The drug agent gemcitabine has been the mainstay of the medical treatment of pancreatic cancer. This assertion has perhaps been challenged by extensive 5-FU combinations in the past couple of years, but is still mostly held to be true by clinicians.
The wide adoption of the use of gemcitabine since 1997 has also engendered a question, why does it ultimately fail? The thought is that resistance to gemcitabine occurs – which then allows the tumor to overpower the effects of the drug.
Now comes a Phase I study by Kurzrock and colleagues at MD Anderson Cancer Center / University of Texas (Houston) that pairs (together with gemcitabine) the leukemia drug dasatinib, which has shown in pre-clinical studies to help overcome resistance to gemcitabine.
Two of eight of the patients with pancreatic cancer either showed stable disease for more than six months or showed a partial response during the treatment.
It is an early study, but perhaps a useful approach to begin to discover methods to extend the benefit of one of the key drugs used in the treatment of pancreatic cancer.
Dale O’Brien, MD
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Chinese researchers have utilized an innovative modality for the treatment of advanced pancreatic cancer – High-Intensity Focused Ultrasound (“HIFU”). This mode of therapy involves a manner of directing acoustic energy in a very directed fashion at the tumor itself. HIFU is considered to be essentially a noninvasive procedure (or at least only minimally invasive).
In the journal Hepatobiliary & Pancreatic Diseases International, Ye and colleagues have recently reported out a study of twenty-five patients with metastatic pancreatic cancer (adenocarcinoma) that were treated with one or more sessions of HIFU. They found that increased activity performance levels, and decreased pain levels – in 23 of the patients. Also, overall CA19-9 marker levels were dramatically improved at one month post-procedure; and in five the CA19-9 levels became essentially undetectable.
Further and importantly, the median survival duration of the patients was ten months, with a rate of survival of 42% at one year (post-diagnosis). These results are somewhat remarkable for advanced pancreatic cancer and suggest the need for further confirmation and evaluation of this interesting technology.
Dale O’Brien, MD