Hello, jba-ga!
I am glad the surgery went so well and that there has been no sign of
cancer anywhere outside of the pancreas. That sounds like a very good
sign.
I have found a good deal of information for you which should provide
some answers to your question. Since I am not a medical doctor, I have
not tried to provide you with any advice. I will let the articles and
research speak!
The following should start you off with some solid references to
explore:
===========
From "Pancreatic Cancer: Treatment Overview." Cancer Care.
http://www.mdcancer.org/types/content.cfm?ContentID=176&CancerTypeID=38
Overview:
Following surgical removal of pancreatic cancer, a stage I cancer is
said to exist if the final pathology report shows that the cancer is
confined to the pancreas. The cancer does not extend beyond the
confines of the pancreas, involve any adjacent organs, spread to any
of the local lymph nodes, and cannot be detected in other locations in
the body. Most early pancreatic cancers can be removed by surgery.
Unfortunately, early pancreatic cancer only accounts for a minority of
newly diagnosed cases. To help increase the chance of being cured, a
combination of anticancer drugs and/or radiation therapy is often
given after surgery.
Stage I adenocarcinoma of the pancreas is currently best managed by
surgical removal of the cancer. Depending on the features of the
cancer, approximately 10-35% of patients will be alive and without
evidence of cancer 5 years after surgery and are probably cured. The
most common surgical procedure is a pancreaticoduodenectomy, or
Whipple procedure, which involves removal of a portion of the
pancreas, duodenum, and stomach as well as the entire gallbladder. The
exact surgical procedure may differ based on the location and extent
of the cancer within the pancreas.
Despite all visible cancer being removed by surgery, approximately
60-70% of patients with stage I pancreatic cancer will experience
recurrence of their cancer. It is important to realize that a few
patients with stage I disease already have small amounts of cancer
that have spread outside the pancreas and were not removed by surgery.
These cancer cells cannot be detected with any of the currently
available tests. Undetectable areas of cancer outside the pancreas are
referred to as micrometastases. It is the presence of micrometastases
that causes the relapses that follow treatment with surgery alone. An
effective treatment is needed to cleanse the body of micrometastases
in order to improve the cure rate achieved with surgical removal of
the cancer."
Types of Adjuvant Therpay
==========================
Radiation Therapy with or without Chemotherapy:
"Radiation therapy is the use of high energy x-rays aimed at portions
of the body to kill cancer cells. Chemotherapy can be given to attack
cancer cells that have spread beyond the area of radiation treatment
or used to increase the effectiveness of radiation treatment itself.
Radiation therapy is the use of high energy x-rays aimed at portions
of the body to kill cancer cells. Chemotherapy can be given to attack
cancer cells that have spread beyond the area of radiation treatment
or used to increase the effectiveness of radiation treatment itself."
Effectiveness of Radiation and Chemotherapy:
"The results of a single small clinical trial support the use of
concurrent chemotherapy and radiation therapy following surgical
removal of pancreatic cancer. This trial demonstrated an improvement
in survival when 5-FU chemotherapy and radiation therapy were used
after surgery. Patients received external beam radiation therapy to
the area of operation. Following surgery, chemotherapy was started
during radiation therapy and continued for up to 2 years. Patients
treated with this adjuvant chemoradiation strategy had an average
survival of 20 months compared with only 10 months for patients
treated with surgery alone. Approximately 4 years after treatment
almost twice as many patients treated with combined chemotherapy and
radiation therapy survived without evidence of cancer recurrence.
Similar results have been reported by doctors in Europe. They reported
an average survival of 23 months when chemotherapy alone was
administered following surgery compared to 11 months for surgery
alone. The results of the European trial call into question the value
of radiation therapy since patients had a similar outcome with
chemotherapy alone. Clinical trials are currently ongoing to
determine whether the addition of radiation therapy to chemotherapy
after surgery improves outcome."
Types of New Adjuvant Therapy Regimens:
The new therapies currently being tested are aimed at "cleaning" the
body of the micrometastases, or undetectable areas of cancer that may
occur in areas outside of the pancreas. The new therapies currently
under testing follow:
New Chemotherapy Regimens:
"Several new chemotherapy drugs may be able to kill cancer cells more
effectively and are now being tested as adjuvant therapies.
