Discovering the Better Drug Treatment After Surgery for Pancreatic Cancer

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What is the best chemotherapy for preventing pancreatic cancer relapses after the tumor is surgically removed?

One clinical trial compares the effectiveness of two different post-surgery treatment regimens for pancreatic cancer, as well as the side effects caused by each regimen.

Researchers also want to know which drug regimen is more closely associated with relapse-free survival. Scientists are looking at participants’ genomes to see if there is a correlation between the genes of a patient and the return of the cancer.

Comparing Chemotherapies

One group of patients receives gemcitabine and Abraxane (brand name for nab-paclitaxel) as their chemotherapy regimen. Gemcitabine is converted into two metabolites that cause cell death. One reduces the number of proteins available to make DNA; the other shortens the DNA strands. Abraxane inhibits cell division and promotes cell death.

The other group of patients gets a four-drug combination known as FOLFIRINOX: FOL (leucovorin calcium, or folinic acid), F (fluorouracil), 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 copying of DNA when cells copy themselves, and so interferes with cell growth. Oxaliplatin, a platinum compound, disrupts DNA and kills cancer cells.

Does a Patient’s Genome Play a Role?

As part of the trial, the genome of each participant will be analyzed to see if there are any particular characteristics of genes or DNA that could be associated with risk of relapse in either drug regimen. The researchers are looking for any associations between relapses and particular genetic characteristics, and also relationships between known mutations and relapses.

This trial is for patients who have had their tumor completely surgically removed. Participants are randomly assigned to one of two chemotherapy regimens that are currently used to treat metastatic pancreatic cancer. Both trial groups will receive radiation therapy as well.

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 Clinical Trial Finder for a listing of all active pancreatic cancer clinical trials.


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