PAC5 trial is open to postoperative pancreatic patient enrollment

The CCTG PAC5 trial is now open to patient enrollment in Canada. The trial is evaluating whether lanreotide can reduce the risk of postoperative pancreatic fistula (POPF), one of the most important complications following pancreatic surgery. A pancreatic fistula occurs when pancreatic fluid leaks from the surgical connection or cut surface of the pancreas after an operation. While some leaks are relatively minor, clinically significant POPF can lead to serious complications, including infection, abscess formation and bleeding. Patients may require drainage procedures, prolonged hospitalization or additional surgery, and recovery can be substantially delayed. Despite this, there is currently no medication routinely used to prevent POPF. 

“Postoperative pancreatic fistula is the Achilles’ heel of pancreatic surgery. It impairs patient recovery leading to poor quality of life, delays to chemotherapy, and worse long-term survival. Better treatments to prevent this complication are sorely needed,” says Dr Paul Karanicolas, surgical oncologist at Odette Cancer Centre and the PAC5 principal investigator. 

More than half of patients undergoing pancreatic surgery experience major postoperative complications with POPF among the most consequential. Beyond its immediate effects on recovery, POPF can delay the start of potentially important postoperative cancer treatment and substantially increase the healthcare resources required following surgery. 

PAC5 is investigating whether lanreotide can help prevent this complication. Lanreotide is a long-acting synthetic analogue of the naturally occurring hormone somatostatin and is already widely used in the treatment of neuroendocrine tumours. Somatostatin analogues also reduce pancreatic exocrine secretions, providing a strong biological rationale for evaluating lanreotide as a means of reducing pancreatic leakage and the development of clinically significant POPF following surgery.