Gemcitabine, Docetaxel, and other new chemotherapy drugs are
currently being tested with and without radiation therapy after
surgery."
Portal Vein Chemotherapy Infusion:
"Because many patients develop cancer recurrence in the liver,
chemotherapy delivered directly into the blood supply of the liver has
been used in an attempt to eradicate cancer cells. By infusing
chemotherapy over several days or weeks through the portal vein, the
chemotherapy is delivered directly to the cancer. Cancer cells appear
to be killed more effectively. Portal vein infusion is being evaluated
in clinical trials at many cancer centers."
Biological Therapy:
"Biologic therapies are naturally occurring or synthesized substances
that direct, facilitate, or enhance your body's normal immune
defenses. Biologic therapies include interferons, interleukins,
monoclonal antibodies, and vaccines. In an attempt to improve survival
rates these and other agents are being tested alone or in combination
with chemotherapy in clinical trials."
New Radiation Therapy Modalities:
"Intraoperative radiation therapy (IORT) is given in the
specially-equipped operating rooms to deliver a single dose of
radiation directly to the area of surgery. The radiation doctor is
able to see the area being treated and move sensitive normal
structures, such as the small bowel, away from the radiation beam.
Some studies that have evaluated IORT after surgery suggest cancer may
recur less often in the area of the surgery.
Three-dimensional conformal radiation therapy can precisely target
radiation to the areas of where cancer cells may be located, and
therefore minimize side effects from radiation to normal structures
such as the liver, stomach, and kidneys. Because many patients develop
areas of cancer cells in the liver, low-dose radiation therapy aimed
at the entire liver has been used in an attempt to destroy cancer
cells.
========================
Some other therapies highlighted on the Life Extension Website are
available for your review. I have highlighted only the therapies that
have backup from a medical journal. However, depending on how open you
are to various treatments, this website has a lot to consider!
"Pancreatic Cancer." Life Extension
http://www.lef.org/protocols/prtcl-113.shtml
There is much more in the article than the following two excerpts!
GM-CSF Vaccine
===============
"The GM-CSF vaccine consists of tumor cell lines that are genetically
engineered to produce the immune system-stimulating cytokine known as
granulocyte-macrophage colony-stimulating factor (GM-CSF). The immune
system would be able to recognize the pancreatic cancer cells as
foreign and mount an attack against them.
"A study conducted at Johns Hopkins University and reported in the
January 2001 issue of the Journal of Clinical Oncology revealed the
results of the GM-CSF vaccine used on 14 patients with pancreatic
cancer whose tumors had been surgically removed. The patients received
varying amounts of vaccine 8 weeks after their surgeries. Twelve of
the patients also received 6 months of chemotherapy and radiation
therapy. One month following the chemotherapy and radiation, six
patients who were in remission received additional vaccinations. Three
patients receiving one of the higher vaccine dosages showed immunity
to their tumor cells and experienced a disease-free survival time of
at least 25 months following their diagnosis. The researchers
concluded that the vaccine is safe and without side effects and the
response dose-dependent (Jaffee et al. 2001).
"An article in International Journal of Cancer presented the results
of a clinical trial involving 48 patients with pancreatic cancer that
were vaccinated by injection of synthetic mutant Ras peptides in
combination with granulocyte-macrophage colony-stimulating factor
(GM-CSF). Peptide-specific immunity was induced in 25 of 43 (58%)
patients, indicating that the vaccine used is very potent and capable
of eliciting immune responses even in patients with end-stage disease.
