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Bending the Curve Trial by Trial
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PANOVA-3

Tumor Treating Fields with gemcitabine and nab-paclitaxel for locally advanced pancreatic adenocarcinoma (PANOVA-3)

Phase 3N = 571NCT03377491

Population
Newly diagnosed unresectable locally advanced pancreatic adenocarcinoma
Design
Global, randomised, open-label phase 3 trial: gemcitabine 1,000 mg/m2 and nab-paclitaxel 125 mg/m2 (days 1, 8, 15 of a 28-day cycle) with or without tumour treating fields (alternating electric fields delivered by a device) in newly diagnosed unresectable locally advanced pancreatic adenocarcinoma. Primary endpoint overall survival.
Primary endpoint
OS
Arms
  • TTFields plus gemcitabine and nab-paclitaxel (experimental, n = 285): Tumour treating fields with gemcitabine 1,000 mg/m2 and nab-paclitaxel 125 mg/m2
  • Gemcitabine and nab-paclitaxel (control, n = 286): Gemcitabine 1,000 mg/m2 and nab-paclitaxel 125 mg/m2
People
Babiker HM
OSHR 0.82 (95% CI 0.68–0.99)Δ median OS+2 months
Show the numbers
Results reported for PANOVA-3
EndpointAnalysisTTFields plus gemcitabine and nab-paclitaxelGemcitabine and nab-paclitaxelEffect
OSITT (all randomised patients, 571)primaryBabiker 2025median 16.2 months (15–18)median 14.2 months (12.8–15.4)HR 0.82 (95% CI 0.68–0.99)P=.039
Results reported for PANOVA-3
EndpointAnalysisTTFields plus gemcitabine and nab-paclitaxelGemcitabine and nab-paclitaxelEffect
OSITT (all randomised patients, 571)primaryBabiker 2025median 16.2 months (15–18)median 14.2 months (12.8–15.4)HR 0.82 (95% CI 0.68–0.99)P=.039
Hazard ratio (95% CI) by endpoint. Values below 1 favour the experimental arm.
OS0.512◀ experimentalcontrol ▶
Data table
EndpointHR95% CI
OS0.820.68–0.99
Illustrative — modelled from reported values, not trial data. OS, primary.
0%25%50%75%100%010203040Months (modelled)
  • TTFields plus gemcitabine and nab-paclitaxel (experimental)
  • Gemcitabine and nab-paclitaxel (control)

Median-only curves assume a constant hazard (exponential) and fit plateaus, as seen with some immunotherapies, poorly.

Data table (modelled values)
MonthsTTFields plus gemcitabine and nab-paclitaxelGemcitabine and nab-paclitaxel
0100.0%100.0%
1065.2%61.4%
2042.5%37.7%
3027.7%23.1%
4117.3%13.5%
Primary publication: Babiker HM, Picozzi V, Chandana SR, Melichar B, Kasi A, Gang J, et al. Tumor Treating Fields With Gemcitabine and Nab-Paclitaxel for Locally Advanced Pancreatic Adenocarcinoma: Randomized, Open-Label, Pivotal Phase III PANOVA-3 Study. J Clin Oncol. 2025;43(21):2350-2360. PubMedDOI

Appears in

Sources

  1. Babiker HM, Picozzi V, Chandana SR, Melichar B, Kasi A, Gang J, et al. Tumor Treating Fields With Gemcitabine and Nab-Paclitaxel for Locally Advanced Pancreatic Adenocarcinoma: Randomized, Open-Label, Pivotal Phase III PANOVA-3 Study. J Clin Oncol. 2025;43(21):2350-2360.

    PubMedDOI