Raising Hope for Pancreatic Cancer

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I would like to start today's post with a question: What is the most dreaded form of cancer… the one we hope none of us ever develop?

One question, one answer: pancreatic cancer.

It's quite clear why a diagnosis of pancreatic cancer can be so devastating to a patient. Long regarded as the most lethal form of cancer, and a leading cause of death from cancer worldwide, pancreatic cancer remains largely elusive to early detection and warning symptoms, ultimately causing 34,000 deaths annually. Worldwide, approximately 230,000 cases are diagnosed every year (≥43,000 of which occur in the United States), and those treated for locally advanced or metastatic pancreatic cancer typically have a median survival time of approximately 5 to 6 months.

Despite its staggering death toll, there have been several well-known individuals, notably Steve Jobs and Patrick Swayze, who beat the odds of pancreatic cancer, having lived with the daunting malignancy for far longer than expected, before succumbing to their disease. Having battled pancreatic cancer so bravely, individuals such as Jobs and Swayze have surely brought hope to other pancreatic cancer patients that longer survival times are possible. And, although advancements in the development and use of multimodal treatment (surgery, chemotherapy, targeted therapy) have made these longer survival times possible, more drug development is needed to adequately fill the pipeline for pancreatic cancer.

Currently in Phase 3 is BioSante's GVAX pancreatic cancer vaccine, which uses inactivated pancreatic cancer cells to stimulate the immune system. The vaccine has already been successful in Phase 1b clinical trials, where it increased median survival of patients with previously treated, locally advanced, or metastatic pancreatic adenocarcinoma from 3.3 months, when treated with ipilimumab (Yervoy, Bristol-Myers Squibb), to 5.5 months. In Phase 2, when 60 pancreatic cancer patients received GVAX after pancreatic resection, their median survival time increased from 17.3 months (95% CI, 14.6–22.8) to 24.8 months (95% CI, 21.2–31.6); the vaccine was also generally well tolerated.

AMG 479, a targeted antibody-based therapy from Amgen Corporation currently being investigated in Phase 3 trials, should also raise the hopes of pancreatic cancer patients. Previously, in a randomized, open-label, Phase 2 study, co-administration of AMG479 and gemcitabine resulted in a median overall survival of 7.3 months vs. 6.2 months in the gemcitabine arm (HR=0.69, 95% CI: 0.38-1.25; P=0.22). Patients who have received AMG 479 also experienced longer progression-free survival of 5.1 months vs. 2.1 months [HR=0.60 (95% CI: 0.36–1.01; P=0.055). Phase 3 data collection is expected to be completed in October 2013.

More information on these trials can be found in our latest feature article, "Novel Agents Fill the Pipeline for Pancreatic Cancer."

How will these potential pancreatic cancer therapies, if approved, affect the way in which you treat your patients?

Readers: We'd love to hear from you in the comments section below! If you have a case study or a more extended response to this subject, click here to submit an item for us to publish


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