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Drug May Help Fight Rare Pancreatic Cancer

Study Shows Sutent Deprives Tumors of Nutrient Supply

By Charlene Laino
WebMD Health News

Reviewed By Louise Chang, MD

Jan. 25, 2010 (Orlando, Fla.) -- A pill that cuts off the supply of nutrients to tumors shows promise for treating people with the rare type of pancreatic cancer that afflicted Apple CEO Steve Jobs.

In a study of 171 people with advanced pancreatic neuroendocrine tumors, the drug, Sutent, doubled the length of time before their disease worsened.

Cancer progressed in 5.5 months among patients on placebo vs. 11.4 months among patients on Sutent. Sutent also cut the risk of dying by 60%, says Eric Raymond, MD, head of medical oncology at the Hospital Beaujon in Clichy, France.

The findings were presented at the 2010 Gastrointestinal Cancers Symposium (GCS).

"For the first time in 18 years, [a new drug] has demonstrated benefit in these patients," Raymond tells WebMD.

"Even though they are rare, these tumors are a life-limiting event for patients who have them. This is a very strong study," says Richard M. Goldberg, MD, head of the North Carolina Cancer Hospital in Chapel Hill.

"I am hopeful it will change how we treat these patients," says Goldberg, who was not involved with the research.

Sutent Cuts Blood Supply to Tumors

Pancreatic neuroendocrine tumors account for about 1% of all pancreatic cancers. An estimated 42,500 people were diagnosed with pancreatic cancer in 2009, according to the American Cancer Society.

If diagnosed early, neuroendocrine tumors can often be surgically removed before they have spread throughout the body, experts say.

Neuroendocrine tumors also grow more slowly than other pancreatic tumors. "But once they progress, they can progress quickly," Raymond says.

People with advanced neuroendocrine tumors have very few options, he says. There's chemotherapy, but that requires a hospital stay and causes a host of side effects from extreme vomiting and nausea to hair loss. Only about one in three patients benefit, Raymond says.

Enter Sutent, which puts the brakes on the growth of tumor-feeding blood vessels and deprives tumor cells of blood and nutrients needed for growth. It also curbs the proliferation of tumor cells.

Sutent is part of a class of drugs called tyrosine kinase inhibitors. It is already approved to treat advanced kidney cancer and recalcitrant gastrointestinal stromal tumors (GIST).

In the new study, patients with advanced pancreatic neuroendocrine tumors took either three Sutent capsules every morning or placebo pills. All were also given medication to treat pain and diarrhea as needed.

The side effects were the same as those observed when Sutent is used to treat other cancers, including low levels of certain blood cells, high blood pressure, and fatigue.

"The adverse events were generally tolerable and manageable with a drug holiday or dose reduction," Raymond says.

The study was sponsored by Pfizer, which makes Sutent.

SOURCES:

2010 Gastrointestinal Cancers Symposium, Orlando, Fla., Jan. 22-24, 2010.

Eric Raymond, MD, head of medical oncology, Hospital Beaujon, Clichy, France.

Richard M. Goldberg, MD, Gastrointestinal Cancers Symposium Steering Committee; head, North Carolina Cancer Hospital, University of North Carolina, Chapel Hill.

© 2010 WebMD, LLC. All rights reserved.



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