Hung Justine T, Mynam Ritwick S, Patel Monica A, Ozogbo Stanley, LoConte Noelle K, Kratz Jeremy D
Division of Hematology, Medical Oncology and Palliative Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
University of Wisconsin Carbone Cancer Center, Madison, WI, USA.
J Gastrointest Cancer. 2025 Apr 22;56(1):103. doi: 10.1007/s12029-025-01194-z.
Immune-based treatment strategies have emerged across solid organ malignancies largely with the development of immune checkpoint inhibitors. To date, these strategies have not improved clinical outcomes in pancreatic ductal adenocarcinoma (PDAC).
Here, we perform a systematic review to summarize available evidence for recent immune-based treatment strategies in PDAC. We analyze trends in activated clinical trials queried from clinicaltrials.gov in the years 2020-2022. We review study design, sponsorship, and trends in the phase of development. There is a growing emergence of multiple new classes of immune-based targets and combination strategies in early-phase development.
Immune-based clinical trials in PDAC are highly collaborative including primarily stakeholders in government, industry, and academic medical centers. In this period, a majority of trials have integrated a non-randomized design (83.2%), including a trend towards an increase in Phase I/II clinical trials. This analysis found a growing list of studies using combinations including inhibitors of vascular endothelial growth factors (VEGF), an expanded set of vaccine-based strategies, and the use of Bispecific T-Cell Engagers (BiTEs). Immune checkpoint inhibitors have been a mainstay of combination strategies including the use of new immune checkpoint inhibitors (CD40, TIGIT).
Immune-based strategies in PDAC have expanded across new targets and the complexities of combinatory approaches. Integrating this work across key stakeholders remains of critical importance to improve clinical outcomes.
随着免疫检查点抑制剂的发展，基于免疫的治疗策略已在多种实体器官恶性肿瘤中出现。迄今为止，这些策略尚未改善胰腺导管腺癌（PDAC）的临床结局。
在此，我们进行一项系统综述，以总结PDAC中近期基于免疫的治疗策略的现有证据。我们分析了2020年至2022年从clinicaltrials.gov查询到的正在进行的临床试验的趋势。我们回顾了研究设计、资助情况以及开发阶段的趋势。在早期开发中，多种新型基于免疫的靶点和联合策略不断涌现。
PDAC中基于免疫的临床试验具有高度协作性，主要包括政府、行业和学术医疗中心的利益相关者。在此期间，大多数试验采用了非随机设计（83.2%），包括I/II期临床试验增加的趋势。该分析发现，使用联合治疗的研究越来越多，包括血管内皮生长因子（VEGF）抑制剂、一系列扩展的基于疫苗的策略以及双特异性T细胞衔接器（BiTEs）的使用。免疫检查点抑制剂一直是联合策略的主要组成部分，包括使用新型免疫检查点抑制剂（CD40、TIGIT）。
PDAC中基于免疫的策略已扩展到新的靶点和联合方法的复杂性。整合关键利益相关者的这项工作对于改善临床结局仍然至关重要。
