“Nadunolimab’s unique mechanism of action is highly relevant for treatment of pancreatic cancer. This important publication in an impactful scientific journal confirms its significance to the medical community” said Göran Forsberg, CEO of Cantargia.

PDAC is one of the cancer forms with the highest medical need. The incidence is increasing, and the survival is poor. A major clinical challenge in PDAC is its distinct and protective tumor microenvironment (TME), which shields the tumor from the immune system and facilitates tumor growth, metastasis, and resistance to therapy. The crosstalk between cancer cells and cancer-associated fibroblasts (CAFs) plays a pivotal role in shaping this TME.

The IL-1 family, through IL1RAP, helps activate CAFs, which attract myeloid immune cells like monocytes and neutrophils into the tumor. This study reveals that nadunolimab blocks this process by inhibiting IL1RAP, reducing the number of immune cells recruited, which weakens the tumor’s defenses. Through its other mechanism of action (ADCC), nadunolimab enhances tumor destruction.

The relevance of these preclinical results could be linked to clinical results using nadunolimab monotherapy in the CANFOUR study. In late stage metastatic PDAC patients, high tumor baseline levels of IL1RAP strongly correlate with increased progression free survival (IL1RAP high vs low: 3.5 vs 1.2 months; p=0.0023) and a trend for survival advantage (5.0 vs 2.2 months) with a follow up of 11.5 months. This is in line with previous published results examining nadunolimab with chemotherapies, gemcitabine and nab-paclitaxel, which showed promising efficacy in first line IL1RAP-high PDAC patients.

These findings strongly signify the clinical relevance of targeting IL1RAP in PDAC using nadunolimab. This is particularly noteworthy since IL1RAP is considered as a prognostic marker where high IL1RAP expression is linked to shorter survival in PDAC patients.

“This study reveals how PDAC tumor cells and cancer-associated fibroblasts drive the immunosuppressive microenvironment through IL-1 signaling. It highlights IL1RAP targeting as a promising therapeutic approach for pancreatic cancer patients” said Dr Marcus Järås, corresponding author and Cantargia co-founder, from Lund University.

This study used data from the Pancreatic Cancer Action Network’s (PanCAN) Know Your Tumor® precision medicine program as a validation dataset, accessed through the PanCAN SPARK health data platform. This dataset was used to study the impact of IL1RAP expression in PDAC and revealed IL1RAP as a prognostic marker.

 “These results underscore the importance of biomarker testing that allows patients to learn about the genetic makeup of their tumor and allow researchers access to treatment and outcomes data. Ongoing research using real-world datasets like from the Know Your Tumor program in the PanCAN SPARK platform brings researchers one step closer to better treatments and improved outcomes for patient with pancreatic cancer,” said Anna Berkenblit, MD, MMSc, Chief Scientific and Medical Officer at PanCAN.

The article, titled “Blocking IL1RAP on cancer associated fibroblasts in pancreatic ductal adenocarcinoma suppresses IL-1 induced neutrophil recruitment”, by Hansen et al., is available via Journal for Immunotherapy of Cancer website:  https://jitc.bmj.com/ and at Cantargia’s website https://cantargia.com. This publication is based on results that, in part, have been presented at scientific conferences during 2022 and 2023.