Pancreatic cancer: Targeted treatments hold promise

Center for Drug Evaluation and Research (CDER) Trade Press Scientists are working to develop breakthrough therapies for pancreatic cancer, one of the deadliest cancers affecting men and women.

FDA has approved 3 treatments in the past 20 years for advanced pancreatic cancer to help patients live longer: (1) gemcitabine; (2) erlotinib in combination with gemcitabine; and (3) nab-paclitaxel in combination with gemcitabine.

Pancreatic cancer is a disease that frequently presents no symptoms until it reaches very advanced stages. Surgery is the only chance for a cure, but most patients are not surgical candidates because of the location of the tumor in the pancreas or because the cancer has spread. Moreover, most people who undergo surgery relapse and subsequently die of pancreatic cancer.

Related: Oral oncoloytics Part 2: Assessing the value of newer agents versus current standards of care as part of P&T process

“Pancreatic cancer is the fourth leading cause of cancer deaths in the United States and most patients with pancreatic cancer die of their disease,” said Tim W. Irvin, FDA spokesperson. “Therefore, effective treatments for pancreatic cancer will have an important impact on public health.”

Today more is known about this form of cancer. It usually starts in the pancreatic ducts and that the KRAS gene is mutated in tumor samples from most patients with pancreatic cancer.

This cancer accounts for less than 3% of new cancer diagnoses each year, but it is aggressive and deadly. The 5-year survival rate is only about 5%. If untreated, patients can die quickly. Treatments include chemotherapy and, for some patients, surgery and/or radiation therapy.

Scientists are researching how certain factors increase the risk for pancreatic cancer. They include smoking, pancreatitis (chronic inflammation of the pancreas, characterized by abdominal pain, chronic pain, loss of weight and diarrhea), longstanding diabetes, genetic changes (BRCA1 and BRCA2 mutations) and Lynch syndrome (an inherited disorder that increases the risk for certain cancers).

Scientists are exploring the cells of tumors to learn why pancreatic cancer is resistant to most available chemotherapy drugs. Researchers are also exploring immune therapies, which have been successful in treating melanoma and other cancers. With immune therapy, doctors could improve the patient’s own defenses against the cancer.