Medical - Conventional Ideas  -  Pancreatic Cancer What's New Articles 1 | 2

Section devoted to those ideas discussed on the net that appear to be accepted more in the mainstream medical world. Send us your info here.

Gene Therapy and Vaccines All » GVAX® (GM-CSF) | 5.3 mths About: From Cell Genesys. From site...Cell Genesys' GVAX® pancreatic cancer vaccine is a non patient-specific vaccine designed to induce a systemic immune response against the patient's pancreatic cancer. The vaccine is comprised of two pancreatic cancer cell lines that have been genetically modified to secrete granulocyte-macrophage colony stimulating factor (GM-CSF), an immune stimulatory hormone, and then irradiated to keep them from dividing. Results: Trial - Discusses results of a Phase 2 trial for 50 patients with inoperable pancreatic cancer. They also had some criteria of them having failed at least 2 prior chemo regimens. from page - "Despite the very advanced stage and extensive prior chemotherapy in the majority of patients, there was a trend toward an improved outcome with combination therapy in cohort B by all measures of clinical activity. Forty percent of patients in cohort B demonstrated stable disease, compared with 16.7 percent in cohort A. Moreover, the median time to progression was 57 days in cohort B and 42 days in cohort A, and median survival in cohort B was 4.3 months compared with 2.3 months in cohort A. In addition, there was a correlation between survival and the patients' post-vaccination blood level of GM-CSF produced by GVAX® pancreatic vaccine. Median survival was 5.3 months for patients above the median peak level and 1.8 months for patients below that level (p=0.03)." Click here for info (at the bottom) about their current trials. Comments: They are still early on in the trial stages and appear to be trying it with other low dosage chemo. » 11/2/2004 » OncoVEX® (GM-CSF) | 13 mths About: From Biovex Limited (UK privately held company). Bilogic vaccine therapy utilizing the body's immune system to kill cancer cells. GM-CSF further stimulates the immune system to attack cells displaying distinct antigens. Not exactly sure how this works and they mention it was given following surgery which may or may not mean after they take tissue samples. Results: Trial - The average disease-free survival time following treatment for these patients was 13 months. Three patients remained cancer-free for approximately 2.5 years. This appears to be a significant improvement, as the average survival time for pancreatic cancer patients receiving standard treatment following surgery is approximately 7.5 months. Additionally, this treatment was well-tolerated in patients, producing minimal side effects. The Company is now planning a Phase II study in the US in 2004. Comments: So far of all the trials these results are some of the best. The only thing I don't get is why in the trial they mention it was given following surgery but it may have been after taking tissue samples. » 10/29/2004 » TNFerade (TNF) | 7.8 mths (halted) About: TNFerade is from GenVec. Used with radiation and chemo. Chemo makes radiation more effective and radiation makes TNF multiply faster. Results: Trial - The trial notes 33% had tumors shrink more than 50%. Click here for article of a Pancreatic cancer survivor from UCI using TNFerade with Dr. Kenneth Chang. GenVec in Oct. 2004 suspended a Phase2 Esophageal cancer trial due to the FDA's concerns over increased blood clots with higher dosage in patients. They are currently enrolling pancreatic cancer patients in TNFerade PhaseII trial here, but it sounds like all TNFerade trials are suspended so need to check first. Comments: The tumor shrinkage results with TNFerade seem very promising, but the studies being halted cannot be good to determine how the results look for Pancreatic Cancer patients. » 11/2/2004 » MetXia (P450 Gene) | In trial About: MetXia is from BioMedica a UK based bio company. They claim that along with chemo MetXia helps chemo target the tumor directly which should mean fewer healthy cells are killed. From their site: " The product is based on a highly engineered retrovirus vector expressing the human cytochrome P450 gene, CYP2B6. MetXia converts a tumour into a ‘drug factory’, enabling increased local production of the anti-tumour, cytotoxic derivative of the prodrug cyclophosphamide (CPA). MetXia is potentially useful in the treatment of all solid tumours and their metastases. It is particularly effective in those indications where CPA is already used in chemotherapy." Results: New Trial - Claim their trial is the first gene therapy trial to treat patients with pancreatic cancer. They started the trial based on their good results with breast cancer noted here. Comments: This appears to be too new in the trial stages right now making it hard to make a decision on it of course. » 11/2/2004 » Gastrin-17 (G17DT) | 5 mths About: Made by Aphton a biopharmaceutical company but not approved yet. From their site: G17DT..."targets the hormone gastrin 17 to treat gastrointestinal cancers, including pancreatic, gastric, esophageal and colorectal cancer.  