Tag Archives: gemcitabine

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SHC’s Von Hoff honored for cancer advances

In association with its 50th anniversary, the American Society of Clinical Oncology (ASCO) has named Daniel D. Von Hoff, M.D., FACP, one of ASCO’s 50 Oncology Luminaries, celebrating 50 doctors who over the past half-century have significantly advanced cancer care.

Dr. Von Hoff is Chief Scientific Officer for Scottsdale Healthcare’s Virginia G. Piper Cancer Center Clinical Trials and Physician-In-Chief and Distinguished Professor at Phoenix-based Translational Genomics Research Institute (TGen). He is an internationally recognized physician and scientist whose research during the past 30 years has contributed to the development of many anticancer agents that are routinely used in clinical practice. Among these drugs are fludarabine, mitoxantrone, paclitaxel, docetaxel, irinotecan, topotecan, nelarabine, gemcitabine, vismodegib, and nanoparticle paclitaxel.

ASCO was founded in 1964 by oncologists to improve the care of cancer patients. Profiles of the 50 Oncology Luminaries are being featured on the ASCO website, and their accomplishments will be celebrated at ASCO’s 50th annual meeting, May 30-June 3 in Chicago.

Although it is difficult to pick one highlight of his career, Dr. Von Hoff and his team played an instrumental role in the development of gemcitabine, the first drug to improve the survival of patients with stage IV pancreatic cancer. In 1997, they published the results of a clinical trial that showed that gemcitabine not only increased the rate of clinical benefit in patients with pancreatic cancer compared with fluorouracil (5-FU), but it also improved overall survival.

This work was followed by recognition of the activity of nab-paclitaxel plus gemcitabine against pancreatic cancer with the recent finding that that regimen also improved survival for patients with stage IV pancreatic cancer. On Sept. 6, 2013, the U.S. Food and Drug Administration (FDA) approved nab-paclitaxel as a frontline therapy for patients with advanced pancreatic cancer.

International clinical trials that led to the FDA’s approval were led by Dr. Von Hoff at Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare, a partnership of Scottsdale Healthcare and TGen, at Scottsdale Healthcare Shea Medical Center in Scottsdale, Ariz.

Dr. Von Hoff has also been instrumental in the concept of development of personalized therapy for patients with refractory cancer based on using molecular techniques to profile their cancers. This work included the initial clinical trials to determine what percentage of patients could benefit from that approach.

Dr. Von Hoff has spent the past 30 years of his career leading teams in phase I trials and the development of new therapies, first as the founding director of the Institute for Drug Development at the Cancer Therapy and Research Center in San Antonio, then as the director of the Cancer Center and Professor of Medicine at the University of Arizona. He also is Professor of Medicine at the Mayo Clinic and serves as Chief Scientific Officer for US Oncology.

When Dr. Von Hoff was awarded ASCO’s David A. Karnofsky Memorial Award in 2010, he took several minutes at the beginning of his lecture to memorialize all of the patients that he and his team had lost during phase I trials the previous year, mentioning several of them by name. The gesture reflected what Dr. Von Hoff named as the greatest accomplishment of his career: working hard to help as many people as he could.

“I have been extremely fortunate to have many great (and incredibly patient) teachers, mentors, and co-workers,” Dr. Von Hoff said. “Truly though I think the greatest teachers and mentors for me have been those I have been privileged to care for.”

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TGen, Scottsdale Healthcare study may help pancreatic cancer patients

A multi-center Phase III clinical trial demonstrates that Abraxane (nab-paclitaxel) plus gemcitabine is the first combination of cancer drugs to extend survival of late-stage pancreatic cancer patients compared to standard treatment.
The MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial) study was led by physicians from Scottsdale Healthcare’s Virginia G. Piper Cancer Center Clinical Trials, a partnership between Scottsdale Healthcare and the Translational Genomics Research Institute (TGen).

Their findings show that Abraxane plus gemcitabine was well tolerated and resulted in clinically meaningful outcomes compared to gemcitabine alone, the current standard of care. The study abstract was released today and the data will be presented at the American Society of Clinical Oncology (ASCO) 2013 Gastrointestinal Cancers annual meeting Jan. 25 in San Francisco.

“We are ecstatic that this clinical trial of Abraxane plus gemcitabine improves survival for patients with advanced stage IV pancreatic cancer,” said Dr. Daniel Von Hoff, international lead investigator for MPACT, chief scientific officer for Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare, and TGen’s Physician-In-Chief. “It once again demonstrates that laboratory science based medicine can make a difference for patients.”

MPACT is the largest phase III clinical trial completed in advanced pancreatic cancer with more than 800 patients. Findings from the study showed a 59 percent increase in one-year median survival rates from less than a quarter of the patients (22 percent) to more than a third (35 percent). The two-year survival rate for this cancer is negligible, less than 4 percent, but that more than doubles (9 percent) with the nab-paclitaxel/gemcitabine combination.

One of those patients was Lynne Jacoby, 48, of Phoenix, who works as a director of compliance for a healthcare company. Jacoby was given only weeks to live when her Stage 4 pancreatic adenocarcinoma, a tumor the size of a golf ball, was first diagnosed in April 2012 — nine months ago.

“If you had to live your life in a year, and that is all the time you have, wouldn’t you do everything you could to experience this time,” said Jacoby, who for nearly a year before her diagnosis had experienced night sweats, indigestion, stomach pains, neck and back pain, and an elevated white-blood count.

She began the treatment of Abraxane plus gemcitabine in May 2012 and continues on the medications, saying now that she “feels awesome, wonderful.” She is scheduled to remain on the drug combination through May 2013.

“Life is priceless. No amount of money can be placed on life. I know I would be gone already if it was not for Dr. Von Hoff,” said Jacoby, who also refers to him as “Dr. Von Hope.”

The study showed significant improvement among some of the sickest patients including those with increased metastases. Significantly there was no increase in life-threatening toxicity. Other drug combinations that have demonstrated benefit have been limited by increased toxicities.

“This is a major improvement in a cancer with the lowest survival rates among all cancer types,” said Dr. Ramesh Ramanathan, medical director of Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare and principal investigator for the clinical trial in the United States. “Advanced pancreatic cancer is fourth most common cause of cancer death in the United States and throughout the world. It is difficult to diagnose with a majority of the cases diagnosed at a late stage after the disease has already advanced.”

Abraxane wraps traditional chemotherapy, paclitaxel, in near-nano sized shells of albumin, a protein that the tumor sees as food. The tumor uses various mechanisms to preferentially attract the albumin, which then acts like a “Trojan Horse” to release its package of chemotherapy inside the tumor. It is approved in the U.S. for metastatic breast cancer and non-small cell lung cancer.

The pancreas is a gland behind the stomach that secretes enzymes into the upper part of the small intestine to help digestion. It also produces hormones, including insulin, which helps regulate the metabolism of sugars.

The incidence of pancreatic cancer is increasing worldwide with an estimated 279,000 cases per year, including nearly 44,000 in the U.S. in 2012, and resulting in more than 37,000 American deaths last year.

Individuals seeking information about eligibility to participate in clinical trials at the Virginia G. Piper Cancer Center at Scottsdale Healthcare may contact the cancer care coordinator at: 480-323-1339; toll free at 1-877-273-3713; or via email at clinicaltrials@shc.org.