Gemcitabine, an antimetabolite (blocks DNA production) chemotherapy agent, and 5-fluorouracil are the standard drugs used to treat pancreatic cancer. They are often used in conjunction with surgical procedures or radiation to eradicate the cancer cells. Pancreatic cancer has low survival rates, with only about 20 percent of patients living 1 year beyond diagnosis and 5 percent living 5 years beyond diagnosis, according to The American Cancer Society. There are several studies and clinical trials investigating the use of these drugs with other chemotherapy agents and producing new cocktails to increase the effectiveness of chemotherapy treatments for pancreatic cancer.
GTX
GTX is a chemotherapy cocktail consisting of gemcitabine, docetaxel and capecitabine. A study published in 2008 in issue 61 of "Cancer Chemotherapy Pharmacology" found that the mixture of these three chemotherapy agents increased the patient survival rates over gemcitabine alone. Patients receiving GTX had a 12-month survival rate of 43 percent, an 18-month survival rate of 29 percent, a 24-month survival rate of 20 percent and a 30-month survival rate of 11 percent.
Gemcitabine and EGFR
A new chemotherapy cocktail that combines gemcitabine with EGFR (epidermal growth factor receptor) inhibitors such as erlotinib is being studied by Dr. Meredith Morgan at the University of Michigan. EGFR is a new type of cancer treatment that specifically targets the cancer cells thereby causing fewer systemic side effects. The study published in the August 15, 2009, issue of "Clinical Cancer Research" found that the addition of EGFR inhibitors produced some delay in tumor growth over the use of gemcitabine alone.
Cisplatin, 5-Fluorouracil and Interferon-alpha
A study conducted by Dr. Vincent Picozzi at the Virginia Mason Medical Center evaluated the use of cisplatin with 5-fluorouracil and interferon-alpha to treat pancreatic cancer after surgical removal of the tumor. The study found that 67 percent of the patients treated lived for 2 years after their surgery, which is promising according to Dr. Picozzi. This chemotherapy cocktail does have a high toxicity rate, with 96 percent of the patients experiencing toxicity. Because there were no toxic deaths, doctors hope to be able to reduce the toxicity while maintaining the effectiveness.
Gemcitabine, Cisplatin, Epirubicin, and Fluorouracil
A study reported by the American Cancer Society found that a chemotherapy cocktail mixing gemcitabine with cisplatin, epirubicin and fluorouracil improved the effectiveness of chemotherapy on pancreatic tumors. Tumors were reduced by half in 38.5 percent of patients receiving the 4-drug cocktail, as opposed to only 8.5 percent of patients who received gemcitabine alone. This 4-drug chemotherapy cocktail increased the number of patients living 1 year after diagnosis from 21 percent to 38.5 percent.
References
- American Cancer Society: New Drug Combo Improves Outcome of Advanced Pancreatic Cancer
- Cancer Chemotherapy Pharmacology: The gemcitabine, docetaxel, and capecitabine (GTX) regimen for metastatic pancreatic cancer: a retrospective analysis
- Clinical Cancer Research: The combination of EGFR inhibitors with gemcitabine and radiation in pancreatic cancer
