The Duke Cancer Institute has a team of leading medical experts who manage and treat pancreatic cancer. Our surgeons collaborate with colleagues from across the medical center to offer multidisciplinary care to our patients.
With a team consisting of surgical oncology, medical oncology, radiation oncology, gastroenterology, pathology, radiology, and nursing, our program is not only focused on standard-of-care treatments but also on innovative research in the realm of pancreatic cancer.
Our hope is to provide optimal care to patients with this disease as well as to provide them with hope of more effective therapies. Current research programs are listed below.
Immunotherapy for Surgically Resected Pancreatic Cancer
Michael Morse, MD, a Duke medical oncologist, is working in collaboration with the Division of Advanced Oncologic and GI Surgery on a multicenter phase III trial of chemotherapy and chemoradiotherapy with or without HyperAcute-pancreatic cancer vaccine in subjects with surgically resected pancreatic cancer.
Scientists have shown that pancreatic cancer cells produce a number of defective proteins or express normal proteins in highly uncharacteristic ways. In some cancers, these abnormal proteins can trigger an immune system response to the cancer cells much like it responds to infection. In progressive cancers, the immune system may not be as effective in identification or response to these abnormal cells.
This clinical trial proposes an innovative way to stimulate the immune system to recognize abnormal components of pancreatic cancer cells and to stimulate the immune response that destroys or blocks the growth of the cancer.
This new method of treatment helps the immune system of pancreatic cancer patients to "identify" the cancerous tissue so that it can be eliminated from the body.
As an example, after an organ transplant patients receive special drugs because they are at great danger of having an immune response that destroys or "rejects" the transplanted organ. This rejection occurs when their immune system responds to differences between the cells of the transplanted organ and their own immune system by attacking the foreign tissue in the same way as it would attack infected tissue.
When the differences between foreign tissues and the patient's body are even larger—like differences between organs from pigs and humans—the rejection is very rapid, highly destructive, and the immunity it generates is long lasting. This is called hyperacute rejection.
The medicine used to immunize patients in this protocol tries to teach a patient's immune system to fight their pancreatic cancer just as the body would reject a transplanted organ from an animal.
To do this, the investigators placed a mouse gene into human pancreatic cancer cells so that the immune system will easily recognize them as foreign, stimulating the patient immune system to attack the vaccine cells just as they would any other animal cells.
As part of the process of destroying the immunotherapy cells, the patient immune system is stimulated to identify as many differences from normal human cells as possible.
This extra stimulation is thought to encourage immune responses against the pancreatic cancer in the patient based on shared abnormalities of pancreatic cancer vaccine cells and the patient's pancreatic cancer cells.
In this experimental therapy, patients are given injections of an immunotherapy consisting of two types of cancer cells that the investigators have modified to make them more easily recognized and attacked by the immune system.
The investigators propose to test this new treatment in patients with pancreatic cancer who have undergone tumor removal surgery but remain at extremely high risk of disease progression to demonstrate that treatment with the immunotherapy increases the time until the tumor recurs or increases overall survival when given in combination with the current standard of care therapy for this disease.
Michael Morse, MD
Department of Medicine
Division of Medical Oncology