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Study: Pre-Op Chemo May Not Benefit Pancreatic Cancer Patients

Catching pancreatic cancer early improves survival chances. University of Cincinnati researchers wanted to know if administering chemo before surgery in stage I and II patients, in addition to after, would lengthen survival.

Traditionally, pancreatic cancer is treated with surgery first and chemotherapy second. But UC Oncologist Dr. Davendra Sohal was looking for ways to improve outcomes. So in a clinical trial, he and others enrolled 102 early-stage patients and administered chemotherapy before surgery and after.

"Unfortunately, it did not lead to a cure in more patients than the usual approach, but it has taught us important lessons - how to do it and how to make improvements upon it in future trials," says Sohal.

He explains, "We have reached the ceiling of the benefit with chemotherapy, so whether before or after surgery, there is a maximum benefit that we have achieved."

His research, published Thursday in the JAMA Oncology, found that patients didn't live any longer than expected after getting pre-operative chemotherapy from either of the two standard regimen-mFOLFIRINOX (a combination of fluorouracil, irinotecan and oxaliplatin) and a combination of gemcitabine and nab-paclitaxel.

Sohal and his fellow researchers are convinced, "We now need to find better treatments, better so-called targeted therapies or immunotherapy approaches that have worked in other cancers."

He plans to design more so-called "intelligent" clinical trials with better testing and drugs.

According to the American Cancer Society, pancreatic cancer is the fourth most deadly form of cancer in the U.S. Only 20% of patients are alive one year after diagnosis. After five years it's 7%.

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