Spanish research Fulgar and colleagues published a recent article in the journal Anticancer Research detailing the results of their multi-center Phase 2 clinical trial evaluating oral erlotinib (Tarceva – 150 mg per day) coupled with the also orally administered capecitabine (Xeloda). Capecitabine is a pro-drug of 5-FU that becomes 5-fluorouracil in the course of its metabolism.
They treated 32 patients with a 12-month survival rate of twenty-two percent. 34% of those treated developed a notable skin rash (perhaps related to Tarceva).
The authors indicate that the regimen appears to be active and reasonably safe. They suggest that this oral combination could perhaps be considered as a 1st Line treatment for cancer of the pancreas.
This is an early study that requires further inquiry.
Dale O’Brien, MD
It’s hard to keep up with company changes in the biotech world, but a recent published study in the Annals of Oncology, the official journal of the European Society for Medical Oncology (ESMO) includes highly intriguing results of an unusual combination for advanced pancreatic cancer of gemcitabine and the fully human monoclonal antibody (Mab) AGS-1C4D4.
This particular Mab has been developed by Agensys, Inc., which is an affiliate of Astellas Pharma Inc. (of Japan) and which also now includes the company OSI Pharmaceutical in their fold – that has given us Tarceva, one of the few drugs to be approved by the U.S. FDA (in combination with gemcitabine) for the treatment of pancreatic cancer.
In any case, the researchers of the study in question were from worldwide institutions, as anchored by M Hildago, published under the Dana-Farber (Harvard) Cancer Institute, involved ECOG institutions in the United States, and also included Pancreatica Science Board member, Eileen O’Reilly, MD of Memorial Sloan-Kettering Cancer Center.
They looked at 196 chemo naïve patients with advanced pancreatic cancer who were randomly assigned to receive either gemcitabine alone (63 patients) or the combination of gemcitabine and AGS-1C4D4 (133 patients). At six months the median survival rate was 57.1% in the gemcitabine arm of the trial, and was 79.5% in the combination arm.
As the results of this clinical trial for metastatic pancreatic cancer are encouraging, we must assume that further studies with this gemcitabine plus monoclonal antibody treatment regimen will be forthcoming.
Dale O’Brien, MD
Researchers from the University of California at San Diego have published a recent study in the journal Carcinogenesis that showed that Bitter Melon Juice (BMJ) caused cell death in four lines of pancreatic cancer cells, and appeared to inhibit pancreatic cancer tumor activity in mice.
The fruit of the vine Momordica Charantia is called by many names: bitter melon, bitter gourd, bitter squash, goya, and karavella are but a few of these. It is found widely in Asia, Africa and in the Caribbean. And as the names implies it is perhaps the bitterest of fruits. Bitter melon is used as an ingredient in specialty cooking in many parts of the world.
Also Bitter melon has been studied in several medical conditions and been found to inhibit breast cancer cells, function as an anti-malarial agent, generally be antibiotic, oppose nematodes (parasitic worms), contain substances which may reduce diabetes mellitus, and generally has been used for many purposes of folk medicine. The seeds of the fruit are reported to be toxic for children; and the fruit is contraindicated in pregnancy.
This study is preliminary, and the results need to be validated and further explored. Pancreatica does not particularly endorse the use of this agent, but we do try to include scientific studies on alternative treatments whenever possible
Dale O’Brien, MD