Patients with advanced cancer demonstrating an immune response to the
peptide vaccine showed prolonged survival (an average of 148 days)
from the start of treatment compared to nonresponders (average
survival of 61 days) (Gjertsen et al. 2001
Rubitecan
=========
"Although not a home run, pancreatic cancer patients should be aware
of the drug Rubitecan (previously known as RFS-2000). A study,
appearing in the International Journal of Oncology, detailed a group
of end-stage pancreatic cancer patients who were treated with the
experimental drug. Of the 60 evaluative patients, 31.7% responded
favorably with a median survival of 18.6 months. Another 31.7%
stabilized and had a median survival of 9.7 months. Nonresponders
(36.6%) lived 6.8 months, with no deaths attributable to treatment
(Stehlin et al., 1999). Typically, pancreatic cancer patients live
from 3-12 months following diagnosis. It is hoped that combining
Rubitecan with other cancer therapies may provide some hope; in
addition,
** pancreatic cancer patients (diagnosed earlier in the disease
process) are expected to respond better than those with more advanced
disease. **
"Rubitecan has shown significant advantage against a number of
cancers, apart from pancreatic cancer. The numbers of active trials
evaluating its overall efficacy illustrate the enthusiasm for the
drug. For example, Phase II clinical trials are being expanded to
include liver cancer, melanoma, glioma (brain tumor), and sarcoma (a
malignant tumor arising from connective tissue). European-based
Rubitecan trials are already underway involving prostate, colorectal,
and gastric cancers, as well as lung, breast, cervical, and head and
neck cancers. M.D. Anderson Cancer Center (Houston) is currently using
Rubitecan against blood-related tumors. The drug, usually administered
orally on an outpatient basis, can produce side effects described as
relatively benign (hematological toxicities, cystitis [bladder
irritation], and gastrointestinal complaints). To learn more about
entering a clinical trial using Rubitecan call John Marinaro, Senior
Director of Clinical Research at SuperGen, the provider of the drug
(1-925-327-0200). Visit SuperGen's Web site at www.supergen.com.
===
Alternative Treatments from Sloan Kettering
"Pancreatic Cancer Treatment. Memorial Sloan-Kettering Cancer Center.
http://www.mskcc.org/mskcc/html/2092.cfm
Immunotherapy & Other Investigational Approaches:
"Researchers at Memorial Sloan-Kettering develop and evaluate new
approaches to treatment. These investigational therapies are sometimes
offered to eligible patients through the clinical trial process. Some
of these research efforts are highlighted below. For up-to-date
details about current clinical trials at Memorial Sloan-Kettering
Cancer Center, please visit our clinical trial database."
"Research is under way at Memorial Sloan-Kettering to evaluate
pancreatic cancer vaccines as a way to prevent recurrence of the
disease. The vaccines are intended to stimulate the patient's immune
system. Unlike vaccines that prevent common viral diseases from ever
occurring, pancreatic cancer vaccines are designed to prevent
recurrence after cancer has appeared."
"One vaccine trial focuses on the common mutations of the K-ras
protein that occur in pancreatic cancers. K-ras is a protein that
occurs in many cells in the body. This protein, which plays an
important role in how cells function and interact with each other, is
mutated (altered) in more than 85 percent of patients with pancreatic
cancer. The goal of this pancreatic vaccine study is to activate the
immune system by developing an immunologic response to the abnormal
K-ras protein, and in doing so, ultimately reduce the risk of
recurrence. Another approach under study uses substances custom-made
from "heat-shock" proteins that are purified from the patient's own
tumor and are intended to stimulate the immune system to kill any
remaining cancer cells."
"For patients who will not benefit from surgery because their disease
has spread either to the area near the pancreas (known as locally
advanced disease) or to distant sites in the body (metastatic
disease), there are still treatments being investigated. For locally
advanced disease, Memorial Sloan-Kettering doctors are seeking to
combine radiation therapy with a chemotherapeutic agent, gemcitabine,
to evaluate whether the combination makes the radiation therapy more
effective. For patients with metastatic disease, a clinical trial here
will assess the effectiveness of two chemotherapeutic agents,
gemcitabine and irinotecan (CPT-11). Other agents under study are
paclitaxel (in combination with radiation therapy) and DX-8951f .
"Another potential treatment currently being evaluated at Memorial
Sloan-Kettering is photodynamic therapy. The patient receives an
injection of a special light-sensitive drug that collects in the
tumor. The doctor then shines a laser light on the pancreatic tissue
through a minimally invasive laparoscopic procedure. The light
activates the drug that has collected in the cancerous tissue and
enables it to kill cancer cells. Because the drug collects only in
cancerous tissue, normal tissue is spared from the drug's toxic
effects. Although more research is necessary, photodynamic therapy is
showing promise for treating cancers that are close to the surface of
the pancreas and for relieving obstructions in the pancreatic ducts."
