Dr. Bajor is a Hematology/Oncology Fellow in the Department of Medicine at the Perelman School of Medicine, University of Pennsylvania (Philadelphia, PA). He received the Paul Carbone, MD Fellowship Award in 2012.
Financial support awarded by the ECOG Research and Education Foundation through this fellowship will foster my progression toward becoming an independent researcher in two ways: by helping to protect valuable time during my first year as an instructor, and by funding, in part, my training for Penn’s Masters of Translational Research degree at the Institute for Translational Medicine and Therapeutics. Pursuit of the latter formal training will enable me to develop, administer, and publish studies that will ultimately provide meaningful benefit to our patients.
The work acknowledged by the award focuses on pancreatic ductal adenocarcinoma (PDA), a disease in which improvement in standard of care has been slow to develop, and when an advancement does occur, it is often at the cost of high toxicity in patients. The investigator-initiated study supported by this award, and sponsored in part by the Cancer Immunotherapy Trials Network, examines the neoadjuvant and adjuvant effects of gemcitabine combined with a monoclonal antibody that activates CD40 on the surface of antigen-presenting cells, thereby activating them. This combination therapy has been shown to be safe, effective, and well tolerated in a phase I trial of first-line, inoperable PDA, where responses were seen in both primary and metastatic lesions. Previous studies suggest that this combination serves to produce alterations in the tumor microenvironment that result in an immune response to PDA.1 Importantly, the application of this combination in the neoadjuvant setting allows for a better characterization of the immune response to PDA through the examination of both surgical specimens and blood samples collected serially over time. Similarly, if patients progress while on study, or are found to have unexpected metastatic disease at the time of surgery, biopsies will be obtained and studied immunologically, if sufficient material is available. We expect that this protocol will allow an unprecedented look at the mechanistic activity of this combination in human disease and further enhance our biological understanding of this highly morbid condition.
I am thankful for the support of the ECOG Research and Education Foundation in these endeavors and look forward to contributing to the new ECOG-ACRIN organization, and in particular, to its goal of improving patient-centered outcomes through the practical application of innovative science and rational therapeutic strategies.
About the Research: The study, entitled Phase I Study of Preoperative Gemcitabine Plus CP-870,893 Followed by Addition of CP-870,893 to Standard-of-Care Adjuvant Chemoradiation for Patients With Newly Diagnosed Resectable Pancreatic Carcinoma, is an open-label, single-arm trial being conducted at the Abramson Cancer Center of the University of Pennsylvania under Principal Investigator Robert Vonderheide, MD, DPhil. Ten patients with newly diagnosed resectable pancreatic carcinoma receive gemcitabine and CP-870,893 2 weeks prior to surgical resection and subsequently during standard-of-care adjuvant chemoradiation therapy (at which time CP-870,893 is given on day 3 of each of three 28-day cycles of gemcitabine). Previously established doses of each agent are used and given by intravenous infusion.
Additional information at ClinicalTrials.gov: NCT01456585
1Beatty GL, Chiorean EG, Fishman MP, et al. CD40 agonists alter tumor stroma and show efficacy against pancreatic carcinoma in mice and humans. Science. 2011;331(6024):1612-1616.