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“Monumental leap forward”: we comment on ESPAC 4 clinical trial results

Posted by: Comms 25 January 2017

Pancreatic Cancer UK has heralded the results of the ESPAC 4 pancreatic cancer clinical trial, published in The Lancet today (Wednesday, 25th January), as a “monumental leap forward” in the treatment of the disease.

The trial found that 29 per cent of patients treated with a combination of the chemotherapy drugs gemcitabine and capecitabine after surgery lived for at least five years, compared with 16 per cent of patients given gemcitabine, the current standard treatment after surgery, alone.

Pancreatic Cancer UK says this progress is incredibly exciting because the disease has the lowest survival rate of all the 21 most common cancers, and survival rates have barely improved since the early 1970s. The disease has attracted just one per cent of the UK cancer research budget in the last decade, and there are very few treatments for the disease.

The charity is now urging the NHS to introduce the combination treatment used in the trial, which was funded by Cancer Research UK, as a standard treatment across the UK for people with the disease who have had surgery to remove their tumour. If this was to happen, Pancreatic Cancer UK estimates that around 100 more patients each year would live for five years or more (1).

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.”

Over 700 patients took part in the ESPAC 4 trial, the results of which were first presented at the American Society of Clinical Oncology (ASCO) in June last year. The results have now been peer reviewed.

Patients and families can find out more about current clinical trials which may be available in their area from Pancreatic Cancer UK’s Trial Finder, the first UK-wide map and database of trials dedicated specifically to pancreatic cancer, at www.pancreaticcancer.org.uk/trialfinder


1)The ESPAC 4 trial found that 29 per cent of patients treated with the combination treatment lived for five years, compared with 16 per cent of patients being treated with gemcitabine alone; an increase in five-year survival of 13 per cent in the group being treated with the combination. Cancer Research UK stats show that around 10,000 people are diagnosed with pancreatic cancer each year and eight per cent (800 patients) are able to have surgery each year.  Extrapolating the 13 per cent increase in five-year survival if the combination treatment were to be brought in as a standard on the NHS, Pancreatic Cancer UK estimates that an extra 13 per cent a year, or an additional 104 people who were able to have surgery a year, would live for five years or more.