=====
Interferon
==========
"Adjuvant Treatment of Pancreatic Adenocarcinoma?"from Medscape
Hematology-Oncology. (2000)
http://www.medscape.com/viewarticle/413490?WebLogicSession=Pr3vQWGNPjadmauJ7tlwQc8vAoIaGvJcYe6dIeZMdRlrOEH85ehE|-1648151365876665183/184161392/6/7001/7001/7002/7002/7001/-1
Question"
"Does interferon have a role in the adjuvant treatment of resectable
cancer of the pancreas?"
Atef Yousef, MD
Response
from Manuel Hidalgo, MD, 12/07/2000
"The optimal treatment of patients with adenocarcinoma of the
pancreas, who undergo a complete surgical resection, is a matter of
controversy. The use of postoperative chemoradiation has become a
frequent practice in this clinical setting after publication of the
results of a clinical trial by the Gastrointestinal Tumor Study Group
(GITSG). In this study, radiation therapy was given as a split course
of 20 Gy, 2 weeks apart. 5-fluorouracil (5-FU) was given concomitantly
during the first week of radiotherapy and for 2 years thereafter.
Postoperative 5-fluorouracil chemotherapy and radiation therapy was
found to result in a significantly increased survival rate at 2 years
(43% vs 18%, P < .03).
However, in a subsequent larger randomized clinical trial performed
by the European Organization for the Research and Treatment of Cancer,
the original results of the GITSG could not be duplicated; patients
treated with adjuvant chemoradiation did not have a survival better
than those who received no additional therapy after resection."
"The use of interferon-alpha in combination with chemoradiation has
been studied in this setting using cisplatin/5-FU chemotherapy. As in
most nonrandomized phase 2 clinical trials, the results seem to be
better that those obtained in previous controlled studies: actuarial
survival at 2 years approaches 80%. However, it cannot be discerned
from these data whether these promising results are the consequence of
patient selection, use of cisplatin in addition to 5-FU, use of 5-FU
as a continuous infusion instead of bolus regimen, or use of
continuous radiation therapy instead of split course treatment.
Therefore, at this time, the role of interferon-alpha in the adjuvant
treatment of pancreatic cancer remains investigational. Results from
phase 2 studies seem promising, but well-designed randomized trials
are needed to define its therapeutic value."
Articles:
*********
"Adjuvant Chemotherapy Without Radiation Improves Survival in
Pancreatic Cancer." The Lancet, Volume 358, No 9293, pp 1576-1585,
2001)
http://www.mdcancer.org/news/_cancernews.cfm?CFID=787747&CFTOKEN=19053965&contentid=1796
Excerpts:
"According to results recently published in the Lancet, the delivery
of chemotherapy after surgery for early pancreatic cancer
substantially increases patient survival over surgery alone. In
contrast, chemotherapy plus radiation following surgery does not
appear to produce any survival benefit over surgery alone in these
patients."
"Little research has been done to compare the effects of adjuvant
therapies on survivability of early stage pancreatic cancer. Results
from earlier studies evaluating differing adjuvant regimens have not
been consistent. Thus, researchers from the European Study Group for
Pancreatic Cancer conducted a clinical trial to evaluate adjuvant
regimens in patients with early stage pancreatic cancer. In this
trial, 541 patients underwent surgery and then received chemotherapy
and radiation (chemoradiation), chemotherapy alone or no additional
treatment. Chemotherapy consisted of fluorouracil-based regimens."
"Patients who were treated with adjuvant chemotherapy only lived an
average of 19.7 months after surgery, compared to 14.0 months in
patients treated with surgery alone. In contrast, patients who were
treated with adjuvant chemoradiation survived an average of .6 months
less than patients treated with surgery alone."
"These results suggest that adjuvant chemotherapy increases survival
in patients with operable pancreatic cancer, but adjuvant
chemoradiation produces no benefit over surgery alone. Clinical trials
are ongoing to evaluate more precisely delivered radiation and
different chemotherapy regimens as adjuvant treatment to help define
the clinical role of adjuvant therapy in patients with pancreatic
cancer. Individuals diagnosed with pancreatic cancer may wish to
discuss with their physician the risks and benefits of adjuvant
chemotherapy or about participating in a clinical trial."
