The National Health Research Institutes (NHRI) has developed a combination chemotherapy regimen to treat pancreatic cancer that reduces the side effects and extends survival to nearly a year, it said yesterday.
An institute research team’s phase 1 and 2 clinical trials on a chemotherapy regimen of S-1, leucovorin, oxaliplatin and gemcitabine (SLOG) showed promising efficacy and safety in treating patients with metastatic pancreatic ductal adenocarcinoma (PDAC), National Institute of Cancer Research associate investigator Chiang Nai-jung (姜乃榕) said.
PDAC is a highly fatal disease, and as pancreatic cancers often do not show symptoms early in their onset, they are often only detected after they have grown large or spread outside the pancreas, meaning that 80 to 85 percent of patients are in the advanced stages of the disease at their time of diagnosis, Chiang said.
Photo: Lin Hui-chin, Taipei Times
The overall five-year survival rate of PDAC is lower than 5 percent, and systemic chemotherapy is the standard treatment for patients with unresectable advanced or metastatic pancreatic cancer, she said.
The median overall survival of patients with metastatic pancreatic cancer who received first-line gemcitabine monotherapy is three to six months, but newer combination chemotherapy regimens — such as folinic acid (also known as leucovorin), fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX), and nab-paclitaxel plus gemcitabine (AG) — extended the median overall survival to about eight-and-a-half to 11 months, Chiang said.
Although FOLFIRINOX and AG are more effective than monotherapy, they are associated with a higher degree of hematological toxicity and neutropenia, especially in Asians, she said, adding that their team tried to find other regimens better suited for Asian patients.
Some patients are less willing to tolerate the side effects of chemotherapy, but reducing the chemotherapy dosage might also reduce its efficacy, so the institute has been pursuing better solutions for several years, National Institute of Cancer Research deputy director Liu Ko-jiunn (劉柯俊) said.
The researchers spent four years coming up with the SLOG regimen — a fixed-rate infusion (10mg/m2 per minute) of 800mg/m2 of gemcitabine, followed by 85mg/m2 of oxaliplatin once per two weeks, and an oral dosage of S-1 and 20mg/m2 of leucovorin twice per day in the first seven days of a two-week cycle, Chiang said, adding that it can be used as a first-line treatment for PDAC.
With assistance from the Taiwan Cooperative Oncology Group, National Cheng Kung University Hospital, National Taiwan University Hospital, Linkou Chang Gung Memorial Hospital and Kaohsiung Medical University Chung-Ho Memorial Hospital, a total of 73 patients participated in the two phases of clinical trials.
Researchers found that the median overall survival of patients on the SLOG regimen was 11.4 months, the tumor shrinkage rate was above 30 percent, and the gastrointestinal side effects and rates of neutropenia were also reduced, Chiang said.
The biweekly treatment is a feasible regimen with promising effects and safety for patients with advanced PDAC, and it has been included in the clinical practice guidelines in several hospitals, she said.
The researchers are conducting a randomized phase 2 clinical trial comparing SLOG with a modified FOLFIRINOX regimen in patients with advanced pancreatic cancer, Chiang said.
The team’s research was published in the European Journal of Cancer last month.
A group of Taiwanese-American and Tibetan-American students at Harvard University on Saturday disrupted Chinese Ambassador to the US Xie Feng’s (謝鋒) speech at the school, accusing him of being responsible for numerous human rights violations. Four students — two Taiwanese Americans and two from Tibet — held up banners inside a conference hall where Xie was delivering a speech at the opening ceremony of the Harvard Kennedy School China Conference 2024. In a video clip provided by the Coalition of Students Resisting the CCP (Chinese Communist Party), Taiwanese-American Cosette Wu (吳亭樺) and Tibetan-American Tsering Yangchen are seen holding banners that together read:
UNAWARE: Many people sit for long hours every day and eat unhealthy foods, putting them at greater risk of developing one of the ‘three highs,’ an expert said More than 30 percent of adults aged 40 or older who underwent a government-funded health exam were unaware they had at least one of the “three highs” — high blood pressure, high blood lipids or high blood sugar, the Health Promotion Administration (HPA) said yesterday. Among adults aged 40 or older who said they did not have any of the “three highs” before taking the health exam, more than 30 percent were found to have at least one of them, Adult Preventive Health Examination Service data from 2022 showed. People with long-term medical conditions such as hypertension or diabetes usually do not
POLICE INVESTIGATING: A man said he quit his job as a nurse at Taipei Tzu Chi Hospital as he had been ‘disgusted’ by the behavior of his colleagues A man yesterday morning wrote online that he had witnessed nurses taking photographs and touching anesthetized patients inappropriately in Taipei Tzu Chi Hospital’s operating theaters. The man surnamed Huang (黃) wrote on the Professional Technology Temple bulletin board that during his six-month stint as a nurse at the hospital, he had seen nurses taking pictures of patients, including of their private parts, after they were anesthetized. Some nurses had also touched patients inappropriately and children were among those photographed, he said. Huang said this “disgusted” him “so much” that “he felt the need to reveal these unethical acts in the operating theater
Heat advisories were in effect for nine administrative regions yesterday afternoon as warm southwesterly winds pushed temperatures above 38°C in parts of southern Taiwan, the Central Weather Administration (CWA) said. As of 3:30pm yesterday, Tainan’s Yujing District (玉井) had recorded the day’s highest temperature of 39.7°C, though the measurement will not be included in Taiwan’s official heat records since Yujing is an automatic rather than manually operated weather station, the CWA said. Highs recorded in other areas were 38.7°C in Kaohsiung’s Neimen District (內門), 38.2°C in Chiayi City and 38.1°C in Pingtung’s Sandimen Township (三地門), CWA data showed. The spell of scorching