Research Papers:

A comprehensive analysis of clinical trials in pancreatic cancer: what is coming down the pike?

Erryk S. Katayama, Jonathan J. Hue, David L. Bajor, Lee M. Ocuin, John B. Ammori, Jeffrey M. Hardacre and Jordan M. Winter _

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Oncotarget. 2020; 11:3489-3501. https://doi.org/10.18632/oncotarget.27727

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Erryk S. Katayama1, Jonathan J. Hue1,2, David L. Bajor3,4, Lee M. Ocuin5, John B. Ammori1,2, Jeffrey M. Hardacre1,2 and Jordan M. Winter1,2

1 Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

2 Department of Surgery, University Hospitals Seidman Cancer Center and Case Comprehensive Cancer Center, Cleveland, Ohio, USA

3 Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA

4 Division of Hematology and Oncology, University Hospitals Seidman Cancer Center, Cleveland, Ohio, USA

5 Division of Hepatobiliary and Pancreatic Surgery, Atrium Health, Charlotte, North Carolina, USA

Correspondence to:

Jordan M. Winter,email: [email protected]

Keywords: pancreatic cancer; pancreatic ductal adenocarcinoma; clinical trial; novel treatment; drug development

Received: June 20, 2020     Accepted: August 17, 2020     Published: September 22, 2020


Objective: Pancreatic cancer is the most aggressive common cancer and is desperately in need of novel therapies. Unlike many other common cancers, there have been no new paradigm-changing therapies in the past 40 years beyond multi-agent chemotherapy. In this study, we perform the first comprehensive analysis of the current clinical trial landscape in pancreatic cancer to better understand the pipeline of new therapies.

Materials and Methods: We queried https://clinicaltrials.gov/ for registered pancreatic cancer clinical trials. Studies were curated and categorized according to phase of study, clinical stage of the study population, type of the intervention under investigation, and biologic mechanism targeted by the therapy under study.

Results: As of May 18, 2019, there were 430 total active therapeutic interventional trials testing 590 interventions. The vast minority of trials (n = 37, 8.6%) are in phase III testing. 189 (31%) interventions are immunotherapies, 69 (11%) target cell signaling pathways, 154 (26%) target cell cycle or DNA biology, and 35 (6%) target metabolic pathways. Of the late phase trials, only 14 are currently testing novel interventions. Rather, 23 phase III trials examine new ways to deliver existing FDA-approved drugs, procedures, or pain management.

Conclusions: A large number of novel therapeutic strategies are currently under investigation. They include a broad range of therapies targeting diverse biologic processes. However, only a small number of novel therapies are in late-stage testing, suggesting that future progress is likely several years away, and dependent on the success of early-stage trials.

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