Treating Tumors Before Pancreatic Cancer Surgery

Chemical & Engineering News; Flickr

Which treatment works better to slow the disease before surgery to remove pancreatic tumors—chemotherapy and radiation or chemotherapy alone?

Chemotherapy is often given before and after surgery to remove pancreatic cancer. Researchers want to determine if adding radiation to the presurgical chemotherapy regimen prevents or slows the spread of pancreatic cancer.

Treatments Being Tested

FOLFIRINOX is one of the standard treatments for advanced pancreatic cancer. It is a four-drug combination: FOL (leucovorin calcium, or folinic acid), F (fluorouracil, or 5-FU), IRIN (irinotecan hydrochloride), OX (oxaliplatin). Each of these drugs enhances the action of the others. Fluorouracil (5-FU) is an antimetabolite that disrupts a specific part of the cell replication cycle. Derived from folic acid, leucovorin enhances the effects of 5-FU. Irinotecan inhibits the replication and transcription of DNA, and so interferes with cell growth. Oxaliplatin, a platinum compound, binds to DNA and blocks DNA replication.

FOLFOX is similar to FOLFIRINOX, consisting of leucovorin (folic acid), fluorouracil, and oxaliplatin. It does not include irinotecan.

Compared to standard radiotherapy, hypofractionated radiation consists of higher doses of radiation given over a shorter period of time. It is supposed to be more effective in killing tumor cells and have fewer side effects.

Comparing Results

Trial participants are randomly assigned to either of two treatment groups. One group receives FOLFIRINOX before surgery to remove the tumor, and FOLFOX after surgery. The other group gets FOLFIRINOX followed by hypofractionated radiation before the surgery, and FOLFOX post-recovery.

We encourage you to consult your physicians for clinical trials that may be right for you. The website ClinicalTrials.gov provides more details about this trial as well as many others. You can visit the EmergingMed Trial Finder for a listing of all active pancreatic cancer clinical trials.

This trial is active, but no longer recruiting participants.

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