Pancreatic cancer drug trial shows low-cost switch could almost double chance of survival

Combining two chemotherapy drugs available on the NHS increased the number of patients living following surgery to remove their tumours, according to a new Cancer Research UK study.

Experts hope the drugs may also help people in more advanced stages of the cancer, which kills almost 9,000 people in the UK every year.

Pancreatic cancer has very poor survival rates, with only a fifth of all cases surviving a year after diagnosis and just five per cent living after five years.

Surgery is usually the only way to cure the cancer but it is only suitable for around 10 to 15 per cent of people.

Professor John Neoptolemos, from the University of Liverpool, led the trial and described its results as “overwhelmingly good”.

“In the 1970s and 80s, people said you shouldn’t operate on pancreatic cancer because it was a waste of time to treat these patients at all,” he said.

“In the space of 20 or 30 years, we’ve made a huge leap. This shows us it is a tumour we can get our head around.”

The new study, presented at the American Society of Clinical Oncology (ASCO) conference in Chicago, saw 732 patients who had undergone surgery to remove their tumour divided into two groups. The first received the chemotherapy drug gemcitabine (Gemzar) – the standard treatment for pancreatic cancer – while the second received a combination of gemcitabine and capecitabine (Xeloda).

The results showed that around 85 per cent of people given both drugs were still alive after one year, while almost 60 per cent were still alive after two years.

Almost 30 per cent of patients given the drug combination lived for at least five years compared with only 16 per cent of those given gemcitabine alone.

Prof Neoptolemos, who is the clinical lead for new guidelines which are currently being drawn up by the National Institute for Health and Care Excellence (Nice), said patients should be switched to the new relatively low cost regime.

He said: “It will lead to a re-thinking of the way we use chemotherapy drugs in pancreatic cancer. The view has been that chemotherapy doesn’t work in pancreatic cancer but this shows we shouldn’t close the door on chemotherapy.”

A further clinical trial is now underway to see if the drug combination can help to shrink tumours in people whose pancreatic cancer is considered to be borderline for surgery.

If their tumours can be shrunk, these patients may be suitable for surgery, which would significantly boost their chances of survival.

Prof Peter Johnson, Cancer Research UK’s chief clinician, said: “Nearly 10,000 people are diagnosed with pancreatic cancer each year in the UK and it remains a very difficult disease to find and treat.”

Alex Ford, chief executive of Pancreatic Cancer UK, said: “These are incredibly exciting results from a major trial for those diagnosed with this dreadful disease. We now need to see these results quickly translate to a change in approach by clinicians.”

A spokesman for Nice said the combination therapy is currently used off-label in clinical practice but it would take account of the new trial in its upcoming guidelines.