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Treatments update from the All Party Parliamentary Group on Pancreatic Cancer

Posted by: Policy and campaigning 29 September 2016

On Wednesday 14th September, the APPG on Pancreatic Cancer held a meeting looking at treatments for pancreatic cancer. The meeting brought together parliamentarians, clinical experts, patient organisations, industry representatives and members of the public to discuss current treatments for the disease, emerging promising treatments, and supportive interventions.

Speaking at the meeting were Pancreatic Cancer UK Director of Operations Anna; Consultant Medical Oncologist at the Royal Marsden Professor David Cunningham; Consultant Hepatobiliary and Transplant Surgeon at the Freeman Hospital Professor Derek Manas; Former President of the Pancreatic Society of Great Britain and Ireland Professor Andrew Hart; and Academic Clinical Fellow in Gastroenterology, Norfolk and Norwich University Hospital NHS, University of East Anglia Dr Andreas Koulouris.

Current treatment options

Attendees heard how pancreatic cancer patients currently suffer from a lack of access to treatments, and how speeding up access to new treatments is vital to improving pancreatic cancer rates. Pancreatic Cancer UK Director of Operations Anna Jewell gave an overview of current pancreatic cancer treatments and highlighted areas for improvement. Currently, surgery is the only curative treatment for pancreatic cancer, but only 8% of pancreatic cancer patients will go on to receive surgery. Meanwhile, there are very limited treatment options for locally advanced and advanced pancreatic cancer patients. These patients will most often receive chemotherapy, however this is largely seen as palliative treatment aimed at slowing down tumour progression, relieving symptoms and improving quality of life. Advancements in chemotherapy have also been too slow. The standard first-line treatment for pancreatic cancer is currently gemcitabine, which has not changed since 1997.

The APPG also heard how there is a postcode lottery across the UK when it comes to access to pancreatic cancer drugs. Abraxane, which has been shown to extend survival by two months when compared to gemcitabine, is available to patients in Wales and Scotland, but not in Northern Ireland or England. It was highlighted that the National Institute of Health and Care Excellence (NICE) had announced it is bringing forward the reappraisal of Abraxane, following its decision not to recommend the drug for routine use last year. Pancreatic Cancer UK will be fighting for NICE to approve the drug, so that patients across the UK can benefit from access to it.

Emerging treatments

Despite the huge gaps in current treatment options for pancreatic cancer patients, the APPG heard that there was reason to be optimistic about the potential for new treatments in the future.

Professor David Cunningham argued that emerging innovations, such as immunotherapy, provided reason to be “strongly positive” that we could see a breakthrough in pancreatic cancer over the next five to ten years. However more funding, high quality research and international partnerships are essential to achieving this. Highlighting progress that had already been made, Professor Cunningham noted that five-year survival for operable pancreatic cancer had increased from 10% to around 30%.

The APPG also heard about another innovative procedure, which could help improve survival in pancreatic cancer patients. Professor Derek Manas spoke about Irreversible electroporation (IRE), which early trial data shows could increase overall survival in pancreatic cancer patients from 13 months to 20 months. The intervention is not currently recommended for use among pancreatic cancer patients in the UK, although NICE is in the process of reviewing its guideline for the procedure. Again, Pancreatic Cancer UK will be engaging in this process to help ensure the patient voice is heard. If you have received NanoKnife, or know someone who has, and are willing to share your experience please contact us.

Supportive interventions

Professor Andrew Hart and Dr Andreas Koulouris discussed supportive interventions for pancreatic cancer, and how they can help improve survival. They explained how helping patients manage the symptoms and side-effects of pancreatic cancer and pancreatic cancer treatments, such as weight loss and pain, can help patients cope with treatment for longer and ultimately improve overall survival.

They stressed the importance of patients receiving the correct supportive interventions and argued for better training in medical pancreatology and for more research into medical supportive therapies.

Conclusions

The overwhelming message received by the APPG was that, whilst big improvements are needed when it comes to treatment options for pancreatic cancer patients, promising, emerging drugs and interventions give cause for optimism. To benefit from the potential demonstrated by these new treatments, more funding for high quality research into new drugs and supportive interventions is desperately needed. Achieving this requires collaboration between researchers, clinicians, industry, patient organisations and policy makers.

Through our Key to Survival campaign Pancreatic Cancer UK will continue to work with others to fight for better access to treatments for pancreatic cancer patients to achieve the kind of breakthrough needed.