Chemo Combo May Help Stave Off Pancreatic Cancer
WEDNESDAY, May 11 (HealthDay News) -- A four-drug chemotherapy
regimen for deadly pancreatic cancer nearly doubled patients'
survival time compared to standard chemotherapy, a new study
In late-stage trials, French researchers split a group of 342
patients with advanced pancreatic adenocarcinoma, the most common
form of the disease, into two groups. Half received gemcitabine,
the standard treatment, while the rest received FOLFIRINOX, a
four-drug combination of oxaliplatin, irinotecan, leucovorin and
The median survival time improved from 6.8 months for those in
the gemcitabine group to 11.1 months in the FOLFIRINOX group,
according to the study, which is published in the May 12 issue of
New England Journal of Medicine. Those in the combination group did suffer greater side effects from treatment, however.
"We explain to the patients the advantages and toxicities of both regimens," said study author Dr. Thierry Conroy, a professor of medical oncology at Nancy University and Centre Alexis Vautrin in Nancy, France. "The FOLFIRINOX regimen was able to stabilize patients longer with improved quality of life and delay degradation of quality of life. Unfortunately, it is still a palliative treatment but able to save months, and sometimes years of life."
Pancreatic adenocarcinoma was the fourth leading cause of cancer
deaths in the United States in 2010, the study said, and the
five-year survival rate is only 6 percent in both the United States
Study participants, whose average age was 61, were still fully
active and able to carry out daily activities, and sicker patients
were not eligible. The trial was conducted at 15 centers in France
during the second phase of the trial and expanded to 48 centers
during the third phase of the trial.
Patients discontinued the study at their request or if they
experienced unacceptable toxic effects -- which included diarrhea,
low blood cell counts and sensory neuropathy -- or evidence of
disease progression. One patient from each group died from
treatment-related causes, and 273 of the 342 patients had died by
the end of the median follow-up period of 26 months.
Dr. Alberto Montero, an assistant professor of medicine at
Sylvester Comprehensive Care Center at University of Miami Miller
School of Medicine, said the results were "remarkable" because the
FOLFIRINOX group experienced such an improved survival rate.
Montero cautioned, however, that a small minority of patients
with pancreatic adenocarcinoma match the condition of patients in
the study, who were still conducting normal daily activities. Even
newly diagnosed patients are often extremely ill, he said, and
might not be able to tolerate the combination drugs' toxic
"To see a doubling in survival is impressive," said Montero, also a medical oncologist. "For many reasons, this cancer is very resistant to chemotherapy. I think this trial is a first step."
The U.S. National Institutes of Health has more on
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