Clinical research at the Froedtert & the Medical College of Wisconsin health network — anchored by Froedtert Hospital,
eastern Wisconsin’s only academic medical center — opens the door to personalized treatment options that offer extensive expertise, resources and innovation and give you access to the highest level of care.
Pancreatic cancer is one of the most formidable cancers. It can develop without causing symptoms and by the time of diagnosis, it has often spread beyond the pancreas. After treatment, it can recur since it is resistant to chemotherapy and radiation therapy.
“Our specialists are nationally known for excellence and innovation in pancreatic cancer treatment,” said Mandana Kamgar, MD, MPH, medical oncologist and Medical College of Wisconsin faculty member. “We focus on the right treatment for each patient and determine if surgery will provide the best outcome. Still, some patients have a chance of the cancer coming back, at which point it is incurable. The challenge is that currently no standard treatment exists in this setting that can safely and effectively prevent cancer recurrence.”
Dr. Kamgar is the principal investigator leading the PROTECTPANC clinical trial to evaluate a precision medicine strategy for treating people with pancreatic cancer after surgery. The phase II trial is only available through the Froedtert & MCW Cancer Network. Patients who are at high risk of the disease recurring after surgery include those who have persistent cancer tumor marker elevation, leftover cancer cells after surgery (positive surgery margin), detectable tumor DNA in the blood or who have cancer that has spread to the lymph nodes.
“For these individuals, it’s just a matter of time before the cancer comes back,” Dr. Kamgar said. “Treatment can be limited because they have already had chemotherapy and radiation therapy before surgery and cannot tolerate more in doses high enough to be effective. The idea for this trial is to match medicines to each patient’s cancer, identifying personalized therapies that offer the best chance to control the cancer.”
In the PROTECT-PANC trial, researchers examine the molecular profile of tumor tissues or blood, identifying DNA mutations that drive the cancer’s development and continued growth.
“Some mutations are like turning on the cancer growth switch,” Dr. Kamgar said. “We have medicines to turn them off— that is called targeted therapy. Other tumors allow us to ‘train’ the immune system to fight the cancer — that is immunotherapy.”
After evaluation of tumor tissue, pathologists review each patient’s tumor profile with the molecular tumor board. This multidisciplinary team of experts recommends individualized treatments that target specific molecular changes found in each patient’s cancer. Since most cancers have multiple drivers, study participants will likely receive a combination of drugs.
“This is what we mean by precision medicine,” Dr. Kamgar said. “Instead of using one drug for everybody, we choose medicines that can produce the best response for a particular patient.”
The regimen may involve pills and IV infusions. The study calls for six months of treatment, but it can continue as long as a patient tolerates it. Treatment can be adjusted based on response.
“With this trial, we are offering novel, personalized therapies,” Dr. Kamgar said. “Relying on the unique molecular makeup of each patient’s cancer, we devise personalized targeted therapies and immunotherapies. We work to find the treatment with the best chance of success and the least potential for side effects in each patient.”
