Chemotherapy drug gemcitabine delays progression of operable pancreatic cancer

Sep 27 2007

Giving pancreatic cancer patients the chemotherapy drug gemcitabine after surgery delays progression of the disease by about six months, according to new research by Japanese scientists.

The study, presented at the European Cancer Conference (ECCO 14) in Barcelona, found that the drug more than doubled the average disease-free survival from 4.9 months to 11.4 months.

“We believe that a median disease-free survival of 11.4 months is an outstanding result. It means an improvement, or reduction in the risk of recurrence, of 41 percent,” said the study's lead researcher, Dr Tomoo Kosuge, deputy director of the National Cancer Center Hospital in Tokyo, Japan. “That is difficult to achieve in patients with pancreatic cancer.”

Pancreatic cancer has among the poorest prognoses. Most often, it has already spread by the time it is diagnosed, but in about 20 percent of patients, surgery is a viable option. However, even if it can be operated on, the cancer normally recurs and more than half of patients die within 20 months of their diagnosis. Only around 20 percent of them are still alive five years after being diagnosed.

Chemotherapy with gemcitabine is the standard treatment for advanced pancreatic cancer that cannot be operated on. As for resectable pancreatic cancer, researchers are investigating whether chemotherapy or chemoradiation might help. However, there is no universally accepted adjuvant treatment for patients whose pancreas can be removed, so mere observation after surgery is still the widely accepted approach.

In the latest study, 118 patients whose pancreatic cancer could be cut out were either given gemcitabine chemotherapy after surgery or closely monitored by doctors. Both groups were followed for more than 20 months.

The disease recurred in 72 percent of the patients getting gemcitabine, compared with 85 percent of those on observation. The overall survival, meaning survival regardless of whether the disease progressed, was better in the gemcitabine group, but those results were not statistically significant.

“In the results of our study, the lack of a significant difference in the overall survival means the observation approach was not altogether negated. We therefore propose that chemotherapy with gemcitabine, as well as observation, now be considered as optimal treatment for patients with operable pancreatic cancer,” Kosuge said.

The Japanese study bolsters the findings of a German study published earlier this year that similarly found gemcitabine delays progression of the disease after surgery.

http://www.ecco-org.eu