This video presents three key clinical trials from ASCO 2026: the X-PEL-PANC trial demonstrating that BXCL701 combined with pembrolizumab can generate immune responses in metastatic pancreatic cancer, including microsatellite-stable disease; the PROGEM trial showing that proglumide, a stromal-modifying agent, reduces fibrosis and improves immune cell infiltration when combined with gemcitabine and nab-paclitaxel; and a second-line biliary tract cancer study confirming that nanoliposomal irinotecan plus 5-FU/leucovorin is effective and now incorporated into NCCN guidelines, though it carries significant toxicity risks requiring careful patient selection.
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Critical Updates on Pancreatic Cancer and Biliary Tract Cancer | ASCO 2026Hinzugefügt:
My name is Ben Weinberg. I'm a GI medical oncologist at the Ruesch Center for the Cure of Gastrointestinal Cancers at the Lombardi Comprehensive Cancer Center at Georgetown University. I'm here highlighting three posters presented at this ASCO meeting, two on pancreatic cancer and one on biliary tract cancer. We are very excited to present results from EXPO-PanK, which was a second-line study looking at an oral dipeptidyl peptidase and FAP inhibitor BioXcel 701 in combination with pembrolizumab in patients with metastatic pancreas cancer who had already received one prior line of chemotherapy. We showed two objective responses in microsatellite stable patients and one patient with microsatellite instability high disease who also had a very impressive response, showing that we can generate actionable immune targets in this disease that has been very refractory to immunotherapy.
We're excited to do some correlative analyses that so far are showing that these responders see a huge influence of both CDA positive T cells and NK cells in the tumor microenvironment. We also displayed the results of ProGem, which was a smaller phase one study, similar concept of using a stromal modifying agent progulmide, a CCKB receptor antagonist, which also we think disrupts intratumoral fibrosis, allows more immune cell infiltrate in the tumor. In this case, combined with gemcitabine and nab-paclitaxel, we showed that the regimen's very safe, tolerable, and indeed, using pre- and on-treatment biopsies, showing a pharmacodynamic effect of decreasing intratumoral fibrosis and also decreasing tumor-related pain. Finally, in the biliary tract space, we had a second-line study with irinotecan and 5-FU leucovorin, similar regimen that's used in second-line pancreatic cancer in patients with biliary tract cancer following progression or intolerance to a gemcitabine platinum-based chemotherapy regimen, and we met our primary endpoint showing that about half of patients were alive and progression-free at the four-month time interval. This regimen has now been incorporated into the NCCN guidelines and we helped contextualize this because there were positive and negative studies in Korea, Japan and and Germany. We showed that in a US population that it is a feasible and effective regimen. It is quite toxic about a fifth of patients came off early for toxicity, especially diarrhea, hypokalemia. So there's some suggestion that maybe we should start a lower dose in this patient population that has underlying liver dysfunction. Thank you for your time and attention.
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