Although rare, about 38,000 Americans die from pancreatic cancer each year, making it the fourth deadliest type of cancer in the United States. In an effort to slow the death rate of this disease, doctors and researchers have worked feverishly to come up with advancements in treatment.
Roswell Park recently participated in a promising Phase III clinical trial, led by Dr. Daniel Von Hoff of the Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare in Arizona. The results of the MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial) study showed that survival of Stage IV metastatic pancreatic cancer patients who received a combination of Abraxane (trade name for nab-paclitaxel) and gemcitabine, was almost two months longer than patients who received only gemcitabine.
In the trial, one group of patients received the combination of Abraxane and gemcitabine intravenously once per week for three weeks, followed by one week of rest. Another group received gemcitabine by itself, also intravenously, once per week for seven weeks followed by a week of rest. The results revealed that the median survival for patients who received the drug combination was 8.5 months, as opposed to 6.7 months for those who received only gemcitabine. Treatment with the drug combination doubled the survival rate at the two-year mark (9 percent vs. 4 percent) compared to only gemcitabine.
This study was born after Dr. Von Hoff’s group discovered that a molecular marker called SPARC is found in abundance in the connective tissue of pancreatic cancer. Laboratory research found that SPARC may have a strong affinity for Abraxane and help to increase the uptake of Abraxane by pancreatic cancer than other chemotherapy drugs, providing the scientific rationale of why we looked at the combination of Abraxane and gemcitabine to treat pancreatic cancer.
As with any cancer treatment, there are various side effects to watch for. Patients who receive gemcitabine may experience nausea, fatigue and anemia. They may also be at increased risk of infection and have a low platelet count. Abraxane’s side effects can include hair loss and neuropathy (numbness or pain in fingers or toes). When patients receive any, or both, of these drugs, they must be closely monitored.
Patients who present with pancreatic cancer may first notice jaundice, or yellowing, in their eyes or face. Abdomen pain is also typically present, as is weight loss and a poor appetite. There are some risk factors associated with pancreatic cancer including smoking, alcohol use and a history of pancreatitis, however there is not a single major factor that definitely causes pancreatic cancer.
Overall, I believe this treatment should be seriously considered for patients with Stage IV pancreatic cancer. These newfound results represent a major milestone in the treatment of pancreatic cancer and gives reason for hope. That said, an increase of median survival of Stage IV pancreatic cancer patients to 8.5 months is not enough. We will continue to look at novel ways to improve the way we treat pancreatic cancer.
Roswell Park Cancer Talk
Breaking the Silence for Pancreatic Cancer Awareness Month by Dr. Iyer (11/29/12)