Effective Treatment Options for Metastatic Pancreatic Cancer

Recently, Federal Practitioner talked with Fengming Zhong, MD, PhD, about treatment options for patients with pancreatic cancer. Metastatic pancreatic cancer is one of the deadliest malignancies, with patients usually being diagnosed at an advanced stage. While 5-year survival is only between 25% and 30%, new clinical trials and treatment options may improve survivorship in coming years.

Dr. Zhong’s article, “Systemic Treatment and Outcomes of Metastatic Pancreatic Cancer,” appeared in Federal Practitioner’s August 2014 issue.

Federal Practitioner: In your article, you discuss that pancreatic cancer is one of the deadliest malignancies. Why do you think that is the case?

Fengming Zhong, MD, PhD: Pancreatic cancer does not get diagnosed in the early stages. Most early stage patients are asymptomatic, so if early stage diagnosis is made, it is usually just because of another test or scan conducted for some other reason. Surgery is the only way to potentially cure this cancer, but because of that low level of early diagnosis, only 20% of patients are candidates for surgery at diagnosis. Even for patients who have early stage surgery, the 5-year survival is only 25% to 30%. Currently available therapies are only marginally effective for treatment, especially in the late stages most patients present with. The tumor biology is also poorly understood. We need more basic research to understand how this cancer grows and to help develop a new treatment.

FP: The article also states that pancreatic cancer incidence rates have been increasing in men and women since 2000. Why do you think this is?

FZ: According to data, the rates have been increasing slightly over the past decade or so. The rates of increase, we think, is because the population is aging. Other lifestyle factors like smoking, drinking alcohol, diet, and obesity may also be contributing to the increased rates of pancreatic cancer.

FP: What kinds of treatment options do you feel are most effective for pancreatic cancer?

FZ: The treatment of pancreatic cancer is a rapidly developing area. We now have more options available for treatment, including the systemic treatment discussed in my article. Many other options are currently available in clinical trials, so we hope that patients will participate when they are eligible to help develop more comprehensive treatment.

FP: What do you think needs to be changed in order to improve patient outcomes?

FZ: For the general population, there needs to be a reduction of risk factors and people need to live a better lifestyle. With these new clinical trials, we are hoping to make earlier diagnosis a reality, and we will hopefully be able to improve the outcomes for pancreatic cancer. This will help identify new and more efficient treatment. Also, we need to see increased funding in basic research to understand the biology of the disease. There are some exciting things developing.

Dr. Zhong is the author of “Systemic Treatment and Outcomes of Metastatic Pancreatic Cancer” in Federal Practitioner’s August 2014 issue.

Dr. Zhong serves as staff physician, Hematology and Oncology, at VA New Jersey Health Care System and is an assistant professor for the Department of Medicine at Rutgers-New Jersey Medical School.