Pancreatic cancer may potentially be safely and effectively treated with immunochemotherapy, according to recent research from a preclinical study. This approach combines chemotherapy and immunotherapy, which uses the patient’s own immune system to help fight against disease.

This study used [pIC]PEI, which is a combination of the already-established immune-modulating molecule, polyinosine-polycytidylic acid (pIC), with delivery molecule polyethlenimine (PEI), a polymer often used in detergents, adhesives, and cosmetics. Its delivery inside pancreatic cancer cells triggers cancer cell death without harming normal pancreatic cells.

This preclinical study was led by Paul B. Fisher, MPh, PhD, and Luni Emdad, MBBS, PhD, both of the Institute of Molecular Medicine and the Massey Cancer Center at Virginia Commonwealth University in Richmond.

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Pancreatic cancer is one of the deadliest cancers, with an overall 5-year survival rate of less than 6%. Its high fatality is attributed to failure to diagnose the disease before it spreads to other organs, as well as its resistance to current therapies. Surgical removal of the cancer, chemotherapy, and radiation each offer little resistance against this aggressive disease.

“Pancreatic cancer is currently the fourth leading cause of cancer death in the US. Developing an effective treatment is a vital step, and immunochemotherapy may be the key,” said Emdad.

Published in Cancer Research (2014; doi:10.1158/0008-5472.CAN-14-0819), this is the first study that links the proteins involved in programmed cell death as prime mediators in cancer-specific killing by [pIC]PEI. Emdad and Fisher have found that, in cell cultures models, [pIC]PEI selectively induces cell death in pancreatic cancer cells, and that, in animal models, [pIC]PEI also inhibited tumor growth via cell death.

“Since [pIC]PEI is extremely and selectively toxic to pancreatic cancer cells both in vitro and in vivo, the use of this compound, alone and in combination with other therapeutic agents, could potentially lead to a novel, safe, and effective approach for treating pancreatic cancer by directly attacking the cancer cell chemotherapeutically and stimulating the immune system to confront the cancer, an immunochemotherapy approach,” said Fisher.

“The results are promising, and we look forward to conducting more extensive preclinical studies. Our ultimate hope is to bring this innovative scheme into the clinic to treat patients with pancreatic cancer.”

As the need exists for newer and more effective strategies to treat pancreatic cancer, these findings are critical. While the current focus of this research is on pancreatic cancer, this approach also has applications for melanoma, breast cancer, and hepatocellular carcinoma.

Several important questions related to [pIC]PEI will be explored in future research, including assessing its efficacy in additional and expanded in vitro and in vivo studies, and testing it in new combinations with conventional chemotherapies.