Latest Chemotherapy Combination Shows Promise for Pancreatic Cancer Patients
Bologna, Italy – February 23, 2026 – A novel chemotherapy regimen is offering renewed hope for individuals battling pancreatic cancer, potentially extending survival rates and improving quality of life. The breakthrough stems from the CASSANDRA trial, a phase 3 clinical study coordinated by IRCCS San Raffaele Hospital in Milan, with participation from the Policlinico di Sant’Orsola in Bologna.
The CASSANDRA Trial: A New Approach to Pancreatic Cancer Treatment
Published in The Lancet, the results of the CASSANDRA trial demonstrate improved survival outcomes compared to the current standard of care for non-metastatic ductal adenocarcinoma – an aggressive form of pancreatic cancer accounting for 95% of malignant pancreatic neoplasms. The trial directly compared two chemotherapy schemes: mFolfirinox, the current standard, and a new combination dubbed Paxg.
Paxg vs. MFolfirinox: Understanding the Chemotherapy Options
The research project, funded entirely by patient associations, aimed to evaluate the effectiveness of these two distinct chemotherapy combinations in patients undergoing surgical removal of ductal adenocarcinoma of the pancreas. Paxg consists of four different drugs, developed at San Raffaele over the past dozen years.
Significant Improvement in Progression-Free Survival
Patients treated with the Paxg regimen experienced significantly longer progression-free survival – the time without disease progression, recurrence, or death – compared to those receiving mFolfirinox (16 months versus just over 10 months). Policlinico di Sant’Orsola participated in the trial, contributing to these promising results.
AIFA Recognition and International Implementation
The Italian Medicines Agency (AIFA) recognized the potential of this research, requesting a transition from a phase 2 to a phase 3 study, indicating its potential for regulatory approval and guideline changes. Professor Michele Reni, director of Oncology and Day Hospital at San Raffaele, presented the data at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago last June. IRCCS San Raffaele Hospital has been at the forefront of this research.
Future Research and Long-Term Survival
Researchers are now focusing on long-term survival data, extending the study to assess outcomes over five years. Mariacristina Di Marco, a researcher at the University of Bologna working at the Medical Oncology of Sant’Orsola, emphasized the importance of this continued research, building on years of collaboration with the Pancreatic and Endocrine Surgery directed by Professor Riccardo Casadei. “This milestone promises to significantly improve patients’ life prospects,” she stated.
The Role of Policlinico di Sant’Orsola
Founded in 1592, Policlinico di Sant’Orsola has a long history of medical innovation and patient care. Its involvement in the CASSANDRA trial underscores its commitment to advancing cancer treatment.