Bologna, Italy – A novel chemotherapy regimen is offering renewed hope for individuals battling pancreatic cancer, a disease historically known for its aggressive nature and limited treatment options. Early results from a large-scale clinical trial suggest a significant improvement in patient survival rates when utilizing this new approach prior to surgery, potentially marking a turning point in how this challenging cancer is addressed.
Pancreatic cancer remains one of the deadliest forms of the disease, with a five-year survival rate of just 10%, according to the American Cancer Society. This low survival rate is often attributed to late diagnosis and the cancer’s resistance to conventional treatments. The new research, still, indicates a potential to shift these odds.
The study, known as the Cassandra trial, was coordinated by the San Raffaele Hospital in Milan, with participation from the Policlinico Sant’Orsola in Bologna. Published recently in the prestigious medical journal The Lancet, the findings demonstrate a notable increase in survival rates compared to the current standard of care for patients with non-metastatic ductal adenocarcinoma – the most common type of pancreatic cancer, accounting for approximately 95% of cases.
Comparing Chemotherapy Regimens: Paxg vs. MFolfirinox
The core of the research centered around a comparison between two distinct chemotherapy combinations: mFolfirinox, the current standard treatment and Paxg, a newer regimen developed at San Raffaele approximately a dozen years ago. The trial aimed to determine which approach was more effective in patients preparing for surgical removal of the tumor.
Researchers evaluated “progression-free survival” – the length of time patients lived without the disease worsening, recurring, or requiring further intervention – as a key metric. The results revealed a substantial difference: patients treated with the Paxg regimen experienced progression-free survival for an average of 16 months, compared to just over 10 months for those receiving mFolfirinox. This represents a significant improvement and suggests a potential for long-term benefits.
A Shift in Preoperative Treatment
The positive findings have garnered attention from the Italian Medicines Agency (AIFA), which has requested the study be advanced from a Phase 2 to a Phase 3 trial. According to Mariacristina Di Marco, a researcher at the University of Bologna affiliated with the Oncology department at Policlinico Sant’Orsola and responsible for the trial at the hospital, this move signifies the potential for the new regimen to turn into a standard treatment option. “AIFA recognized the added value of this research and has asked us to move forward with a potentially registrational study, one that could change the guidelines,” she explained.
Professor Michele Reni, director of Oncology and Day Hospital at San Raffaele, presented the data at the annual Congress of the American Society of Clinical Oncology (ASCO) in Chicago last June. While widespread adoption will take time, the magnitude of the observed difference suggests a potential breakthrough in pancreatic cancer treatment.
Looking Ahead: Long-Term Survival Data
The research team is now focused on analyzing long-term survival data, extending beyond the initial five-year mark. The study began in 2019, and researchers are continuing to monitor patients to assess the lasting impact of the Paxg regimen. Di Marco emphasized the collaborative spirit of the research, highlighting the close partnership with the Pancreas Surgery and Endocrinology department at Policlinico Sant’Orsola, led by Professor Riccardo Casadei. “We were among the first to believe in the potential of preoperative chemotherapy, and this milestone promises to significantly improve the outlook for patients,” she stated.
The project was entirely funded by patient associations, underscoring the critical role of patient advocacy in driving medical research. Further investigation and international validation will be crucial to confirm these promising results and translate them into improved outcomes for individuals facing this devastating diagnosis.
Disclaimer: This article provides information for general knowledge and informational purposes only, and does not constitute medical advice. This proves essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.
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