Advanced Pancreatic Cancer: A Look Ahead

Transcript:Johanna Bendell, MD: And, really, I appreciate all of you being here. I think this has been a great discussion on recent advances in treatment of pancreas cancer, where the future lies for the treatment, and their patient care. Before we end this program, I just want to get final thoughts from each of our panelists, one thought per person. And I’m going to start with, I’m going to be nice to Tom. You hit it.

Thomas A. Abrams, MD: I think that this was a great discussion and it really does show how much is coming down the pike. I think we have reason to be optimistic, and that’s more than we could say yesterday, and, hopefully, tomorrow there’s going to even be more to be optimistic about.

Johanna Bendell, MD: Love it. Caio?

Caio Rocha Lima, MD: I just want to emphasize the value of clinical trials. The participation in clinical trials in this country is still single-digit. So, I hope that with the progress we’ve made—and with the excitement going on with the new drugs, vaccines and activation of the immune system, targeting the stroma, with targeting hyaluronic acid among others—we’ll make the community of oncologists pay more attention to clinical research.

Johanna Bendell, MD: I love it. Philip?

Philip A. Philip, MD, PhD: Treating the whole patient.

Johanna Bendell, MD: Yes.

Philip A. Philip, MD, PhD: Numbers and clinical trials, scans. But treating the whole patient, supporting them with an urgent fashion when they first present, and continuing to do that, and not thinking of starting someone on a chemotherapy before you think about how to make this patient feel more comfortable. You can’t change the diagnosis, but you can change their mental state, and their comfort level—and same for their caregivers. So, that’s very important. And then continue doing that while they’re getting chemotherapy with the idea of, on the one hand, giving them the treatment, not doing less, but at the same time, maintaining their quality of life and dignity. Because by doing that, you can also almost ensure that they will continue as long as their disease allows them to continue in terms of the biology, rather than stopping it at an earlier point. So, back to judge who is an important person—I’m sure, in the community—you give them FOLFIRINOX, and after 3, 4 cycles they crash, which they may after helical, they may stop their treatment. I’d rather give them 6 months of clean gemcitabine than break their chance.

Johanna Bendell, MD: Oh, and, George, now you get the final word.

George P. Kim, MD: Well, they didn’t crash. They did very well. They went for, actually, a checkpoint inhibitor trial, and he’s doing very well. That’s all good news. But I echo actually what you just said, in that you’ve got to keep the patient going. We don’t recognize how heroic these individuals are. Chemotherapy is still, in many ways, controlled poisoning. They go home, they’re sick. Their families are driving them. They’re managing the diarrhea at night, the inability to sleep, the pain. They are very heroic, and I think we just have to continue to help them along the way. That’s why nurse practitioners or mid-levels are so important. And then we’ve got to get away from this negativity. We’re still negative. The gastroenterologists, the surgeons, the radiation, the medical oncologists, we collectively have got to get away from the negativity. We’ve got to keep moving forward. We’re going to see some advances, and there’s some exciting treatments out there. Some of these treatments don’t even involve chemotherapy. They’re monotherapy. They don’t have the typical side effects. So, I think we have to be optimistic. Even George Kim is optimistic.

Philip A. Philip, MD, PhD: I have to say that you’re the most positive I’ve seen you. I haven’t seen you as positive as this before.

Johanna Bendell, MD: I love it. Fantastic. On behalf of our panel, we thank you for joining us.

Transcript Edited for Clarity