The late-stage pancreatic cancer landscape: innovation level modest

The late-stage pancreatic cancer pipeline shows some signs of new modality activity, but overall lacks the innovative targets and mechanisms making an impact in other cancers. Apart from a few exceptions, the seven programs in Phase III to treat pancreatic ductal adenocarcinoma are small molecules against a mixed bag of longstanding cancer targets; whereas two programs in Phase III for pancreatic neuroendocrine tumors are radiopharmaceuticals designed to compete with Novartis’ Lutathera. 

Of the two major types of pancreatic cancer, the more common one, pancreatic ductal adenocarcinoma (PDAC), is among medicine’s most challenging indications. Outcomes are dismal, with survival often six months or less after diagnosis. The standard of care for PDAC, combination chemotherapy, has changed little for decades. The current cohort of Phase III candidate therapies for PDAC spans tried-and-true cell killing mechanisms such as DNA disruption to anti-angiogenesis, immuno-oncology and a handful of other mechanisms. ...