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Combination therapy after surgery shows improved survival outcomes

Posted by: Research 3 June 2016

A major pancreatic cancer clinical trial testing a combination of chemotherapy drugs compared with standard treatment has shown significant improvements in five year survival outcomes for patients who have had surgery to remove their tumour.

Researchers from Liverpool are presenting the findings of the trial, ESPAC-4, at the American Society of Clinical Oncology’s Annual meeting today and say that the results should see the combination treatment become the new standard of care for people with pancreatic cancer.

For patients with pancreatic cancer who are fit enough following surgery, gemcitabine chemotherapy can be offered as a standard treatment to reduce the risk of the cancer returning after surgical removal. In this trial, the researchers investigated whether adding an additional chemotherapy drug, capecitabine, to gemcitabine chemotherapy treatment could improve the effectiveness of the treatment. The trial also looked into the side effects of this new combination.

A total of 732 patients who had undergone surgery to remove their tumour were recruited to the trial across many hospitals in the UK, Sweden, France and Germany. Patients were given either gemcitabine alone, or the new combination of gemcitabine with capecitabine.

The trial showed that an extra 13% of patients lived for at least five years when given the combination of chemotherapy drugs compared to gemcitabine alone, a substantial improvement in outcomes for patients with pancreatic cancer.

The lead researcher on the study, Professor John Neoptolemos, said: “This important trial shows that this drug combination could give pancreatic patients valuable extra months and even years and so will become the new treatment for patients with this disease. The difference in short term survival may seem modest, but improvement in long-term survival is substantial for this cancer.”

Alex Ford, Chief Executive of Pancreatic Cancer UK said: “These are incredibly exciting results from a major trial for those diagnosed with this dreadful disease. 

The outlook for pancreatic cancer has been grim. With few treatment options, survival rates have barely changed in 40 years in the UK. Currently just five per cent of pancreatic cancer patients can expect to live for five years. At the same time incidence is set to soar by a third to more than 12,000 people being diagnosed every year by 2030.

The possibility of increasing survival for those who have undergone surgery for pancreatic cancer will give great hope to hundreds of patients and their families who may benefit. The importance of clinical trials to help transform the outlook for pancreatic cancer cannot be over-estimated.

We now need to see these results quickly translate to a change in approach by clinicians so that patients start to benefit more widely straight away.”

For more information see here for the study abstract and here for the BBC news story.