131TiP ASCEND: Randomized, double-blinded phase II study of gemcitabine and nab-paclitaxel with CEND-1 or placebo in untreated metastatic pancreatic ductal adenocarcinoma - An Australasian Gastro-Intestinal Trials Group (AGITG) trial ACTRN12621001290886

Most patients with pancreatic ductal adenocarcinoma (PDAC) present with unresectable or metastatic disease. Standard first line chemotherapy is with gemcitabine and nab-paclitaxel, or FOLFIRINOX and median overall survival (OS) remains poor, under 12 months. The dense PDAC stroma acts as a barrier to drug delivery. CEND-1 is a novel cyclic tumor-penetrating peptide iRGD (internalizing arginylglycylaspartic acid) that may improve drug delivery by activating an endocytic/exocytic transport pathway by binding αvB3/5-integrins and downstream neuropilin-1.