Novel Drug NP137 Shows Unprecedented Promise in Turning the Tide on Pancreatic Cancer

LYON, France, and GENEVA, Switzerland – April 22, 2026 – By Linda Coleman

In a significant development for one of the most lethal forms of cancer, new clinical data published today in the prestigious journal Nature reveals a potential breakthrough in the treatment of locally advanced pancreatic cancer. Results from a Phase 1b trial show that a first-in-class drug, NP137, when combined with standard chemotherapy, not only extended patient survival but, crucially, enabled a significant number of patients with previously inoperable tumors to undergo potentially curative surgery.

The study, sponsored by clinical-stage oncology company NETRIS Pharma, evaluated their anti-netrin-1 monoclonal antibody NP137 in patients with locally advanced pancreatic ductal adenocarcinoma (LAPC). For decades, a pancreatic cancer diagnosis has come with a grim prognosis, largely due to the disease's aggressive nature and its resistance to treatment. These new findings offer a tangible beacon of hope, suggesting a novel strategy to overcome one of cancer’s most formidable defenses.

A Clinical Breakthrough: Unpacking the LAPNET-01 Data

The LAPNET-01 trial combined NP137 with mFOLFIRINOX, a potent chemotherapy regimen that is a standard of care for patients healthy enough to tolerate it. The results in 43 patients were striking. The combination achieved a median progression-free survival (PFS) of 10.85 months and a median overall survival (OS) of 16.43 months.

While these survival metrics represent an encouraging improvement over historical benchmarks, the most transformative finding lies in the rate of conversion to surgery. LAPC is, by definition, considered unresectable at diagnosis. The primary goal of initial therapy is to shrink the tumor enough to make surgery possible. Historically, this has been a difficult goal to achieve, with major trials like NEOPAN reporting R0 resection (a complete, margin-free removal of the tumor) rates of just 6% with FOLFIRINOX alone.

The LAPNET-01 trial reported that an astonishing 23% of all patients treated with the NP137 combination were able to undergo successful R0 resection. This nearly four-fold increase over historical data suggests the drug combination can fundamentally alter the treatment course for a substantial portion of patients, opening a pathway to a potential cure that was previously closed.

A New Era of Precision: The Role of the Neogenin Biomarker

Digging deeper into the data, the researchers uncovered an even more compelling story of precision medicine. The team identified a predictive biomarker, a tumor receptor called neogenin, that appears to single out patients who benefit most dramatically from NP137.

In the subset of patients whose tumors expressed high levels of neogenin, the results were unprecedented. These patients achieved a median progression-free survival of 15.65 months. Even more remarkably, their median overall survival has not yet been reached, with a 100% survival rate at the 12-month mark. The conversion-to-surgery rate in this neogenin-high group soared to 40%.

"Achieving this early clinical efficacy in pancreatic ductal adenocarcinoma is very promising for patients who have limited options," said Dr. Gael Roth, the study's lead investigator and a Professor in GI Oncology at Grenoble Alpes University Hospital. "The group of neogenin-high patients, where we saw dramatically extended PFS and OS is unprecedented and opens a path for personalized and potentially more effective treatments of this group of pancreatic cancer patients."

The identification of neogenin as a candidate biomarker is a critical step forward. Pancreatic cancer has largely lacked effective biomarkers to guide therapy, forcing a one-size-fits-all approach. If validated, a neogenin test could allow doctors to select patients most likely to have a profound response to NP137, ushering in a new, more personalized standard of care.

Hacking Chemoresistance: The Science Behind NP137

The success of NP137 stems from its unique biological target. The drug is a first-in-class antibody designed to block a protein called netrin-1. In a healthy body, netrin-1 is involved in processes like neuronal guidance. However, many cancers, including pancreatic cancer, hijack this protein and overexpress it as a survival mechanism.

Netrin-1 promotes what is known as the epithelial-to-mesenchymal transition (EMT), a process where cancer cells become more aggressive, migratory, and, critically, resistant to chemotherapy. By blocking netrin-1, NP137 is believed to inhibit this EMT process. It effectively dismantles the cancer cell's defensive shield, making it vulnerable once again to the effects of chemotherapy like mFOLFIRINOX.

This mechanism is orthogonal, or distinct, from most other cancer therapies. While immunotherapies and targeted drugs like KRAS inhibitors have revolutionized other cancers, they have shown limited success in the complex and immunosuppressive environment of pancreatic tumors. NP137's ability to overcome chemoresistance by targeting a novel pathway represents a fundamentally new strategy in the fight against the disease.

Navigating the Path Forward: From Trial to Treatment

While the results from LAPNET-01 are generating significant excitement, it is important to maintain a balanced perspective. The findings come from a small, single-arm Phase 1b study. Without a randomized control arm receiving chemotherapy alone, direct comparisons are based on historical data, which is a limitation.

NETRIS Pharma's leadership is keenly aware of the steps that lie ahead. "While this is only a Phase 1b trial, we are thrilled to observe the strong PFS and OS being achieved in the neogenin-high PDAC patients," said Patrick Mehlen, CEO of NETRIS Pharma. "We are eager to confirm these results in a larger study... We are engaging with US and EU regulatory authorities as we design the development pathway for NP137 to treat PDAC and other solid tumors."

The company plans to initiate a randomized, potentially registrational, Phase 2 trial. Crucially, this next study will incorporate a neogenin test to prospectively validate its use as a companion diagnostic. This dual development of the drug and its predictive biomarker is essential for realizing the promise of a personalized therapeutic strategy.

For patients and families affected by pancreatic cancer, the road to a new approved therapy remains long. However, the data published today represents more than just a promising scientific finding; it is a significant and tangible step forward, providing a clear and hopeful path for future trials that could one day change the definition of what it means to be diagnosed with this challenging disease.