======
"Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic
cancer: a randomised controlled trial." Neoptolemos JP, Dunn JA,
Stocken DD, Almond J, Link K, Beger H, Bassi C, Falconi M, Pederzoli
P, Dervenis C, Fernandez-Cruz L, Lacaine F, Pap A, Spooner D, Kerr DJ,
Friess H, Buchler MW; European Study Group for Pancreatic
Cancer.Department of Surgery, Liverpool University, Liverpool, UK.
j.p.neoptplemos@liverpool.ac.uk. Lancet 2001 Nov 10;358(9293):1576-85
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11716884&dopt=Abstract
"BACKGROUND: The role of adjuvant treatment in pancreatic cancer
remains uncertain. The European Study Group for Pancreatic Cancer
(ESPAC) assessed the roles of chemoradiotherapy and chemotherapy in a
randomised study. METHODS: After resection, patients were randomly
assigned to adjuvant chemoradiotherapy (20 Gy in ten daily fractions
over 2 weeks with 500 mg/m(2) fluorouracil intravenously on days 1-3,
repeated after 2 weeks) or chemotherapy (intravenous fluorouracil 425
mg/m(2) and folinic acid 20 mg/m(2) daily for 5 days, monthly for 6
months). Clinicians could randomise patients into a two-by-two
factorial design (observation, chemoradiotherapy alone, chemotherapy
alone, or both) or into one of the main treatment comparisons
(chemoradiotherapy versus no chemoradiotherapy or chemotherapy versus
no chemotherapy). The primary endpoint was death, and all analyses
were by intention to treat.Findings 541 eligible patients with
pancreatic ductal adenocarcinoma were randomised: 285 in the
two-by-two factorial design (70 chemoradiotherapy, 74 chemotherapy, 72
both, 69 observation); a further 68 patients were randomly assigned
chemoradiotherapy or no chemoradiotherapy and 188 chemotherapy or no
chemotherapy. Median follow-up of the 227 (42%) patients still alive
was 10 months (range 0-62). Overall results showed no benefit for
adjuvant chemoradiotherapy (median survival 15.5 months in 175
patients with chemoradiotherapy vs 16.1 months in 178 patients
without; hazard ratio 1.18 [95% CI 0.90-1.55], p=0.24). There was
evidence of a survival benefit for adjuvant chemotherapy (median
survival 19.7 months in 238 patients with chemotherapy vs 14.0 months
in 235 patients without; hazard ratio 0.66 [0.52-0.83],
p=0.0005).Interpretation This study showed no survival benefit for
adjuvant chemoradiotherapy but revealed a potential benefit for
adjuvant chemotherapy, justifying further randomised controlled trials
of adjuvant chemotherapy in pancreatic cancer."
====
A bright and hopeful article!!
"New Weapons Battle Pancreatic Cancer." Hopkins Medical News. (1999)
http://www.hopkinsmedicine.org/hmn/W99/mu_5.html
The entire article follows:
"Hopkins researchers are taking on this deadly disease on several
fronts. Here are two: Gene Therapy: "Even with our best treatment, the
five-year survival for pancreatic cancer patients is a dishearteningly
low 10 percent," says oncologist Elizabeth Jaffee, M.D. "We had no
doubt that we had to try something different."
Buoyed by her tests of a genetically engineered vaccine in patients
with renal cancer, Jaffee has begun Hopkins’ first trials of a
therapeutic gene vaccine for pancreatic cancer. Like any good vaccine,
this one focuses on boosting patients’ immune response to abnormal
cells, but aims to work after malignancy has a foothold.
Extracting cancer cells from the pancreatic tumors of two Hopkins
surgical patients, Jaffee established those cell lines in culture. She
then inserted genes for the immune-stimulating protein GM-CSF into the
cells and eased small numbers of them - now made harmless by
irradiation - into patients via injection. The cells migrate to lymph
tissue where they ostensibly spark an immune cascade ending in T cells
targeted to pancreatic tumor cells anywhere in the body.
Several months into the trials, each of nine patients shows no signs
of harm from the vaccine. But, more important, the pa-tients appear
able to mount an immune response to their own tumor cells. When Jaffee
tries a skin test - injecting patients with small numbers of their
tumor cells reserved from surgery - the patients mount "the impressive
signs of a classic immune reaction. We’re happy to see that
2-centimeter swelling at the injection site," she says. "No such
reaction appeared in patients before the vaccine."
