Panova-3: Efficacy, Safety and Quality of Life of Tumor Treating Fields ( Ttfields) with Gemcitabine and Nab-Paclitaxel for Locally Advanced Pancreatic Ductal Adenocarcinoma (La-Pac)

Document Type

Conference Proceeding

Publication Date

2-13-2026

Publication Title

Oncol Res Treat

Keywords

Oncology

Abstract

Background: To date, no phase 3 clinical trial has demonstrated an overall survival (OS) benefit in patients with unresectable locally advanced pancreatic adenocarcinoma (LA-PAC). TTFields are electric fields that disrupt cancer cell division. We report final data from PANOVA-3 (NCT03377491), the largest phase 3, randomized, open-label trial in unresectable LA-PAC to date, comparing TTFields + gemcitabine/ nab-paclitaxel (GnP) vs GnP. Methods: Adults with newly diagnosed unresectable LA-PAC were randomized 1:1 to TTFields (150 kHz) + GnP or GnP. The primary endpoint was OS. Secondary endpoints included progression-free survival (PFS), local PFS, and pain-free survival. Quality of life (QoL) was assessed using the EORTC QLQ C-30 questionnaire and PAN26 module. Distant PFS and pain medication use were analyzed post hoc. Result: 571 patients were randomized. Baseline characteristics were balanced between the study arms. Efficacy endpoints with a significant difference in TTFields + GnP vs GnP were median times for OS (16.2 vs 14.2 months [mo]), pain-free survival (15.2 vs 9.1 mo) and distant PFS (13.9 vs 11.5 mo; post hoc). There were no differences in PFS or local PFS. No systemic adverse events (AE) were observed for TTFields. The most frequent device-related AEs were grade 1/2: dermatitis (27.7%), rash (17.5%), and pruritus (15.0%); grade 3 and 4 occurred in 9.1% and 0.4% of patients, respectively. The following QoL scales showed a significant difference of TTFields + GnP vs GnP: median times to deterioration of pain (10.1 vs 7.4 mo), pancreatic pain (14.7 vs 10.2 mo), global health status (7.1 vs. 5.7 mo), meaningful pain medication (6.9 vs 4.9 mo; post hoc) and opioid use (7.1 vs 5.4 mo; post hoc), and all digestive symptom scales except for indigestion. There was no difference in insomnia and fatigue. Discussion: This is the largest phase 3 trial exclusively performed in unresectable LA-PAC and the first to show a significant OS benefit and benefits in pain and QoL with no additive systemic AEs. Conclusion: TTFields therapy is a potential new standard treatment for unresectable LA-PAC.

Volume

49

Issue

Suppl. 1

First Page

120

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