SPOTLIGHT: Tumor Treating Fields Extend LA-PAC Survival by 2 Months

The randomized phase 3 trial PANOVA-3 (NCT03377491) demonstrated a significant breakthrough, adding approximately 2 months to overall patient survival in locally advanced pancreatic cancer (LA-PAC), with notable improvements in quality of life and pain progression prevention, according to data presented at the 2025 American Society of Clinical Oncology Annual Meeting.

Vincent Picozzi, MD, medical oncologist and director of the pancreaticobiliary program at Virginia Mason Franciscan Health in Seattle, Washington, presented the data and later spoke with The American Journal of Managed Care (AJMC).

This transcript has been lightly edited.

AJMC: What were the key findings from the PANOVA-3 trial, and what makes them clinically significant for patients with LA-PAC?

Vincent Picozzi, MD | Image: Virginia Mason Franciscan Health

Picozzi: The PANOVA-3 trial looked at the use of so-called tumor-treating fields, electrical fields passed through the patient’s body that are directed to the cancer with the use of gemcitabine and nab-paclitaxel. The trial was a 1:1 randomization between chemotherapy with or without the tumor-treating fields. The exciting results are that it was a positive trial in that the use of the tumor-treating fields added about 2 months to overall survivorship with the use of gemcitabine and nab-paclitaxel alone. This is the first positive trial ever in locally advanced pancreatic cancer. With that, there was an improvement seen in quality of life, particularly with respect to the prevention of pain progression. Also, the Optune device proved to be practical and safe to use, so all those things together really make the use of the device a new standard for treatment in local advanced pancreatic cancer.

AJMC: How does the observed improvement in overall survival compare with other available treatment options for LA-PAC? What subgroups, if any, showed the most pronounced benefit?

Picozzi: The subgroup analysis hasn’t really been performed yet in detail, but the improvement in overall survival of the aggregate group [was] about 2 months. If one looks at…the modified intention-to-treat group, it was somewhat longer than that, about 3 months. This improvement in survival is typical of other successful trials in pancreatic cancer, such as the trial that was done with NALIRIFOX [liposomal irinotecan (Onivyde), oxaliplatin, 5-fluorouracil, and leucovorin], gemcitabine, and [nab-paclitaxel], the phase 3 NAPOLI 3 trial [NCT04083235].

AJMC: Were there any notable safety or tolerability signals to be aware of?

Picozzi: Well, the major adverse effect directly related to the use of devices [was] skin toxicity, which occurred in a meaningful way, between 5% and 10% of people, but this proved to be a manageable toxicity, and the significant majority of people were able to continue.

Reference
Babiker HM, Picozzi V, Chandana SR, et al; for the PANOVA-3 Study Investigators. Tumor treating fields with gemcitabine and nab-paclitaxel for locally advanced pancreatic adenocarcinoma: randomized, open-label, pivotal phase III PANOVA-3 study. J Clin Oncol. 2025;43(suppl 17):LBA4005. doi:10.1200/JCO-25-00746