Surgery Plus Drugs for Advanced Pancreatic Cancer

Surgical resection combined with a four-drug chemotherapy regimen can triple the survival of patients with advanced pancreatic cancer, according to a study of 12 patients reported at the annual Clinical Congress of the American College of Surgeons in Chicago (IL, USA).

Patients in the study were thought to be candidates for surgery to remove their pancreatic tumors, but surgeons discovered the tumors were too extensive for the growths to be excised. Instead, they treated the patients with chemotherapy to shrink the tumors to a resectable size. Patients received four different low-dose chemotherapy drugs until the pancreatic tumors in all but one patient were small enough to remove surgically. The median survival from the time of diagnosis was 35 months in those patients who had surgical resection. About 82% lived for two years, 41% lived for three years, and 27% lived for four years. Although seven of the 12 patients died of recurrent disease, five were still alive and disease free between 10 and 117 months after diagnosis.

"For patients who present with unresectable pancreatic cancer, the role of therapy has focused on the pancreas,” said William Isacoff, M.D., assistant clinical professor in the department of hematology and oncology at the University of California, Los Angeles, Jonsson Comprehensive Cancer Center (USA). "But three months after they finish radiation, amny patients have liver metastases. Well, the liver metastases were already there, too small to see; so what the patients needed was effective systemic treatment.”





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