NORA WHITFIELD, Chicago