Because the test requires a patient’s own tumor cells, Jaffee says,
people in the trials must first have surgery here at Hopkins. Six
weeks after tumor surgery, patients get the vaccine. "But because the
trials exist alongside standard treatment for pancreatic cancer," says
Jaffee, "patients have follow-up sessions of radiation or chemotherapy
before a second vaccination." She adds: "We’re really enthusiastic
about this vaccine and are looking to begin the efficacy trials early
next year."
Finely tuned Adjuvant Therapy:
The fact is, far fewer people develop pancreatic cancer than, say,
lung cancer - some 29,000 as opposed to 171,000 projected for this
year. But because the disease is so difficult to treat and only 3 to 4
percent of patients are, by definition, cured, its mortality pushes it
way up there with the biggies. Pancreatic cancer is the fourth leading
cause of cancer death.
"Such figures breed a certain nihilism among oncologists, says
associate professor of oncology Ross Abrams, M.D., and some would say
that adjuvant therapy for pancreatic cancer isn’t effective." But a
team of Hopkins clinicians has a different view. 'We are believers,
based on experience here," says Abrams, "that people who’ve had
adjuvant therapy clearly do better than those who haven’t."
Last year, the team of eight surgeons and medical and radiation
oncologists began an in-house study of adjuvant therapy for the
disease, fine-tuning combinations of radiation and chemotherapy to
optimize survival after a pancreaticoduodenectomy (the Whipple
procedure).
The new protocol follows the Hopkins tradition of improving the tools
at hand. An earlier study of adjuvant therapy showed it could increase
median patient survival from about 10 to 22 months. "That’s still too
low, we think," says Abrams. "So we’ve built upon what we learned in
this new protocol.”
The approach uses chemotherapy combined with a split course of
radiation therapy (two weeks of radiation followed by two weeks of
rest and then two more weeks of radiation.) "The strength of the
treatment has been increased on both the radiation and chemotherapy
sides," Abrams explains, "and the radiation is slightly more intense
than what’s typical, but patients deal well with it." Next comes four
cycles of chemotherapy - 5 FU, mitomycin and two enhancing agents,
leucovorin and dipyramidol - without radiation, for a total of six
months of treatment.
"We’re trying to offer pa-tients something not right off the shelf,
something you can’t get everywhere," Abrams adds, "and though the
study hasn’t yet reached 10 months, it looks promising. "We believe
we’re making slow but definite progress."
====
An interesting article from Johns Hopkins Hospital discusses factors
associated with long-term survival after pancreaticoduodenectomy.
Read "Surgical Treatment and Research." John's Hopkins Pancreas Cancer
Web. (2003)
http://pathology.jhu.edu/PANCREAS_SURGICAL_TX/
=====
"Novel Treatments and Therapies in Development for Pancreatic Cancer,"
by Walter H. Gunzburg, Matthias Lohr & Brian Salmons. Expert Opinion
Investigational Drugs. (2002)
http://www.austrianova.com/ProofGuenzberg.pdf
===
Research Studies
****************
"Optimizing Radioimmunotherapy for Pancreatic Cancer."
Principal Investigator: Hollingsworth, Michael
Institution: University of Nebraska Medical Center
State: NE
NCI Program Director: Straile, William
NCI Division: Office of the Deputy Director for Extramural Science
Project ID: P50, CA72712-Sub-01
Project Funding Period: 9/01/97 to 1/31/02
This project includes a clinical trial with a novel therapeutic, an
antibody (CC49) with high specificity for pancreatic tumors that has
been conjugated to a radionuclide. Successful development of this
therapy for treating patients with pancreatic cancer is predicted to
extend the survival of these patients.
http://researchportfolio.cancer.gov/cgi-bin/abstract.pl?ProjectID=38592
====
"Immunotherapy and Immunodiagnosis of Pancreatic Adenocarcinoma."
