I just read about this last week. I plan on asking my oncologist about it when I see him the 19th. If you hear anything before I do let me know and I will post what he says when I ask him.
Pancreatic Cancer Questions
Abraxene with gemcitabine for pancreatic cancer
Asked by Linda2010 on Sunday, November 11, 2012
Abraxene with gemcitabine for pancreatic cancer
Does anyone know anything about the clinical trial news using this drugs. Trials said it demonstrated a significant improvement in overall survival. It has not been approved for pancreatic cancer yet but it is already being used for other cancers. According to article you physician can choose to prescribe this.
5 Answers from the Community
I received an email from the Pancreatic Cancer Action Network because I added myself to their mailing list. It mentioned the clinical trial results, and said they would send another message when the results were known. From what I saw elsewhere, it looks like that will be in January. However, there were results from other earlier smaller studies with Abraxane and gemcitabine (Gemzar). In those, it appeared that it may be more effective than gemcitabine alone for many people. It wasn't clear how much better. "Statistically significant" doesn't mean much to me because I have seen those words used with other drug combinations. So I'm interested to see what's in this latest phase. I hope it turns out to be something better for people than the gemcitabine-only or FOLFIRINOX, and that it's effective for a greater number of people in extending life with some kind of quality of life. But is it much better or worth it? I guess we'll see what results they have from the larger study. I understand it was based on over 800 patients. One article I read said the study was designed to show a two-month survival advantage over Gemzar alone. I would expect it to be at least that much if they're boasting about the results. I did read 9 months on another website based on earlier studies. Significant to me would mean at least 12 months or more survival, effective for a greater number of people, with improved odds of making it longer, and no additional horrible side effects to reduce quality of life. With advanced pancreatic cancer, almost anything is an improvement for most people.
Gemcitabine (Gemzar) has been used since the late 1990's for advanced pancreatic cancer. Combinations have been tried later also. Xeloda (the oral 5-FU prodrug capecitabine) and Gemzar, cisplatin and Gemzar, oxaliplatin and Gemzar, the targeted therapy Tarceva (erlotinib) and Gemzar, Gemzar + Taxotere + Xeloda (GTX), and more.
Abraxane is "nanoparticle albumin-bound" or nab-paclitaxel--- paclitaxel (think Taxol) bound to protein for delivery. http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/paclitaxel-protein-bound-suspension
Here's the general news from the Pancreatic Cancer Action Network http://www.pancan.org/section_research/strategic_research_program/news/topic_abraxane_results.php I recommend using that email, located at the end of the article, to talk to their PALS to ask questions. They can point you in the right direction for more information on it.
This is the clinical trial http://clinicaltrials.gov/ct2/show/NCT00844649 if you want to refer to it in your communications.
This journal article from September is about the role of taxanes like Abraxane, also called ABI-007, in pancreatic cancer, under "paclitaxel and new paclitaxel formulations," http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435767/ stating, "A phase IB-II study of ABI-007 in combination with gemcitabine was performed in metastatic pancreatic cancer. The maximum tolerated dose (MTD) was 125 mg/mq for ABI-007 in combination with standard gemcitabine. The PFS for the whole population of patients enrolled into the trial was 6.9 mo and the mOS was 10.3 mo, while in the group of 44 patients treated with ABI-007 at MTD, the mPFS was 7.9 mo and the mOS was 12.2 mo. A phase III clinical trial of gemcitabine and ABI-007 combination vs standard gemcitabine is currently ongoing in patients with metastatic pancreatic cancer (NCT00844649)."
(PFS= progression-free survival, mOS= median overall survival)
If we're talking about a few more months for some people, I'm not sure how that's much better if they spend that throwing up. If we're talking about real hope for some good years left, then it would be a step forward from the status quo. One more tool in the toolbox, and a little more understanding in the long, slow research process.
It's heartwrenching to read some of the people online reaching and hoping for anything they can find. I read a blog where a loved one was talking about how the gemcitabine and nab-paclitaxel eventually failed for their family member during the early clinical trials a couple years ago. People were asking them questions about it for their families. That's true for many different drugs. It's interesting to read the people who are actually going through the cancers, then go to the financial and investment stories where they're talking about how much money certain drugs are expected to make, and what investors are looking forward to. As it stands right now, for the vast majority of people with advanced pancreatic cancer, it's hand over tens of thousands of dollars, then die anyway. I think there should be a money-back guarantee when it doesn't work. That would change the way they do things in a hurry, huh? $5,100. a week here for gemcitabine-only chemo with nothing really to show for it except side effects.
I only know that early trials combining Abraxene with gemcitabine have met with encouraging results for later stage pancreatic cancers. I've used only the Gemzar myself, but was diagnosed relatively early.
I'd at least check with your oncologist and am making the same recommendations to my brother-in-law, who has just been diagnosed with Stage 4 cancer.
The news is in on Abraxane. Not impressed, compared to some of the other options. The study showed possible extension of survival by "nearly two months." It certainly doesn't appear to be the big thing we're all looking for.