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IL-6 blockades with tocilizumab did not improve short-term survival in advanced pancreatic cancer but showed potential anticachexia benefits and improved 18-month survival despite increased toxicity.  

The Randomized Phase II study was published in the May 2025 issue of the Journal of Clinical Oncology. Researchers compared the efficacy of gemcitabine/nab-paclitaxel (Gem/Nab) with or without tocilizumab (Toc) in individuals with advanced pancreatic cancer.   

They administered gemcitabine 1,000 mg/m² and nab-paclitaxel 125 mg/m²  on days 1, 8, and 15, along with Toc 8 mg/kg on day 1 of each 28-day cycle. Participants with modified Glasgow prognostic scores of 1 or 2 were randomized in a 1:1 ratio to receive either Gem/Nab / Toc or Gem/Nab. The primary endpoint was overall survival (OS) at 6 months (OS6), while the secondary end points included progression-free survival (PFS), overall response rate (ORR), and safety. Exploratory measures assessed cachexia, QoL, and biomarkers, including growth differentiation factor 15 (GDF15).  

The results showed that 147 individuals were treated, including 6 in the safety cohort. The median follow-up was 8.1 months (IQR, 4.2–13.9). The OS6 rate was 68.6% (95% CI, 56.3–78.1) for Gem/Nab l/ Toc and 62.0% (49.6–72.1) for Gem/Nab (P = .409). The OS at 18 months favored the combination group at 27.1% vs 7.0% (P = .001). No differences were observed in median OS, PFS, or ORR. Grade ≥3 treatment-related adverse events (TrAEs) occurred in 88.1% of those receiving Gem/Nab / Toc and 63.4% with Gem/Nab alone (P < .001). Muscle loss was reduced with the combination, with median changes of +0.1013% vs –3.430% at 2 months (P = .0012) and +0.7044% vs–3.353% at 4 months (P = .036). At 2 months, muscle loss incidence was 43.48% for the combination vs 73.52% (P = .0045), and at 4 months, 41.82% vs 68.75% (P = .0062). GDF15 levels were not affected by either chemotherapy regimen. 

Investigators concluded that despite not fulfilling the primary end point and increased TrAEs, Toc demonstrated potential anticachexia benefits by improving survival at 18 months and reducing muscle wasting independent of GDF15. 

Source: ascopubs.org/doi/10.1200/JCO.23.01965