Principal Investigator: Hollingsworth, Michael
Institution: University of Nebraska Medical Center
State: NE
NCI Program Director: Straile, William
NCI Division: Office of the Deputy Director for Extramural Science
Project ID: P50, CA72712-Sub-03
Project Funding Period: 9/01/97 to 1/31/02
These studies are leading to a tumor vaccine trial that will build
upon the preclinical studies previously funded by the SPORE. The trial
will target a unique portion of MUC1, the cytoplasmic tail, which has
shown efficacy in preclinical evaluation and has not been previously
investigated in human trials. In addition, pilot projects funded by
the SPORE and carried out in Dr. Joyce Solheim's laboratory are
predicted to provide additional strategies for vaccination of
pancreatic tumor patients
http://researchportfolio.cancer.gov/cgi-bin/abstract.pl?ProjectID=38590
====
Some clinical trials
********************
"Phase II Study of Sequential Paclitaxel and Bryostatin 1 in Patients
With Locally Advanced Unresectable or Metastatic Adenocarcinoma of the
Pancreas." Cancer.gov.
http://www.nci.nih.gov/clinical_trials/view_clinicaltrials.aspx?protocolnum=AECM-019224&version=healthprofessional
OBJECTIVES
Determine the complete and partial response rates in patients with
locally advanced unresectable or metastatic adenocarcinoma of the
pancreas treated with sequential paclitaxel and bryostatin 1.
Determine the survival of patients treated with this regimen.
Determine the toxicity and pharmacokinetics of this regimen in these
patients
===
"Phase II Study of Adjuvant Gemcitabine and Radiotherapy in Patients
With Previously Resected Pancreatic Cancer." Cancer.gov.
http://www.nci.nih.gov/clinical_trials/view_clinicaltrials.aspx?protocolnum=CCCWFU-57198&version=healthprofessional
OBJECTIVES
Determine the time to disease progression, local control, and survival
of patients with previously resected pancreatic cancer treated with
adjuvant gemcitabine and radiotherapy.
===
From Memorial Sloan-Kettering Cancer Center
http://www.mskcc.org/mskcc/html/2270.cfm?peds=no&IRBNO=97-130&team=Pancreatic%20cancer&TT=
"Vaccination of Pancreatic Cancer Patients Against Mutated K-Ras: A
Pilot Trial."
Purpose :
Pancreatic cancer is a difficult disease to treat. Even in the best
circumstances where a patient has had potentially curative surgery,
there is a very high likelihood of the cancer returning. Chemotherapy
and radiation therapy are sometimes given after surgery to try and
decrease the chance that the cancer might recur. In this study,
doctors at Memorial Sloan-Kettering are trying to develop a different
approach to treat patients with pancreatic cancer after surgery. They
will assess a new vaccine designed to boost a patient's immune system
against pancreatic cancer.
K-ras is a protein that plays an important role in regulating how
cells work. In most pancreatic cancers, K-ras is mutated -- that is,
it is slightly altered -- while the K-ras in normal cells remains
normal. Therefore, the mutated K-ras is unique to the tumor cells and
may be recognized by a patient's immune system as foreign.
The purpose of this research study is to see if doctors can immunize
patients with pancreatic cancer against the K-ras mutation found in
their particular tumors. In this study doctors hope that the vaccine
will induce T cells -- white blood cells in a patient's immune system
-- to attack the tumor and to try and reduce the risk of the cancer
returning. Eligible patients will have their tumors tested for ras
mutations, and if one is detected, then the patient will be eligible
to be vaccinated.
Eligibility :
To be eligible for this study, patients must meet several criteria,
including but not limited to the following:
Patients must have either a confirmed diagnosis of pancreatic
adenocarcinoma which can be removed surgically, or a suspected
diagnosis of pancreatic adenocarcinoma prior to surgery.
Patients who have undergone curative surgery for pancreatic
adenocarcinoma within the previous 12 months, and who are free of
recurrence, are also eligible.
Patients are also potentially eligible if they have received a prior
short course of adjuvant chemoradiation (chemotherapy and radiation
therapy), provided they have no evidence of recurrence following
completion of chemoradiation.
====
To see further research studies:
The Cancer Research Portfolio list for Pancreatic Cancer
http://researchportfolio.cancer.gov/cgi-bin/projectlist.pl?SID=22640&ShowCart=R&DisplayType=Summary&x=7&y=8
===
I hope the references I have provided give you some answers to
explore for further follow-up procedures. If the information is
unclear, or the links don't work, please don't hesitate to ask me in a
clarification. I will do my best to help.
I truly hope all goes extremely well and that the successful surgery
is a sign of wonderful and healthy future!
umiat-ga
Google Search Strategy
therapies after Whipple treatment pancreatic cancer
+adjuvant treatment +"pancreatic cancer |
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