Chemo Combination May Treat Pancreatic Cancer

May 9, 2005 -- A mix of chemotherapy drugs could be considered for treating advanced pancreatic cancer,pancreatic cancer, say Italian doctors in The Lancet Oncology's online edition.

Pancreatic cancer has a poor prognosis. More than 80% of patients are diagnosed when the disease is already in advanced stages, says the new study, which was conducted by doctors including Michele Reni, MD, of San Raffaele H. Scientific Institute in Milan, Italy.

Pancreatic cancer has subtle symptoms. At the time of diagnosis the cancer may have spread and infiltrated blood vessels and the liver, making a chance for cure difficult. With standard chemotherapy treatment, less than one-third of patients survive past one year.

However, the researchers say because their study was small, larger studies are needed "before this combination regimen could be regarded as standard treatment."

The combination includes four drugs -- cisplatin, epirubicin, fluorouracil, and gemcitabine. That mix, dubbed "PEFG", was compared to gemcitabine alone, the current standard treatment.

About twice as many people in the PEFG group survived for four months without their disease progressing. One and two years later, overall survival rates were also higher with PEFG, says the study.

About Pancreatic Cancer

In the U.S., pancreatic cancer is the fourth leading cause of cancer death in men and the fifth in women, says the American Cancer Society (ACS). About 32,180 people will be diagnosed with pancreatic cancer and about 31,800 will die of the disease, says the ACS.

Aside from advanced age, smoking is the main risk factor for pancreatic cancer; a smoker is three to four times more likely than a nonsmoker to get the disease. People frequently exposed to certain petroleum products may also be at increased risk. Excessive dietary fat and protein as well as low-fiber intake may promote the disease.

The study included 104 people with advanced pancreatic cancer. They were 18-70 years old and were followed for at least two years.

Patients were assigned to get the PEFG drug combination or gemcitabine alone. The researchers wanted to compare the length of time during and after treatment that the cancer did not grow.

In the PEFG group, 60% survived four months without their cancer progressing, compared with 28% of the gemcitabine group. The PEFG group also had a higher overall survival rate at one year than the gemcitabine group (39.5% compared with 21.3%).

After two years, five PEFG patients were still alive. So was one person in the gemcitabine group.

"The proportion of patients with one-year and two-year survival was greater in the PEFG group than in the gemcitabine group," says the study.