L-Glutamine + Gem/Nab-P Reaches 22-Month mOS in Advanced PDAC

The Phase 1 GlutaPanc trial (NCT04634539) added oral L-glutamine—a metabolic intervention with preclinical evidence of sensitizing pancreatic cancer to chemotherapy—to first-line gemcitabine + nab-paclitaxel in treatment-naive advanced PDAC (n=16). Tumor shrinkage occurred in 94%, with a 44% ORR including 12.5% complete responses; median PFS was 8.5 months and median OS reached 22 months. Grade ≥3 treatment-related adverse events occurred in 66.7%, primarily attributed to chemotherapy. For comparison, gemcitabine + nab-paclitaxel produced a 23% ORR, 5.5-month PFS and 8.5-month OS in MPACT, while the more recent NAPOLI-3 trial reported 9.2-month OS with gem/nab-p versus 11.1 months with NALIRIFOX.