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DNA Marker Differences in Asians vs. Europeans with Pancreatic Cancer

Canzian and estimable European colleagues including Dr. John Neoptolemos of Liverpool University (and again our Professor Markus Buchler of the University of Heidelberg / Pancreatica Science Board)  in a February 2013 article in the Cancer Epidemiology, Biomarkers, and Prevention – a publication of the American Association for Cancer Research through their newly formed collaborative called the PANcreatic Disease ReseArch consortium or PANDoRA, looked at seven identified SNPs (DNA single-nucleotide polymorphisms) in primarily Caucasian Europeans with and without advanced pancreatic cancer(ductal adenocarcinoma of the pancreas).

These seven SNPs have been found in past studies to be associated with increased pancreatic cancer risk in two Asian populations.  With one exception that may be explained by chance due to relatively small population in the Polish sub-group, this study did not appear to demonstrate an association between these possible SNP markers and an increased risk of pancreatic cancer for those of European ancestry.

This published research serves to demonstrate the complexity and difficulty encountered with developing molecular and genetic screening markers for pancreatic cancer across racial and ethnicity backgrounds.

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Dale O’Brien, MD



Evaluating the Xeloda and Tarceva Oral Regimen for Advanced Pancreatic Cancer

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) in pancreatic cancer (ductal adenocarcinoma of the pancreas).  Capecitabine is a pro-drug of 5-FU that becomes 5-fluorouracil in the course of its metabolism.

They treated 32 patients with metastatic pancreatic cancer demonstrating 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 in pancreatic cancer that requires further inquiry.

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Dale O’Brien, MD .

Phase 2 Results of Gemcitabine and Monoclonal Antibody for Advanced Pancreatic Cancer

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 (ductal adenocarcinoma of the pancreas) 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.

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Dale O’Brien, MD