New treatment for pancreatic cancer allows life-saving surgery

December 06, 2005

A new treatment for pancreatic cancer developed by clinical researchers of Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center substantially reduces the size of tumors and lowers the risk of local recurrence of the disease. Fifty percent of patients in the study responded to therapy--one of the highest response rates ever seen with pancreatic cancer. Results of the study were published in the December 2005 issue of the Annals of Surgical Oncology.

Researchers, led by oncologist and principal investigator J. Marc Pipas, M.D., were able to reduce the size of tumors so significantly that a number of patients who previously had been categorized as borderline or inoperable could have their tumors surgically removed.

Surgery, and the complete removal of the tumor, is the only curative hope for people with pancreatic cancer, the fourth leading cause of cancer death in the U.S., according to the National Cancer Institute. NCI estimates that of the 32,180 new cases of pancreatic cancer in 2005, 31,800 will die.

The overall five-year survival rate for pancreatic cancer is only 4%, but for patients whose tumors can be completely removed, long-term survival jumps to 18-24%. Detecting the tumor in an early stage is crucial, but pancreatic cancer has few symptoms and is often diagnosed only after the cancer has grown into surrounding tissue or metastasized, making surgery impossible.

"The only way to cure these tumors is to remove them completely," explains Pipas. "You try to do something to make sure there is no microscopic disease left. If you can't remove it, the prognosis is poor."

Traditional treatment for pancreatic cancer is surgery followed by chemotherapy and radiation. The treatment Pipas developed reverses the treatment steps. He administers chemotherapy and radiation in combination first, in order to reduce the size of the tumor and increase the possibility of surgery. The reverse treatment regimen results in many tumors previously considered borderline or inoperable shrinking to a size where they could be surgically removed. In the Norris Cotton Cancer Center trial, 24 patients were treated with short course, high dose chemotherapy of docetaxel and gemcitabine, followed by a combination of radiation and twice-weekly low-dose gemcitabine. Chemotherapy doses in this trial were higher than previously attempted.

Results showed that 50% of tumors shrank by at least a third, including complete disappearance of a tumor in a patient who previously had been judged inoperable. No tumors progressed during treatment.

The ability to shrink a pancreatic tumor is important because in order to eradicate the cancer, the tumor must be small enough to be completely removed without damaging major blood vessels surrounding the pancreas. Seventeen patients in the study underwent surgery, including nine previously considered inoperable or borderline operable. Subsequent follow-up showed that no patient whose tumor was surgically removed had a local recurrence of the disease, and no patient whose disease was considered inoperable had local progression.

Because the treatment Pipas and his team developed is allowing more patients the option of surgery, it is now the standard treatment for pancreatic cancer at the Norris Cotton Cancer Center.

In a new study, Pipas is using gemcitabine and radiation in combination with cetuximab (Erbitux®), an antibody treatment. Norris Cotton Cancer Center is the only center testing this treatment for pancreatic cancer.

"Our goal for therapy is more people to complete resection," explains Pipas. "That's going to be the first step to curing patients."
-end-
Article: "Docetaxel/Gemcitabine followed by Gemcitabine and External Beam Radiotherapy in Patients with Pancreatic Adenocarcinoma," J. Marc Pipas, Richard J. Barth, Bassem Zaki, Michael J. Tsapakos, Arief A. Suriawinata, Michael A Bettmann, Justin M. Cates, Gregory H. Ripple, John E. Sutton, Stuart Gordon, Carol E. McDonnell, Raymond P. Perez, Nancy Redfield, Louise P. Meyer, John F. Marshall, Bernard F. Cole, and Thomas Colacchio. Annals of Surgical Oncology, Vol. 12, No.12, December 1, 2005; published online November 1, 2005.

The Geisel School of Medicine at Dartmouth

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.