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School of Medicine
We offer clinical trials of experimental therapies at the following stages:
Neoadjuvant Clinical Trial Stage
Pancreas cancer vaccines activate the immune system and lead immune cells, typically unable to detect cancer, to attack the cancer cells in the pancreas and throughout the body. With promising results from early vaccine studies, including a modest, but real improvement in survival time, the investigators continue to improve the efficacy of the vaccine.
The treatment vaccine uses irradiated pancreas cancer cells that are incapable of growing, and have been genetically altered to secrete a molecule called GM-CSF. This molecule acts as a lure to attract immune system cells to the site of the tumor vaccine, where they encounter proteins called antigens on the surface of the irradiated cells. Then, these newly armed immune cells patrol the rest of the patient's body to destroy any remaining, circulating pancreas cancer cells.
In clinical trials, the idea is to alter the tumor’s environment by treating patients with the drug cyclophosphamide before giving patients the vaccine, making the tumor more responsive to the vaccine. Giving this before surgery gives patients an advance attack on the tumor and allows doctors to see what impact the treatment has had when they do operate.
Combined Chemotherapy/Vaccine Therapy:
With promising results from early vaccine studies, including a modest but real improvement in survival time, Johns Hopkins investigators continue to improve the vaccine. One approach is combining chemotherapy with the vaccine. This approach has been found to alter the tumor's environment, which seems to make the tumor more responsive to the vaccine.
Reordering the treatment protocol and administering the vaccinebeofore surgery gives the researchers an advance attack on the lethal tumor and also allows them to see what impact the treatment has had when they do operate.
As part of the their ongoing work, the team has found that giving radiation therapy at the same as (sequentially) with the vaccine actually improves the effectiveness of the vaccine.
First Line Stage
The leading chemotherapy agent is a drug called gemcitabine (Gemzar). Recent studies of gemcitabine combined with a drug called taxol (Abraxane), conducted at Johns Hopkins and elsewhere, have shown increases in survival of more than 10 months, compared to giving gemcitabine alone.
Long used for metastatic breast cancer patients, taxol is a chemotherapy drug encapsulated in tiny shells made to target cancer cells. Additional studies are planned to include a larger number of patients with multiple institutions participating.
Second Line Stage
Vaccine plus ipilimumab
Experts are testing the pancreas cancer vaccine approach in combination with a drug called ipilimumab, which is designed to give an added boost to the immune system.
Other new drugs
Clinical studies using a wide range of experimental drugs are in development and are available to our cancer patients. They include drugs that affect a variety of genetic pathways that can disrupt the cellular mechanisms of cancer cells. To find out if you may benefit from one of these new therapies, please contact us to make an appointment for a consultation at 410-933-PANC (7262).
Some include drugs that affect a variety of genetic pathways, disrupting the cellular mechanisms of cancer cells.
The Hedgehog pathway produces a growth and development signal for cells and is activated in cancers. Drugs designed to block the Hedgehog pathway may stop cancer cells from growing.
Similarly, other apoptosis (cell death) drugs may be able to speed up the aging process in cancer cells and lead those cells to an early death.
Another pathway called mTOR also is involved in cell growth. Investigators believe that inhibition of the mTOR pathway could also thwart the spread of cancer.