Pancreatic cancer in over 90 percent. cases still remains an incurable disease. In the last three years, however, new treatment regimens have emerged that prolong the survival of patients with advanced forms of this cancer, remind oncologists.
On Wednesday, at an educational meeting in Warsaw, they emphasized that for formal reasons in Poland, very few patients have access to them.
The President of the Polish Oncology Union, Dr. Janusz Meder recalled that pancreatic cancer is the seventh most common malignant neoplasm in Europe. It is also the fourth leading cause of cancer deaths.
The oncologist noted that very few patients – on average about 20 percent. – it lives for a year from the moment the disease is detected. And five-year survival, which is a measure of successful cancer treatment, is recorded in approx. 6 percent. patients in European countries.
“In the last 30 years, the incidence of pancreatic cancer in women and men has been increasing. The risk of this cancer increases with age, and most cases are detected after the age of 50, ”said Dr. Meder.
The data of the National Cancer Registry show that in Poland in 2011, pancreatic cancer was diagnosed in approx. 3,3 thousand patients. people.
Among the most important risk factors for pancreatic cancer that we can influence prof. Lucjan Wyrwicz from the Department of Oncological Gastroenterology of the Oncology Center in Warsaw mentioned smoking and drinking alcohol regularly, which contribute to the formation of chronic inflammation in the pancreas.
Experts present at the meeting emphasized that only 10-20 percent. patients with diagnosed pancreatic cancer are potentially eligible for surgery, which is the only chance of a cure.
According to Dr. Medera is related to the fact that pancreatic cancer can run secretly for many years, giving non-specific symptoms such as abdominal pain, pressure in the abdominal cavity, sometimes nausea, vomiting, yellowing of the skin (jaundice). This is one of the reasons why it is recognized late.
Prof. Piotr Wysocki, head of the Oncology Clinic at ul. Wawelska, belonging to the Oncology Center in Warsaw, pointed out that even if patients who can be operated on undergo complementary chemotherapy and radiotherapy, within 2 years after the surgery, 80% of them will relapse or spread to other organs.
The oncologist noted that the treatment of advanced pancreatic cancer is the biggest problem. Thanks to standard therapy, patients with this cancer survive for about half a year.
Prof. Wysocki reminded that for about 17 years, the standard therapy in these patients has been chemotherapy with the use of a drug called gemcitabine. In the last three years, two new treatment regimens have emerged that are improving patient survival.
One of them (abbreviated as FOLFIRINOX) uses four known cytotoxic drugs. Clinical studies have shown that thanks to this therapy, approx. 48 percent. patients with advanced pancreatic cancer survive for a year, while among patients receiving standard treatment with gemcitabine, this percentage is approx. 20%. However, this is a very toxic therapy and can only be used in selected patients in a very good general condition, emphasized prof. Wysocki.
The second treatment regimen involves the use of gemcitabima with a drug called nab-paclitaxel. A clinical study, the results of which were published in 2013, showed that thanks to this method, 35% of them survived the year. sick. As emphasized by prof. Wysocki, this therapy can be used in elderly patients with more advanced cancer who, due to a worse initial state of health, do not qualify for more toxic treatment.
Prof. Wysocki noted that in relation to the previous results of treatment of pancreatic cancer patients, these two schemes are a really big step forward. However, for formal reasons in Poland, they are used in a few patients under the so-called custom chemotherapy.
As explained by oncologists, nab-paclitaxel should be used in the future as part of a drug program, but has not yet been evaluated by the Health Technology Assessment Agency (AOTM). FOLFIRINOX could be included in the chemotherapy catalog, but under the Reimbursement Act it is not possible, because one of the drugs used in this regimen is not registered in the treatment of pancreatic cancer.
It is an old, cheap drug that has many generic equivalents, and none of the pharmaceutical companies is interested in expanding its registration in the new indication, explained Prof. Wysocki. (PAP)