Follow-Up Therapies Needed for Patients with Pancreatic Cancer

New, more effective follow-up treatments are needed to manage patients after surgery for pancreatic cancer because only a small percentage of these patients benefit from the current "standard" adjuvant therapy -- chemoradiation. This is the conclusion of a study by researchers at Roswell Park Cancer Institute (RPCI), published in the June 2003 issue of the Annals of Surgical Oncology.

John F. Gibbs, MD, Chair of Gastrointestinal Surgery at RPCI, and colleagues reviewed seven select series to evaluate the effectiveness of adjuvant therapy for patients who had resected pancreatic cancer. Adjuvant therapies are additional treatments that, when combined with the primary treatments, may improve a patient's prognosis. "Current evidence-based analysis demonstrates that an adjuvant therapy regimen as a standard of care is lacking," according to Dr. Gibbs. "We, therefore, believe that it should be used judiciously outside of clinical trials because its benefits are confined to only a fraction of patients treated by complete resection; patients with residual microscopic disease derived negligible benefits."

Approximately 30,000 new cases of pancreatic cancer will be diagnosed this year. However, only 15 percent of patients will be eligible for surgery, and only 20 percent of those patients will survive for five years. Therefore, the theoretical maximal benefit of adjuvant therapy is 10 to 20 percent.

Dr. Gibbs recommends that, "Given the small impact that current adjuvant therapies have on this disease, clinicians should concentrate on developing new therapies to address pancreatic cancer." The researchers suggest a multi-institutional approach to coordinate research efforts that would optimize the development of new therapies based on molecular and genetic data.

RPCI researchers also note that quality of life issues are important for patients and should be included in any future studies because any survival benefit from therapy needs to justify the quality of life costs to patients. Additionally, medical costs should be considered. The current cost of pancreatic cancer care in the United States is approximately $2.6 billion.

Roswell Park Cancer Institute was founded in 1898, is the nation's first cancer research, treatment and education center and is the only National Cancer Institute-designated comprehensive cancer center in Upstate New York. For more information, visit RPCI's website at www.roswellpark.org.