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Thread: 3 Drug combination in small trial

  1. #1

    3 Drug combination in small trial

    THURSDAY, Oct. 3, 2019 (HealthDay News) -- A three-drug chemo cocktail appears to shrink tumors and improve survivorship among pancreatic cancer patients, a new, small study shows.

    Tumors substantially shrank for just over 71% of patients treated with a three-drug regimen of nab-paclitaxel, gemcitabine and platinum-based cisplatin, the researchers found.

    Further, 16 patients (64%) out of the 25 treated were still alive a year after treatment, more than double the average 26% one-year survival rate for people with advanced pancreatic cancer.

    Ten patients (40%) were still alive after two years, a survival rate unheard of for patients with stage 4 pancreatic cancer, said senior researcher Dr. Daniel Von Hoff. He's director of the Translational Genomics Research Institute's molecular medicine division, in Phoenix.

    All three drugs have been approved by the U.S. Food and Drug Administration for chemotherapy. Nab-paclitaxel and gemcitabine are the current front-line chemo combo used to treat pancreatic cancer, the study authors noted.

    For the study, the researchers added low doses of platinum-based cisplatin to that usual combo, based on laboratory evidence that cisplatin inhibited the ability of pancreatic cancer cells to repair their DNA, causing them to self-destruct.

    "We had preclinical evidence that these tumors have significant trouble repairing DNA damage, so throwing in a little something that causes DNA damage in a tumor would hopefully push it a little further," Von Hoff said.

    Tumors wound up shrinking in seven of every 10 patients, nearly triple the usual response rate of 26%, Von Hoff said.

    The researchers described the additional side effects as "tolerable," involving mainly blood-related conditions that were manageable.

    About two-thirds of the patients experienced a decrease in platelets, the blood cells that help clotting, and one-third developed anemia from a reduction in the red blood cells that carry oxygen through the body. About one-quarter developed neutropenia, a drop in white blood cells that can impair immune response.

    Because cisplatin is a long-standing chemo drug available in generic form, adding the drug should not dramatically increase the cost of cancer treatment, Von Hoff said.

    "I wouldn't say it's dirt cheap, but it's pretty cheap," Von Hoff said.

    Pancreatic cancer is relatively rare, accounting for about 3% of all cancers in the United States and about 7% of all cancer deaths, according to the American Cancer Society. About 57,000 people will be diagnosed with pancreatic cancer this year, and about 46,000 will die from it.

    Based on the study, which was funded by Translational Genomics Research Institute and the HonorHealth Research Institute, Von Hoff expects the three-drug combination will be strongly considered as a potential treatment option by cancer doctors.

    Dr. Len Lichtenfeld, interim chief medical officer for the American Cancer Society, agreed that the study will increase interest in this three-drug combo.

  2. #2
    Super Moderator Top User ddessert's Avatar
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    Oct 2013
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    Not exactly new trial results. This one finished in Oct 2017 but Dr. Von Hoff likes to talk about it a lot. Unfortunately it has not attracted funding for a phase 3 trial and I’m not sure why. The results have never been peer-review published and 3/25 patients did die (grade 5 adverse events) due to complications. It’s also true that most are generics (except Abraxane which already has hefty market share in PanCan), so attracting a big sponsor may be difficult. T-Gen is not big enough to fund a big trial.

    This same clinic is trying a few more trials of the same combo, this time adding ascorbic acid (Vit. C) or paricalcitol (Vit. D) to the combination. I personally find these trials amongst the most promising we have to improve things, but would question them about those adverse event reactions in patients.
    BRCA2 3398del5
    Dec 2010 - back/abd pain
    May 2011 - Unresectable stage III, 2.5cm tumor
    Jun-Aug 2011 - Gem/Cis, 9 rounds
    Oct-Nov 2011 - IMRT+Xeloda
    Oct 2011-Sep 2012 - shrinking tumor
    Feb 2012 - National Familial Pancreatic Study
    Aug 2012 - Downgraded to stage IIA, PGP
    Sep 2012 - Whipple, T3N0M0, 0.5cm tumor, 0/16 lymph nodes
    Dec 2012 - Quebec PanCan Study
    Sep 2012-May 2019 - NED
    Mar 2013-present - NCT01088789
    Jun 2019- NCT03805919


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