New Chemotherapy Regimen Boosts Survival for Pancreatic Cancer Patients

CASSANDRA trial finds PAXG combination extends event-free survival compared to standard treatment

Published on Feb. 23, 2026

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A new chemotherapy regimen called PAXG has shown significant improvements in event-free survival for patients with resectable or borderline resectable pancreatic ductal adenocarcinoma, according to findings from the CASSANDRA phase 3 clinical trial published in The Lancet. The study compared PAXG to the current standard of care, mFOLFIRINOX, and found patients receiving the new PAXG combination experienced an event-free survival of 16 months, compared to around 10 months for those on mFOLFIRINOX.

Why it matters

Pancreatic cancer is an aggressive form of the disease, accounting for 95% of pancreatic malignancies, and has historically had poor survival rates. The CASSANDRA trial results indicate PAXG could become a new standard of care, potentially improving outcomes for many pancreatic cancer patients.

The details

The CASSANDRA trial involved hundreds of patients with resectable or borderline resectable pancreatic ductal adenocarcinoma. It directly compared the new PAXG regimen, which consists of four chemotherapy drugs, to the current standard mFOLFIRINOX treatment. The results showed a substantial improvement in event-free survival for those receiving PAXG.

  • The CASSANDRA trial findings were recently published in The Lancet.
  • Researchers presented the results at the annual American Society of Clinical Oncology (ASCO) conference in Chicago.

The players

San Raffaele Hospital

The hospital in Milan that coordinated the CASSANDRA trial.

Sant'Orsola Polyclinic

The hospital in Bologna that was involved in the CASSANDRA trial.

Italian Medicines Agency (AIFA)

The agency that recognized the potential of the CASSANDRA trial and transitioned it from a phase 2 to a phase 3 trial.

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What’s next

The research team is now focusing on analyzing long-term survival rates – beyond five years – to further validate the benefits of PAXG.

The takeaway

The success of the PAXG chemotherapy regimen in the CASSANDRA trial represents a significant advancement in the treatment of pancreatic cancer, a disease with historically poor outcomes. This research highlights the critical role of patient advocacy groups in driving medical progress and the importance of personalized approaches to cancer care.