Opdivo plus Yervoy and SBRT in Refractory Metastatic Pancreatic Cancer: CheckPAC Trial

On April 27, 2022, Inna M. Chen and colleagues from Copenhagen University Hospital published the results of the CheckPAC Phase 2 clinical trial in the Journal of Clinical Oncology. The study explored a novel combination of immunotherapy and radiation for patients with metastatic pancreatic cancer who had failed previous treatments.

Study Design: CheckPAC Trial

The trial randomized 84 patients with refractory metastatic pancreatic cancer into two groups:

1. Opdivo + SBRT Group (N=41): Nivolumab monotherapy combined with stereotactic body radiotherapy.
2. Opdivo + Yervoy + SBRT Group (N=43): Nivolumab and Ipilimumab combined with SBRT.

The primary endpoint was clinical benefit rate (CBR), defined as complete response, partial response, or stable disease for at least 12 weeks.

Key Results

The addition of Yervoy significantly improved outcomes:

• Clinical Benefit Rate (CBR):
  • Combination Group (Nivo+Ipi+SBRT): 37.2%
  • Monotherapy Group (Nivo+SBRT): 17.1%
• Partial Response Rate: 6 patients in the combination group vs. 1 patient in the monotherapy group.
• Median Duration of Response: 5.4 months for the combination group.

Safety Profile

The incidence of Grade 3 or higher adverse events was 30.2% in the combination group compared to 24.4% in the monotherapy group. The side effects were generally manageable and consistent with the known profiles of these immunotherapies.

Conclusion

The CheckPAC trial demonstrated that the combination of Opdivo, Yervoy, and SBRT achieves an encouraging clinical benefit rate in patients with refractory metastatic pancreatic cancer. While immunotherapy has historically been less effective in pancreatic cancer, these results suggest that combining dual checkpoint inhibition with radiation may overcome some of the immune resistance in this disease. Further studies are needed to refine this approach.

Source: Journal of Clinical Oncology - CheckPAC Trial Results

#PancreaticCancer #Opdivo #Nivolumab #Yervoy #Ipilimumab #SBRT #CheckPAC #Immunotherapy #CancerResearch

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