Chemotherapy Drug Ups Overall Survival in Resected Early Pancreatic Cancer Patients

The chemotherapy drug gemcitabine more than doubles overall survival in patients who have undergone surgery for pancreatic cancer, according to a large multi-center study. (Proc Biol Sci 2008 July 07)

The Charite Onkologie (CONKO-001) study showed that adjuvant treatment with gemcitabine doubles the long-term survival rate after 5 years compared to observation, said co-investigator Dr. Helmut Oettle at a press briefing.

Therefore, gemcitabine should be the standard of care for adjuvant treatment of pancreatic cancer, said Oettle, of the department of medical oncology and hematology, Charite University Medical School, Berlin, Germany.

CONKO-001, the first large-scale phase III study to show chemotherapy benefit in resected early-stage pancreatic cancer patients, showed in 2005 that as an adjuvant, gemcitabine improved disease-free survival.

The trial randomized 368 patients to receive postoperative gemcitabine or undergo observation, which included no specific anti-cancer treatment. All patients first had complete surgical removal of their tumor, with no detectable macroscopic disease remaining.

The primary endpoint of estimated disease-free survival at 3 and 5 years, respectively, was 23.5 percent and 16 percent for the gemcitabine group versus 8.5 percent and 6.5 percent for the observation group. Overall survival at 3 and 5 years was 36.5 percent and 21 percent for the gemcitabine group, versus 19.5 percent and 9 percent for the observation group.

Pancreatic cancer presents a poor prognosis despite curatively intended resection. Although gemcitabine-based chemotherapy is standard in advanced pancreatic cancer, the role of adjuvant chemotherapy is still under discussion.

Studies are ongoing to compare treatment with gemcitabine alone and gemcitabine in combination with targeted therapies like erlotinib and sorafenib in successfully resected patients.