The 2013 Gastrointestinal Cancers Symposium, held on January 24-26 in San Francisco, CA, highlighted research results that have the potential to offer patients with pancreatic ductal adenocarcinoma better treatment options—and outcomes. Nearly 90 abstracts were presented on pancreatic cancer, from preclinical to late-state treatments.
Until recently, options for patients with pancreatic cancer were “extremely limited,” Margaret A. Tempero, MD, Director of the University of California, San Francisco, Pancreas Center told Symposium attendees.1
“A decade ago only one drug, gemcitabine, was approved for use in pancreatic ductal adenocarcinoma with no useful targeted therapeutic on the horizon. In fact, at that time, I was somewhat surprised when any treatment helped my patients,” added Dr. Tempero, who also holds the Rombauer Family Distinguished Professorship in Pancreas Cancer Clinical and Translational Science at UCSF Helen Diller Family Comprehensive Cancer Center and is a past president of the American Society of Clinical Oncology.1
Subsequently, erlotinib “provided some incremental benefit,” as did the combination of 5-fluorouracil (5-FU), leucovorin, oxaliplatin, and irinotecan (FOLFIRONIX).1 However, for the past decade, the incidence of pancreatic cancer has been increasing by 1.5% annually and, for the more than 50% of patients diagnosed at a distant stage of the disease, 5-year survival is 2%.2 (Figure 1)
Results of the phase 3 Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT)4 presented during the Symposium were, therefore, particularly well accepted: the global study in 861 patients with metastatic pancreatic adenocarcinoma found that nab-paclitaxel plus gemcitabine more than doubled 2-year survival, compared with gemcitabine alone.3
Lead investigator Daniel D. Von Hoff, MD, of the Virginia G. Piper Cancer Center at Scottsdale Healthcare/TGen, Scottsdale, AZ, called nab-paclitaxel plus gemcitabine “a new standard for the treatment of patients with metastatic pancreas cancer” that “could become the backbone for new regimens.”5