A cocktail of four chemotherapy drugs improves average survival by more than 60% in people with pancreatic cancer, French researchers reported Wednesday. The drugs had a variety of side effects, but did not impair the quality of life for the survivors. Because survival is so poor with the disease, many patients are happy to accept the side effects of the drug to gain a few months of life.
Pancreatic cancer, which strikes 43,000 Americans annually, killing 36,800 of them, is one of the most deadly forms of cancer. It is the fourth leading cause of cancer death in the U.S., even though it accounts for only about 2.5% of all cancer cases. Fewer than 6% of victims survive for five years.
Dr. Thierry Conroy of Nancy University and Centre Alexis Vautrin in Nancy, France, and his colleagues studied 342 patients with early stage pancreatic cancer. Half received gemcitabine (Gemzar), the primary drug used for pancreatic cancer therapy, and half received a cocktail of four other chemotherapy drugs: oxaliplatin, irinotecan, leucovorin and fluorouracil, known collectively as FOLFIRINOX. All of the patients, who were under the age of 76, were treated for six months.
The team reported in the New England Journal of Medicine that the median survival time for the patients receiving gemcitabine was 6.8 months, compared with a median of 11.1 months among those receiving FOLFIRINOX. Those taking the combination therapy reported many more side effects, including pain, numbness in the extremities, loss of appetite, diarrhea and weight loss, but the side effects apparently did not severely impair their quality of life. After six months of treatment, 31% of those in the FOLFIRINOX group reported a significant decline in their quality of life, compared to 66% in the gemcitabine group. Because of the severity of the side effects, physicians recommended that the drug cocktail be reserved for those ages 75 and younger.