Pancreatic cancer is a devastating disease that kills more than 45,000 Americans each year. About 10% of patients survive five years or more after diagnosis because the disease metastasizes very early in its development and is difficult to treat. More effective and tolerable systemic therapies are needed for treatment of pancreatic cancer patients.

Pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreas cancer. Most PDAC expresses the surface antigen mesothelin. Recombinant immunotoxin LMB-100 (previously called RG7787) is a mesothelin-targeted precision therapy that we have tested in the clinic for patients with PDAC. The immunotoxin binds to mesothelin on the cancer cell surface, leading to cancer cell internalization of the bacterial toxin payload and tumor cell death. In the laboratory we are working to identify effective combination therapies that can: 1) enhance delivery of large molecule therapeutics such as LMB-100 to PDAC, and 2) capitalize on immune priming that results from killing tumor cells using a bacterial toxin payload.

Rarer exocrine tumors of the pancreas are typically treated with standard therapies optimized for PDAC. We are interested in learning more about these tumors so that better treatments can be identified, and are actively recruiting patients with these tumor types:  1) Adenosquamous carcinoma of the pancreas (ASCP) is a highly aggressive variant of PDAC that is driven by the Myc oncogene. Minnelide is an oral drug that reduces Myc expression and inhibits growth of ASCP in pre-clinical models. We are currently testing the anti-tumor activity of Minnelide in a Phase II trial specific for patients with ASCP. 2) Pancreatic Acinar Cell Carcinoma (PACC) is an ultra-rare tumor of the pancreas with distinct genetic and pathologic features from PDAC.  We are interested in developing pre-clinical models of PACC that will permit detailed study of the tumor’s molecular landscape. Patients with PACC and ASCP are encouraged to participate in the Rare Solid Tumor Natural History study to help us better understand the clinical course of PACC. Travel to Bethesda is not required to participate in the Natural History study.