Researchers hope to get best chemotherapy cocktail for pancreatic cancer
EDMONTON — A diagnosis of pancreatic cancer is like a death sentence for most people, so receiving the right chemotherapy drugs is crucial to prolong and improve quality of life.
New research at the Cross Cancer Institute in Edmonton hopes to find a biomarker or sign in people’s pancreatic tumours that would indicate to doctors what treatment would work best. Currently, there are no such indicators identified and oncologists are forced to guess and give drug cocktails with nasty side effects without knowing if the medications will work.
“As we are trying to search for this elusive cure for cancer, wouldn’t it be nice to have a test that we could do up front for people to say, ‘You should get this treatment,’ or ‘You should get this treatment,’ and potentially not allow them to be exposed to a drug that won’t work for them,” said Dr. Jennifer Spratlin, who focuses on gastro-intestinal cancers.
New funding is allowing her team to launch two clinical trials to determine if patients with pancreatic cancer, who have a specific protein in their tumours, do better if given one specific drug regimen that has been the traditional workhorse drug in the industry.
“It’s very important. Everybody wants to have better treatment for pancreas cancer. Bottom line is that pancreas cancer is a bad cancer to get. If you get it, you’re almost sentenced to, at some point, death, and relatively quickly. If we can extend people’s lives, if we can live longer, if we can give them a treatment that doesn’t make them more sick, I think that’s really the key.”
Ken Ritz, 58, was given only a few months to live after he was diagnosed with Stage 4 pancreatic cancer last fall. He had been having unexplainable back aches and stomach troubles since February 2010, but visits to the chiropractor, then blood tests and X-rays couldn’t find anything unusual.
He lost 65 pounds before he found out he had pancreatic cancer that had spread to his lungs and elsewhere.
He was given three options for treatment, one of which included the drug Gemcitabine, which is commonly given to people with pancreas cancer. The problem is, researchers at the Cross Cancer have determined the drug can’t get into the cancer cells to fight them unless the patient has a specific protein that transports the drug into the cell.
If patients do have that protein, Gemcitabine is believed to work well and is more gentle to the system than another chemotherapy drug, which can cause nausea, nerve damage in the fingers and toes and the sensation that the patient’s throat is closing.
Spratlin is testing patients such as Ritz — all of whom have cancer that has spread widely — to see if they have the proper proteins to help absorb Gemcitabine better. If the Gemcitabine treatment then works better on them, cancer doctors would be able to do give the proper drug most suitable to help the patients.
If the protein isn’t present, another drug combination called Folfox might be the better option.
“We’re always aiming to personalize medicine and this is a chance, from our own backyard homework here at the Cross Cancer Institute and University of Alberta,” said Spratlin, whose study is supported with $300,000 from the Alberta Cancer Foundation and Alberta Innovates Health Solutions. “We have developed this from the beginning.”
Spratlin will be searching for 150 patients such as Ritz across Canada. So far, Ritz’s tumours have shrunk slightly. He also made it past Christmas, his first goal.
“I’m already in rarefied air, I’m in my tenth month,” Ritz said. The life expectancy for people whose pancreatic cancer has spread through the body is less than six months. The prognosis is so bad because pancreas cancer comes with few symptoms, so by the time tumours are discovered the disease has progressed significantly. Those whose cancer has spread locally within the pancreas have a life expectancy of nine months to one year. For them, surgery isn’t an option.
“It was a kick at first. It’s certainly something you have to face head on,” Ritz said. The extra time he’s been given has allowed his life to return to some normality, with Ritz back at his job as an engineer for a few half-days each week. “Of the three (treatment) options, there was some uncertainty about it, but I guess that was part of the appeal, that if it worked, it probably would work better. That’s good for me because it lets me get my feet under myself and deal with it on a daily basis with some predictability.”
Each year, about 4,000 Canadians are diagnosed with pancreatic cancer.
jsinnema@edmontonjournal.com
Twitter.com/jodiesinnema
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