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  • New Drug Approved for Treatment of Pancreatic Cancer

    Steve Jobs - Pancreatic Cancer

    Pancreatic cancer is a notoriously lethal disease that overtook Steve Jobs and threatens the life of Justice Ruth Bader Ginsberg. However, help may be on the way for those who suffer from pancreatic cancer in the form of a new drug called Afinitor (a form of Everolimus made by Novartis).

    In May of 2011, the FDA (Food and Drug Administration) approved Afinitor as a pancreatic cancer treatment. Afinitor is specifically used in the treatment of progressive neuroendocrine tumors of the pancreas (PNET) that cannot be surgically removed and/or have metastasized and spread to other bodily organs. PNET is a slow-growing and rare disease. According to the FDA, it affects fewer than 1,000 new patients in the United States each year.

    It was at M.D. Anderson, a cancer research facility based in the University of Texas in Houston, that Associate Professor of Medicine Dr. James Yao found that the drug could also be employed as a cancer treatment. “The FDA approval of Afinitor represents an important step forward for patients with advanced pancreatic NET.

    Patients will now have access to a treatment that has been shown to significantly delay tumor growth and reduce the risk of disease progression,” said Dr. Yao. This is the first FDA approved drug in thirty years that has presented an ability to treat pancreatic cancer. “Patients with this cancer have few effective treatment options. Afinitor has demonstrated the ability to slow the growth and spread of neuroendocrine tumors of the pancreas,” explains Richard Pazdur, MD, director of the FDA’s Office of Oncology Drug Products in the Center for Drug Evaluation and Research.

    Afinitor was originally used to treat patients with advanced renal cell carcinoma after the failure of Sunitinib (Sutent, Pfizer) or Sorafenib (Nexavar, Bayer Health Care), as well as for patients with subependymal giant cell astrocytoma associated with tuberous sclerosis who cannot be surgically treated. Additionally, this drug was also initially used as an anti-rejection drug for patients following organ transplant surgery. Specifically, in the form of a drug called Zortress, Afinitor is used to prevent organ rejection after kidney transplants. Since the discovery of Dr. Yao’s, Afinitor has recently been FDA approved for advanced renal cancer and specific brain tumors that cannot be surgically removed.

    Afinitor is a kinase inhibitor that hinders the growth of cancerous cells by targeting the protein known as mTOR. The mTOR protein regulates both angiogeneic and proliferative tumor progression pathways. In many cancers, cancerous cells lethally control the mTOR pathway. Afinitor has been shown to specifically block mTOR kinase activity and, consequently, the activity of mTOR in protein synthesis. This results in reduced growth and proliferation of tumor cells (meaning fewer new cancerous cells), inhibited glucose uptake and cell metabolism (meaning less nutrition for cancer cells) and inhibited angiogenesis of the tumor (meaning fewer blood vessels leading to the site of the tumor).

    Side effects reported by patients treated with Afinitor for PNET include stomatitis, rash, diarrhea, fatigue, edema, abdominal pain, nausea, fever, and headache.

    Disclaimer: This article represents our best efforts but are in no way meant to replace the critical dialogue and recommendations of a healthcare professional. If you believe that you, or someone you know suffers from the conditions described here, see your healthcare provider. Do not attempt to treat yourself or anyone else without proper medical supervision.

    References:

    Afinitor. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2011.

    Dancey JE. Inhibitors of the mammalian target of rapamycin. Expert Opin Investig Drugs. 2005;14:313-328.

    Hartford CM, Ratain MJ. Rapamycin: something old, something new, sometimes borrowed and now renewed. Clin Pharmacol Ther. 2007;82:381-388.

    Hay N, Sonenberg N. Upstream and downstream of mTOR. Genes Dev. 2004;18:1926-1945.

    Saylor PJ, Michaelson MD. New treatments for renal cell carcinoma: targeted therapies. Journal of the National Comprehensive Cancer Network. 2009;7(6):645-56.

    Wullschleger S, Loewith R, Hall MN. TOR signaling in growth and metabolism. Cell. 2006;124:471-484.