# Precision Promise

Source: https://onco.cc/trials/precision-promise/  
OnCo record `precision-promise` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Precision Promise was the pancreatic cancer charity's attempt to copy I-SPY 2 for one of the deadliest cancers: several new treatments tested at once against standard chemotherapy, with the trial itself learning which patients each helped. Its first two experimental drugs did not extend life, and the trial has closed.

## Summary

Precision Promise was built by the Pancreatic Cancer Action Network with the statisticians behind I-SPY 2 and GBM AGILE and opened in January 2020 at a network of United States pancreatic cancer centres. Patients with metastatic pancreatic adenocarcinoma entering first- or second-line treatment were randomised adaptively between standard chemotherapy (gemcitabine with nab-paclitaxel or modified FOLFIRINOX) and experimental arms, with overall survival as the primary endpoint and a design that let a promising arm expand seamlessly into a registration-quality stage. Tumour and blood samples were collected to search for subgroups that responded.

The first experimental arm, SM-88 (racemetyrosine), was discontinued in 2022 for lack of efficacy. The second, pamrevlumab, an antibody against connective tissue growth factor given with chemotherapy, did not improve survival and was closed after its interim analysis. No further arms graduated, and the registry records the trial as completed with about 500 participants enrolled.

Precision Promise is the cautionary member of the platform family: the machinery worked, but a platform is only as good as the drugs offered to it, and pancreatic cancer had few strong candidates during the years it ran. It leaves a well-characterised control cohort and biobank, and lessons about how a disease charity can sponsor a registration-grade platform, that later pancreatic trials draw on.

## Fields

- Kind: Trial
- Status: completed
- Last checked: 2026-09-17
- Also known as: Precision Promise trial; PanCAN Precision Promise; PRISM
- Registry id: NCT04229004
- Phase: platform
- Setting: Metastatic pancreatic ductal adenocarcinoma in first and second line: a Bayesian adaptive platform comparing experimental regimens with gemcitabine plus nab-paclitaxel or modified FOLFIRINOX on overall survival, with seamless graduation to a confirmatory stage
- Sponsor: Pancreatic Cancer Action Network
- Result: SM-88 discontinued in 2022 for lack of efficacy; pamrevlumab did not improve overall survival; the trial closed with about 500 participants.

## Sources

- ClinicalTrials.gov NCT04229004: https://clinicaltrials.gov/study/NCT04229004
- Pancreatic Cancer Action Network: Precision Promise: https://pancan.org/research/precision-promise/

## Connected records

- collections: [Pancreatic Cancer Action Network (PanCAN)](https://onco.cc/collections/pancan/)
- cancers: [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Monoclonal antibodies](https://onco.cc/technologies/monoclonal-antibody/)
- drugs: [FOLFIRINOX / mFOLFIRINOX](https://onco.cc/drugs/folfirinox/), [Gemcitabine](https://onco.cc/drugs/gemcitabine/), [Pamrevlumab](https://onco.cc/drugs/pamrevlumab/)
- companies: [FibroGen](https://onco.cc/companies/fibrogen/)
- terms: [Interim analysis, readout and data cut-off](https://onco.cc/terms/interim-analysis/), [Master protocol (platform, basket and umbrella trials)](https://onco.cc/terms/master-protocol/), [Seamless, adaptive and Bayesian trial designs](https://onco.cc/terms/seamless-adaptive/)
- bottlenecks: [Trial design, endpoints and cost](https://onco.cc/bottlenecks/b-trial-design/)

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