A new trial called SCALOP-2 (Systemic therapy and Chemoradiation in Advanced LOcalised Pancreatic cancer-2) starting in Oxford will investigate whether particular chemotherapy and chemoradiotherapy treatments can improve outcomes for patients with locally advanced inoperable pancreatic cancer that has not spread beyond the pancreas.
Pancreatic tumours that cannot be removed surgically but have not spread beyond the pancreas are usually treated in the UK with chemotherapy alone or chemotherapy followed by chemoradiation. These treatments control symptoms, but usually do not eradicate the cancer or shrink the tumours enough to allow surgical removal. Lack of oxygen and lack of adequate blood flow both contribute to this treatment resistance.
The drug nelfinavir improved oxygenation and blood supply in pre-clinical studies. SCALOP-2 will investigate whether this drug, when used during chemotherapy, can make pancreatic tumour more sensitive to chemotherapy and other radiotherapy treatments. SCALOP-2 will also investigate whether a higher dose of radiotherapy can improve outcomes.
SCALOP-2 will be the largest chemoradiotherapy trial for pancreatic cancer in the UK. The first stage of the trial will identify a safe dose of nelfinavir that can be used together with chemoradiotherapy. The second stage is a phase II, multi-centre randomised study investigating whether increasing the dose of radiotherapy, adding nelfinavir, or a combination of the two will prolong survival in patients with locally advanced inoperable pancreatic cancer that has not spread beyond the pancreas. Trial participants will receive 4 months of gemcitabine and nab-paclitaxel (Abraxane) chemotherapy. Participants with non-progressing disease will then continue with chemotherapy, with added radiotherapy. They will be randomly allocated to receiving either a standard or higher-than-standard dose dose of radiotherapy and to either receiving or not receiving nelfinavir with their chemoradiotherapy.
Please contact your local doctor for more information.