Newswise – LOS ANGELES – A clinical trial out of Keck Medicine of USC aims to provide a surgical solution for patients with a form of advanced pancreatic cancer that was previously considered inoperable.
The study will examine whether chemotherapy followed by a new type of surgery to remove the cancer is a safe and effective option for patients with locally advanced pancreatic cancer, meaning the cancer has not spread to other organs, but rather in or grown near neighboring organs is blood vessels that surround the pancreas.
“Typically, these types of tumors cannot be safely removed through surgery because of the risk of damage to the blood vessels that supply blood to the stomach, liver and other abdominal organs. However, based on recent advances by Keck Medicine surgeons, we believe patients with locally advanced cancer may be candidates for successful surgery that could significantly improve outcomes,” he said Steven Grossman, MD, PhDCo-leader of the study. Grossman is a medical oncologist at Keck Medicine and associate director of cancer services at USC Norris Comprehensive Cancer CenterPart of Keck Medicine.
The challenge of treating pancreatic cancer
Pancreatic cancer accounts for only about 3% of cancers in the United States, but it is one of the deadliest. There are usually no symptoms until the cancer has become very large or has metastasized throughout the body. Therefore, the cancer is only detected late and the prognosis for patients is poor.
Only 13% of pancreatic cancer patients survive five or more years after diagnosis.
The life expectancy of patients with locally advanced pancreatic cancer, which accounts for a third of all pancreatic cancer cases, has historically been about one year.
For most cancers, surgery is considered the most effective treatment for localized tumors that have not spread to other areas of the body. However, surgery is traditionally not offered for tumors that affect the blood vessels near the pancreas because if the blood vessels were damaged during the procedure and blood flow to the organs was disrupted, it could result in serious side effects or death.
Therefore, the only treatment option for patients with locally advanced cancer is typically chemotherapy and/or radiation, both of which have limited effectiveness in killing pancreatic cancer cells.
“The situation is frustrating because research shows that in the rare cases where locally advanced tumors have been safely removed, disease progression has been slowed and patient survival has increased on average from one year to 28 months, increasing life expectancy more than doubled.” said Sandra Algaze, MDa medical oncologist at Keck Medicine, a member of USC Norris and one of the study’s researchers. “Surgery therefore appears to greatly improve a patient’s survival rate, which is why a surgical solution is urgently sought in the medical field.”
How new surgical advances can benefit patients
The clinical trial will use surgical protocols developed by Keck Medicine surgeons to safely remove locally advanced pancreatic tumors that are attached to arteries. The surgical team is led by a co-principal investigator Yuri Genyk, MDOhEpatobiliary and pancreatic surgeon at Keck Medicine, expert in vascular reconstruction, i.e. the removal and reconstruction of blood vessels. Genyk has already successfully removed about 30 pancreatic tumors that were attached to adjacent arteries.
“Although this operation is very complex, we have the skills and expertise to carry it out and train other experienced surgeons in the procedure. If the study results are positive, we expect the technique could become the gold standard for treating this stage of pancreatic cancer in the future,” said Genyk.
Patients in the clinical trial will first undergo chemotherapy to try to shrink the tumor. Two to eight weeks after completing chemotherapy, they will undergo a laparoscopic examination to determine the location and size of the tumor before surgically removing the tumor and removing and reconstructing the affected blood vessels.
Patients are followed every three months for the first year after surgery and every six months for two years thereafter.
The clinical trial will also examine whether certain biomarkers, such as the tumor’s DNA, as well as a patient’s demographic factors such as age and gender play a role in patient outcomes.
The study will include 20 patients with locally advanced pancreatic cancer who have evidence of arterial involvement of their tumors. The operations will be carried out on Keck Hospital of USC.
“Pancreatic cancer is a devastating diagnosis and Keck Medicine is committed to finding better solutions for the disease,” said Grossman. “Anything we can do to improve patients’ quality of life and extend life expectancy will be a major milestone that could benefit countless patients and their families.”
Those interested in taking part in the study can contact the following address: Charlean Ketchens, RN, at (323) 865-3035 or [email protected].
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For more information about Keck Medicine of USC, visit News.KeckMedicine.org.