Pancreatic cancer: will incremental advances begin to make a difference?

I t made no difference whether the pancreatic cancer patients received 5-fluorouracil (5-FU) plus leucovorin or gemcitabine after surgery: Overall survival, progressionfree survival, and quality of life were the same, according to the results of the European Study Group for Pancreatic Cancer (ESPAC3) trial, published in the Sept. 8 Journal of the American Medical Association . But for clinicians, a more useful interpretation is that 5-FU is just as effective as gemcitabine, the “gold standard,” and much less expensive, said the study’s principal investigator, John P. Neoptolemos, M.D., head of the division of surgery and oncology at the University of Liverpool in the United Kingdom. These results debunked the prevailing wisdom that pancreatic cancer responds strongly only to gemcitabine and that “everything else was not worth the effort,” he said. More than that, the fi nding opens the door to new approaches to treating pancreatic cancer, according to Neoptolemos and