Vincent Picozzi, MD, Virginia Mason Medical Center, Seattle, Washington, discusses results from the PANOVA-3 trial which assessed the efficacy of using tumor treating fields (TTFields) with gemcitabine and nab-paclitaxel in the treatment of newly diagnosed patients with locally advanced unresectable pancreatic adenocarcinoma. 

Study findings show that use of TTFields demonstrates statistically significant overall survival (OS) improvement with no additional systematic toxicity and significant pain-free survival benefit, making it a potential new treatment option for these patients.

Dr Picozzi presented these results at the 2025 ASCO Annual Meeting in Chicago, Illinois. 

Transcript: 

My name is Dr Vince Picozzi, I'm a medical oncologist at the Virginia Mason Clinic in Seattle, Washington, and I'm here at sunny ASCO 2025 in Chicago to present the PANOVA-3 clinical trial. 

As most of you know, pancreatic cancer in general and locally advanced pancreas cancer in particular, has been a very difficult therapeutic challenge for oncologists and their coworkers. In that regard, the idea of using tumor treating fields, alternating electrical energy, came forth as a possible therapeutic vehicle in addition to chemotherapy. What the PANOVA-3 trial does is test this hypothesis in patients with locally advanced inoperable pancreatic cancer that had not been previously treated. The trial consisted of 571 patients who were randomized 1-to-1 to receive gemcitabine and nab-paclitaxel either with or without tumor treating fields. 

This trial was recently analyzed, and very happily, there was a statistically significant overall survival advantage found to the use of the tumor treating fields. And actually, this is the first trial ever in local advanced pancreas cancer that's produced a positive result. Interestingly, this benefit in overall survival seemed to be associated with a benefit not in local but distal disease-free progression. The tumor treating fields therapy also showed benefit with respect to quality of life parameters such as pain and global health status, this was accomplished largely significantly without incremental side effects or toxicity [and] really, the only additional toxicity of the use of tumor treating fields was skin toxicity, which in most cases was manageable [and] did force discontinuation of therapy in about 8% of people. 

Based on this result, improved overall survival, improved quality of life, [and] acceptable/manageable toxicity, the use of tumor treating fields with chemotherapy, gemcitabine and nab-paclitaxel, becomes a potential new standard of care worldwide for locally advanced pancreas cancer and a foundation upon which other therapies can be built.

Source: 

Picozzi V, Babiker H, Chandana S, et al. PANOVA-3: Phase 3 study of tumor treating fields (TTFields) with gemcitabine and nab-paclitaxel for locally advanced pancreatic ductal adenocarcinoma (LA-PAC). Presented at 2025 ASCO Annual Meeting. May 30-June 3, 2025; Chicago, IL. Abstract LBA4005