Chemotherapy Followed By Novel Surgery Can Help Safely Remove Inoperable Pancreatic Tumors

Pancreatic cancer makes up about 3% of all cancers in the United States, yet it ranks among the most lethal. Often, it does not show symptoms until it has significantly progressed or spread throughout the body, leading to late detection and dismal survival rates. Only 13% of those diagnosed with pancreatic cancer live five years or more. Patients with locally advanced pancreatic cancer, which represents a third of all cases, typically have a life expectancy of around one year. Surgery is generally the best treatment for cancers that haven't metastasized, but it's usually not an option for pancreatic tumors affecting nearby blood vessels due to the risk of damaging these vessels and disrupting blood flow to vital organs, potentially causing severe complications or death. Thus, chemotherapy and/or radiation, which are only marginally effective against pancreatic cancer cells, have been the primary treatments available for patients with advanced stages of the disease.

Now, a team of surgeons from Keck Medicine of USC (Los Angeles, CA, USA) is conducting a clinical trial that offers a ray of hope for those considered ineligible for surgery due to the advanced stage of their pancreatic cancer. This trial will evaluate the safety and efficacy of a round of chemotherapy followed by an innovative surgical approach to remove the cancer, even when it has spread to or is located near the vital blood vessels surrounding the pancreas. This approach involves cutting-edge surgical techniques developed by Keck Medicine surgeons for safely excising tumors attached to arteries.

Image: The new study will examine if ‘inoperable’ pancreatic tumors can be safely removed (Photo courtesy of 123RF)

Participants in the trial will first receive chemotherapy to reduce the tumor size. After completing chemotherapy, they will undergo a laparoscopic assessment to ascertain the tumor's size and position, followed by the surgical removal of the tumor and the resection and reconstruction of the affected blood vessels. The trial includes regular follow-ups with the patients every three months for the first year after the surgery and then every six months for the next two years. It will also investigate whether certain biomarkers, like the tumor's DNA, and demographic factors, such as age and gender, influence patient outcomes. The goal is to enroll 20 patients with locally advanced pancreatic cancer showing evidence of arterial involvement by their tumors.

“Usually, these types of tumors cannot be safely removed with surgery because of the risk of damaging the blood vessels, which supply blood to the stomach, liver and other abdominal organs. However, due to recent advancements by Keck Medicine surgeons, we believe that patients with locally advanced cancer can be candidates for successful surgery, which could significantly improve outcomes,” said Steven Grossman, MD, PhD, co-lead investigator of the study.

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Keck Medicine of USC