Drug mix ‘a monumental step forward’ in treating pancreatic cancer

A life-extending combination of two drugs has been hailed a “monumental step forward” in the treatment of one of the most deadly cancers.

Pairing the chemotherapy drugs gemcitabine and capecitabine dramatically increases the chances of people with pancreatic cancer living at least five years, trial results have shown.

The treatment protocol should now become the new standard of care for patients who have had surgery, experts say.

Pancreatic cancer is the deadliest of all the 21 most common cancers, largely because it is often identified at a late stage.

Each year about 9,600 people in the UK are diagnosed with pancreatic cancer and 8,800 die from it.

Just 5% of sufferers can expect to live five years and a mere 1% are still alive 10 years after diagnosis. Survival rates have improved little since the early 1970s.

More than 700 patients from the UK, Germany, Sweden and France took part in the Espac 4 trial which compared post-surgery treatment using both drugs with using gemcitabine alone.

The findings, published in The Lancet medical journal, showed that 29% of patients receiving the drug combination lived at least five years. In contrast, just 16% of patients restricted to gemcitabine survived that long.

Charity Pancreatic Cancer UK is now calling for the combination treatment to be made available to all eligible patients on the NHS.

The move will result in about 100 extra patients each year living for five years or more, it is claimed.

Leanne Reynolds, head of research at Pancreatic Cancer UK, said: “These results are a monumental leap forward in pancreatic cancer treatment.

“We believe this could herald a true step change in the treatment of this tough cancer, offering substantially more patients who have had surgery the chance to live for longer and crucially, without significant added side effects.

“It is wonderful to hear of such positive results which will offer hope to hundreds of people with this disease and their families.

“We must now embrace this opportunity to provide those families with far more precious time together.

“We urge the NHS to introduce this treatment across the UK for patients who have had surgery immediately. Since the early 1970s there has been so little progress for patients in research, treatments and survival rates.

“Golden opportunities like this to transform patients’ lives do not come along often, so we must grab this one with both hands.”

Side effects from the combination treatment were no worse than those experienced by patients on gemcitabine alone.

They included an impaired immune system and increased risk of infection, bleeding or bruising problems, fatigue, nausea, diarrhoea and flu-like symptoms.

Trial leader Professor John Neoptolemos, from the University of Liverpool, said: “This is one of the biggest ever breakthroughs prolonging survival for pancreatic cancer patients.

“When this combination becomes the new standard of care, it will give many patients living with the disease valuable months and even years. The difference in short-term survival may seem modest but improvement in long-term survival is substantial for this type of cancer.”

The study was funded by Cancer Research UK whose chief clinician Professor Peter Johnson described pancreatic cancer as “a notoriously difficult disease to treat”.

He added: “Research that tells us more about how the disease grows and spreads – and trials like this one – will be key to improve survival for patients living with the disease.

“There are still big leaps to be made but Cancer Research UK is investing heavily into research to take on pancreatic cancer and we are just starting to see the results.”

One British trial participant Peter Breaden, 67, who was diagnosed with pancreatic cancer in April 2010, explained why he volunteered for the study.

The retired lab manager, a grandfather of five from Merseyside, said: “I know that new drugs and techniques need to be developed so when the doctors told me about the trial, there was no hesitation in my mind – I wanted to get involved.

“I was very grateful for the opportunity to contribute to this trial. For six months I had chemotherapy on three weekly cycles after my surgery. I am pleased to have been part of a trial that has been such a success. Research is absolutely essential and needs all our support.”

Non-peer reviewed results from the trial were initially presented at the American Society of Clinical Oncology (Asco) meeting in June last year.