A clinical trial aims to offer a lifeline for patients facing advanced pancreatic cancer, traditionally considered beyond surgical intervention.
The study, led by Keck Medicine of the University of Southern California, seeks to determine whether a combination of chemotherapy followed by a novel surgical procedure could pave the way for improved outcomes for people with locally advanced pancreatic cancer.
This form of the disease indicates tumours that haven't spread but are closely positioned near adjacent blood vessels, making surgical removal risky.
Dr Steven Grossman, co-lead investigator of the study and esteemed medical oncologist within Keck Medicine, explained: ‘Typically, these tumours pose insurmountable challenges for surgical excision due to the risk of compromising critical blood vessels supplying vital abdominal organs. However, recent innovations in surgical techniques lead us to believe that surgery could be a viable option, potentially revolutionising the treatment landscape for these patients.’
Pancreatic cancer, though relatively rare, stands as one of the most formidable adversaries in the realm of oncology.
Often diagnosed in advanced stages due to the absence of early symptoms, its prognosis remains grim, with a 13% survival rate beyond five years post-diagnosis.
Locally advanced pancreatic cancer, accounting for a significant portion of cases, historically confined patients to a bleak prognosis of around one year.
Traditional treatments such as chemotherapy and radiation, while palliative in nature, offer limited efficacy against the relentless onslaught of pancreatic malignancies.
Dr Sandra Algaze, another key investigator in the study, noted: ‘Surgery has long been hailed as the cornerstone of treatment for localised tumours in most cancers. Unfortunately, its utility has been severely hampered in pancreatic cancer cases involving adjacent blood vessels. The tantalising promise of extended survival observed in rare cases of successful surgical resections underscores the urgent need for a surgical breakthrough.’
Under the stewardship of Dr Yuri Genyk, a hepatobiliary and pancreatic surgeon renowned for his expertise in vascular reconstruction, the clinical trial will explore the feasibility of surgical resection in cases where tumours intricately intertwine with nearby arteries.
The trial protocol involves administering chemotherapy to shrink the tumour, followed by a meticulous laparoscopic evaluation to assess tumour dimensions and positioning before embarking on surgical excision.
Dr Genyk said: ‘This sophisticated procedure encompasses tumour removal and the intricate reconstruction of involved blood vessels. While undoubtedly intricate, our surgical team stands poised to execute this procedure with precision. Should the trial yield favourable results, we envision this technique becoming the new standard of care.’
With an aim to enrol 20 patients with locally advanced pancreatic cancer, the trial holds the promise of potentially transforming the treatment landscape for a disease characterised by its relentless aggression.
Patients will be closely monitored post-surgery, focusing on identifying biomarkers and demographic factors influencing outcomes.
Dr Grossman concluded: ‘Pancreatic cancer represents a formidable adversary, but Keck Medicine remains unwavering in its commitment to spearheading innovative solutions. Every step forward in improving patient outcomes is a testament to our dedication to alleviating the burden of this devastating disease.’
Photo - Steven Grossman. Credit: Ricardo Carrasco III, Keck Medicine of USC.