Aphton’s anti-gastrin targeted immunotherapy induces patients to produce antibodies that bind and neutralize the hormones gastrin 17 and gly-gastrin (a gastrin precursor), which are known to be involved in tumor progression in gastrointestinal (GI) cancers." Appears to be useful along with chemo as shown here. Results: Trial - Claim a 53% increase in median survival rate to 150 days with 154 patient trial. Comments: This appears to be too new in the trial stages right now making it hard to make a decision on it of course. » 11/2/2004 » Oncophage (HSPPC-96) About: Made by Antigenics but not approved yet. From their site: "Based on proprietary heat shock protein technology, the Oncophage vaccine is designed to capture the particular cancer’s ‘fingerprint.’ This fingerprint contains unique antigens (substances that can provoke an immune response) that are present only on that particular patient’s specific cancer cells. Injection of the vaccine is intended to stimulate the patient’s immune system to recognize and attack any cells bearing the specific cancer fingerprint." Appears to be made from the patient's tumors and shipped overnight to Mass.. Also appears it is directed so far at those that have been able to have surgery on the pancreas. Also is targeted at use in conjunction with chemo. Results: Trial - Unfortunately trial was for group that had their pancreas removed already. But the results note a median survival of 16 months. Comments: Probably doesn't pertain to Dick's diagnosis but good to keep on the radar. » 11/2/2004 Monoclonal Antibodies All » Tarceva (erlotinib HCl) About: From Genentech but still in trials just finishing a Phase 3 in Sep 2004. It is an oral anti-cancer drug that is billed as an EGFR Inhibitor. Its best results for pancreatic cancer so far is with chemo (gemcitabine), so see the combination drug section. Results: See combination study but trial for that showed median 6.4 months survival average Comments: I didn't find any info about this or its results when done by itself, so best to look at combination trials. » 11/2/2004 » Avastin® (Bevacizumab) About: Made by Genentech and approved in Feb 2004 for other types of cancer. Still finishing trials for use in Pancreatic cancer. Targets VEGF growth factors. Results: I did not find trials with this used by itself so see Combined Drugs Trials for this used with gemcitabine. » 10/29/2004 » Erbitrux® (IMC-C225) About: It is a monoclonal antibody, or a protein that has been produced in a laboratory, that binds to EGFR and inhibits the receptor's effects on cellular replication. Currently FDA approved for treatment of colorectal cancer. Results: Did not find any studies for pancreatic cancer used just by itself. See drug combinations where it is used with Gemzar. » Others researching... XR303, and Herceptin. » 11/2/2004 Immunotherapy All » Virulizin® | 6.8 mths About: Made by Lorus Therapeutics. As per this article it was given fast-track status by the FDA. Used with Gemzar and/or radiation. "Virulizin® is a stimulating agent of macrophages, the “big eater” cells of the immune system.  Consequently, Virulizin® enhanced the ability of macrophages to kill tumour cells in our experimental system." Results: In previous study average survival was 6.8 months, with 58% of patients still alive at six months, but currently in Phase III just started in June 2004 and fully enrolled.  » 10/29/2004 » ONYX-015/CI-1042 About: ONYX-015 or CI-1042 (same thing) made by Onyx Pharmaceuticals is a genetically engineered, or altered, adenovirus (a virus that causes a common cold). This virus has been altered in such a way that it will infect and kill cancer cells with a mutated p53 gene, but will not kill normal healthy cells. Many different types of cancers develop due to a mutation (alteration) in a certain gene called the p53 gene, with a large percentage of various cancers carrying a mutation in this gene. ONYX-015 was developed to specifically target and infect cells with a destroyed or mutated p53 gene. It is thought that the cells with intact p53 genes are able to combat the virus in ONYX-015, while cancer cells with a mutated p53 gene or a mutation elsewhere that affects the properties of this gene are not able to overcome the effects of the virus and are subsequently killed. Results: See Drug combinations for info used with Gemzar.   » 10/29/2004 » Immunocal About: Primarily best used to enhance drug therapy effects and boost immune system. It is a whey protein. Site excerpt..."Immunocal contains a critical concentration of three bioactive proteins: the thermolabiles - serus albumin, alpha lactalbumin and lactoferrin. Using modern technology, Immunocal represents a break through in obtaining and consistently preserving, in their native form, the specific cow's milk proteins which share with the predominant human milk proteins, the same extremely rare GSH-promoting components." Appears to be patented and through numerous trials. Results: Click here for clinical studies and good info about its results in various studies. Primarily it discusses how it "enhanced the cancer killing effect of anti-cancer drugs." Comments: This may be something to consider along with a chem regime, but best to pass along to the appropriate doctor.   » 10/29/2004		Drug Therapy | Drug Dev Process All » Rubitecan (Orathecin) About: Made by Supergen is an oral chemo agent for those with refractory pancreatic cancer which are those that are incurable or not responding to standard therapies. Click here for their FDA application. Rubitecan works by inhibiting the replication of cells by inhibiting DNA replication. Results: Recent clinical trial here notes 22% had anti-cancer response, cancer size reduced in 3 of 45 patients by 50%, and cancer stopped growing and/or decreased in size by up to 50% in 7 of 45 patients.  » 10/29/2004 » Taxotere About: Made by Aventis. Chemo drug derived from needles of the European yew tree (Taxus baccata). Click here for more about it. Results: See drug combination trials.  » 10/29/2004 » Doxil About: Made by Ortho Biotech. Made of fat bubbles called liposomes that contain duxorubicin. Click here for more about it. It is still not approved for Pancreatic cancer but in trial. Results: See drug combination trials. » 10/29/2004 » Gemzar (gemcitabine) | 8.8 mths About: Primary treatment of non resectable pancreatic adenocarcinoma. Made by Lilly. Results: See results here for high dose Gemzar treatment. Avg survival 8.8 months, and survival rate after 1 year was 26.1%. You can also read two pancreatic cancer survivor stories on the Gemzar web site who used Gemzar #1 here and #2 here.   » 11/11/2004 » Alimta About: Made by Lilly. Currently approved for lung cancer and in trial for Pancreatic cancer. Results: See drug combination trials.  » 10/29/2004 » Others researching | Drug List Drug: Ensiv, in clinical trials did not show the expected increase in survival or clinical benefit ovr gemcitabine. Drug: Pemetrexed in clinical trials did not improve survival over gemcitabine. Other: These are from this article - Need to research Statin Drugs, Lovastatin, COX-2 Inhibitors, Lodine, Nimesulide, Celecoxib, Sulindac, Silymarin, Metformin. And these are from this article - These are mostly in trials and need to be researched: Camptothecin, TNP-470, R115777 Combined Drugs Trials | Strategies All » Gemzar® + Avastin® | 9 mths About: Combination of Gemzar (gemcitabine) and Genentech's Avastin (Bevacizumab) Results: Trial - Phase II Study of 45 metastatic pancreatic cancer patients. "In this study, the estimated one-year survival was 54 percent and the median time to disease progression was 5.8 months. The results suggest that 21 percent of patients (9/42) experienced a partial response to treatment lasting a median of 9.4 months and 45 percent of patients (19/42) achieved stable disease lasting a median of 5.4 months. Median survival was nine months". Here and here are other trial links with similar results. » 11/2/2004 » GemOx | 5.5 mths About: Combination of gemcitabine (Gem) and Eloxatin (oxaliplatin) (Ox) combined to improve affects of chemotherapy treatment. Results: Trial - Results of a GemOx Phase III study (June 2, 2003) for advanced Pancreatic cancer patients. Study says "...markedly increases tumor shrinkage and time to progression and significantly improves clinical benefit." Noted median survival rate of 5.5 months compared to 3.7 months with Gemzar alone. Comments:This is the chemo combination Dick has chosen to use, and he is doing it at the UCI hospital. » 11/11/2004 » Erbitrux® + Gemzar® | 7 mths About: Combination of gemcitabine (Gemzar) and Erbitrux (monoclonal antibody) combined to improve affects of chemotherapy treatment. Results: Trial - "This trial included 41 patients who had not received prior chemotherapy. Following treatment, 12% of patients achieved a partial disappearance of cancer and 63% achieved stabilization of their cancer. The average duration of survival for the entire group of patients was 7 months, with a one-year survival of over 30%. The most common side effect of treatment was rash, which occurred in 87% of patients."  » 10/29/2004 » Taxotere® + Doxil® | 10 mths About: Combination of Taxotere and Doxil combined to improve affects of chemotherapy treatment. Results: Trial - This trial involved 21 patients who had not received prior therapy. Following treatment with Taxotere®/Doxil®, approximately 30% of patients demonstrated an anti-cancer response and 33% of patients achieved disease stabilization. Survival at one-year following therapy was 33% with the average duration of survival of all patients being 10 months. » 10/29/2004 » ONYX-015 + Gemzar® About: Combination of Gemzar and the genetically altered adenovirus ONXY-015 combined to improve affects of chemotherapy treatment. Results: Trial - The trial above notes "The injections were guided by ultrasound and delivered directly into the areas of cancer in the pancreas. Anti-cancer responses or stabilization of cancer was achieved in nearly 50% (10) of patients, while 11 patients had cancer progression or could not tolerate therapy." It warranted further investigation.  » 10/29/2004 » Alimta® + Gemzar® | 6.5 mths About: Combination of Gemzar and new chemotherapy agent Alimta combined to improve affects of chemotherapy treatment. Results: Trial - The trial above notes "A multi-institutional clinical trial was recently conducted to evaluate the combination of Gemzar® and Alimta® as initial treatment of 40 patients with advanced pancreatic cancer. Anti-cancer response rates were achieved in 15% of patients. The average duration of survival was 6.5 months and approximately 30% of patients were alive one year following therapy. The major side effects were low platelet levels and neurological effects." Click here for a testimonial of a pancreatic cancer patient in this trial. » 11/11/2004 » Gemzar® + Tarceva | 6.4 mths About: Combination of gemcitabine and Tarceva done in phase III trial of 450 pancreatic cancer patients. Results: Trial - Results of the 450-patient pancreatic cancer trial showed that when administered in combination with gemcitabine, Tarceva improved survival (primary endpoint). Combination therapy produced a statistically significant 23.5% improvement in overall survival in patients with locally advanced or metastatic pancreatic cancer compared with gemcitabine alone. Median and one-year survival in the combination treatment arm were 6.4 months and 25.6% respectively, which compared with 5.9 months and 19.7% respectively in those receiving gemcitabine plus placebo. Progression-free survival was also statistically significantly greater in the combination treatment arm. » 11/2/2004 Combined Radiation Trials All » 5-fluorouracil + radiation | 9 mths About: Combination of 5-fluorouracil and radiation. Results: Trial - In a recent clinical study, researchers at the London Regional Cancer Center in Ontario, Canada analyzed their experience treating 25 patients with locally advanced pancreatic cancer with 5-fluorouracil and radiation. The average duration of survival in this group was 9 months and 6 of 25 patients derived benefit as evidenced by decreased pain, increased weight gain, and/or improved performance status. » 10/29/2004 » Colloidal Phos.-32 + Ext Beam Rad About: Combination of External Beam Radiation and Colloidal phosphorous-32 another radioactive substance. Results: Trial - Five patients with locally advanced non-resectable pancreatic cancer were treated with this approach. The therapy was well tolerated and all 5 patients experienced regression of their cancer. Three patients have now survived without local cancer progression over 24 months from initiation of therapy and 1 patient is approaching 36 months. Comments: Small trial group and early stage of results should be considered when looking at 24 month result. » 10/29/2004

Other Strategies			All
» Radiofrequency Ablation - About | About2 | Where It's Done	þ
Not a lot is known about this procedure for cancer as it is typically used for irregular heart beats. It is a needle inserted into a tumor and a radiofrequency is sent through the needle. Some patients can go home the same day. They claim it is also for those patients with metastatic disease. Ablation of liver tumors (including metastatic) has FDA approval. They recommend Chemo be used with this treatment. Costs are less than surgical resection noted here. So far I had not noticed anything specific for Pancreatic cancer patients or especially those in Stage IV.
» Chemo Advice from Biopsy Analysis - by Rational Therapeutics	¨
Formulates best possible plan for chemo therapy by taking biopsy and analyzing tumor. They then recommend the right chemo drug or drug combination that induces cell death (apoptosis). Need to research if later if chemo route it taken. Biopsy must be fresh (done within last 24 hours) so they can apply chem to fresh cells. See their site here for specimen specifics. Cost appears to be $3,000 total and most likely would not be covered by medical insurance.  » 11/1/2004
» Photodynamic Therapy | Trial	¨
About: Works through the use of a photosensitizing agent and light. Injected into a patient's vein a couple of hours prior to surgery. During surgery, the physician applies a certain wavelength of light through a hand held wand directly to the site of the cancer and surrounding tissues. The energy from the light activates the photosensitizing agent, causing the production of a toxin that accumulates in the cancer cells and ultimately destroys them. Results: In this trial, 16 patients were first given the photosensitizing agent meso-tetrahydroxyphenyl chlorin through a vein. Three days later, light was delivered to the cancer through the guidance of computerized tomography (CT) scans. Fourteen patients were able to leave the hospital within 10 days. The average survival time was 9.5 months and 44% of the patients were alive at one year following therapy. Treatment was very well tolerated in the majority of patients; however, two patients developed bleeding that was controlled by surgery and three patients developed an obstruction in their large intestine.  » 10/29/2004
Referred Dr's or Specialists - Referred by friends			All
» Dr. Kenneth Tokita - Speciality: Cancer/radiation oncology | Dick working with
» Dr. Edward Wolin - Specialty: Oncology | Dick's first consultation
Dick had his first oncologist consultation at this oncologist. He was great, but they decided it was too far away. Dr. Tio at Cedars did the biopsy. As per Donna he teaches the endoscopic ultrasound procedure so he's a wonderful resource
» Dr. Yu - Specialty: Gastroenterologist | Consultation for Dick's biopsy
» Dr. Tariq Mahmood - Specialty: Oncology | Dick's Oncologist
Offices in the Irvine Medical Center, and at St. Joseph's Hospital in Orange. Dick is going to St. Joseph's for chemotherapy. Recommended by a few of the Phebus's friends. Dr. Mahmood recommended GemOx chemo to see if the tumors could be made to shrink or disappear.