Oral Salmonella-IL2 bacteria + systemic FOLFIRINOX triples median PFS to 15 mo in stage IV pancreatic cancer

Salmonella-IL2, an attenuated S. Typhimurium engineered to secrete human IL-2 and colonize tumors, was administered orally alongside bi-weekly FOLFIRINOX in a non-randomized Phase II study (NCT04589234). 20 metastatic PDAC patients in Canada received ≥5 doses, the mPFS reached 15 months versus 5.8 months in 37 site-matched FOLFIRINOX controls (HR 0.30, p<0.0001). The mOS was 20.3 vs 11.5 months (HR 0.59, p=0.07). Grade ≥3 toxicities were driven by chemotherapy (anemia 45%, rash 14%); no serious events were linked to the live microbe. Historically, first-line FOLFIRINOX alone delivers ~6 mo PFS and 11–12 mo OS, underscoring the sizable survival improvement observed in this small, non‑randomised study.