New pharmacotherapy slows the spread of pancreatic cancer: study



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Hedy Kindler

(AFP) – For people with advanced pancreatic cancer, the outlook is as bleak as it becomes: The average patient will not live longer than the year.

But a new study involving targeted drug therapy has shown that it was possible to significantly slow down its spread, with one-third of patients receiving the drug still alive two years after the start of a clinical trial, reported Sunday a researcher.

The study focused specifically on patients with inherited BRCA mutations that are known to increase the risk of cancer of the pancreas, ovaries, prostate and breast – which is why actress Angelina Jolie suffered a double preventive mastectomy.

The mutation affects the body's ability to repair damaged DNA, which may be due to a number of factors ranging from excessive sunlight to asbestos exposure.

"Normal cells can repair it, but the cells with the mutation can not repair that damage, and they start to grow abnormally because their DNA is damaged," said lead author Hedy Kindler, an oncologist at the University of Chicago. Medical Center, told AFP.

Enter the "PARP inhibitors" that act somewhat counter-intuitively by blocking a protein, PARP, that helps damaged cells repair themselves.

As cancer cells with BRCA gene abnormalities already have a poor repair system, targeting them with the help of a PARP inhibitor worsens the damage and ultimately kills them.

The trial examined more than 3,300 people with pancreatic cancer and identified about 250 with the defective gene.

They then randomly assigned the drug, called olaparib, to one part of them and one placebo to another group.

Olaparib, sold by Merck under the name "Lynparza", has been shown to reduce the risk of disease progression by 47% compared to the control group.

Patients on olaparib controlled their disease almost twice as long (7.4 months to 3.8 months) as patients on placebo, a measure known as "median progression-free survival."

– narrowing of the tumor –

"The patients whose tumor shrunk with olaparib, accounting for about a quarter of them, have been preserved for more than two years," added Kindler, who presented the results at the annual meeting of the American Society of Clinical Oncology.

"The general idea is this: you can turn a deadly prognosis into a potentially chronic disease, at least for a while, and keep it under control."

Suzanne Cole, a Southwestern Medical Center oncologist who did not participate in the study, said the study was "a huge step forward for patients with metastatic pancreatic cancer."

She added that now that the effectiveness of the drug had been identified, it was important for clinicians to screen the mutation in patients to identify those who might benefit from the therapy.

Kindler cited the case of a patient who had seen his brother die of the disease before learning that he himself was suffering from cancer.

He was found carrying the BRCA mutation and placed in the test.

"Every time we do a CT scan, her tumor is getting smaller," Kindler said. "He takes a pill twice a day and two and a half years later he is still there. He leads a normal life. "

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