Are there therapeutic options for patients living with unresectable (inoperable) pancreatic cancer? According to an article in MedScape, researchers sought to understand whether sunitinib or a combination of peptide receptor radionucleotide therapy (PRRT) with lutetium-octreotate (OCLU) helped to improve 12-month progression-free survival within this patient population. At the EANM 2022 Congress, the research team presented their data from the Phase 2 OCLURANDOM study. Ultimately, they found that using PRRT with OCLU was effective for those with unresectable pancreatic neuroendocrine tumors, a rare form of pancreatic cancer.

Altogether, the Phase 2 OCLURANDOM study followed patients for a median period of 40 months (approximately 3 years and 4 months). Prior to joining the study, patients must have experienced some disease progression. Additionally, they must have previosuly received some former type of treatment: everolimus, somatostatin analogues, or cytotoxic chemotherapy. Patients received either 7.4 GBq of PRRT with OCLU every two weeks for two months or a daily dose of 37.5mg sunitinib. Findings from the study show that:

• Those receiving PRRT with OCLU had a 12-month progression-free survival rate of 80.5%, almost double that of the group receiving sutinib. The latter group had a 42% 12-month progression-free survival rate.
• 74.4% of patients taking sunitinib had to stop therapy because their disease progressed. This is significantly higher than the 5.4% of patients receiving PRRT with OCLU. Additionally, two patients stopped taking PRRT with OCLU due to adverse reactions, while nine using sunitinib had to stop.
• The median duration of progression-free survival was 20.7 months (approximately 1 year and 8.7 months) for those receiving PRRT with OCLU. Again, this was nearly double that of the sutininib group, for which the time length was 11 months.
• Common adverse reactions between groups include lymphopenia (not having enough lymphocytes in the blood) and digestive disturbances.

What is Pancreatic Cancer?

As the name suggests, pancreatic cancer forms in the pancreas. The pancreas, located in the abdomen, helps to regulate blood suga and aids in digestion. Risk factors for developing pancreatic cancer include a family history of pancreatic cancer, being male, older age, obesity, and smoking cigarettes. There are multiple forms of pancreatic cancer. As described above, one form is pancreatic neuroendocrine tumors; these may also be referred to as Islet cell tumors. Exocrine pancreatic cancer, or pancreatic adenocarcinoma, is the most common form. Unfortunately, symptoms often do not appear until the cancer has progressed to later stages. When symptoms do appear, they can (but do not always) include:

• Unintended weight loss
• Dark urine and pale stool
• Newly onset or worsening diabetes
• Bowel obstructions
• Jaundice (yellowing of the skin, eyes, and mucous membranes)
• Abdominal pain that radiates to the back
• Fatigue
• Blood clots