54 | spring 2017
cancer cases are diagnosed after the cancer has spread to
other areas of the body such as the liver, the abdominal lining
or the lungs, which eliminates surgery as a possible cure.
Since Landon’s death, the long-term survival rate has
doubled. Still, just 8 percent of people with pancreatic
cancer live five years or longer, based on data collected
through 2012, up from 4 percent between 1990 and 1992.
Despite these numbers, researchers and physicians point
out several positive trends in treating the disease.
The combination of Gemzar (gemcitabine) and Abraxane
(nab-paclitaxel), two chemotherapy drugs, has become
a standard of care for patients with pancreatic cancer.
Gemcitabine was first approved by the U.S. Food and Drug
Administration as a treatment for locally advanced and met-
astatic pancreatic cancer in 1996, and Abraxane was added to
the regimen in 2013 after studies showed the t wo drugs used
together increased median survival to seven months from
four months when treated with 5-FU alone. While the majority
of patients lived just months longer, 35 percent of patients
on this combination lived a year or longer, according to 2013
data, compared to data published in 1997 that indicated just
2 percent of patients treated with 5-FU lived at least a year.
In 2011, researchers reported in the New England Journal
of Medicine that another combination, called FOLFIRINOX,
which adds leucovorin, Camptosar (irinotecan) and Eloxatin
(oxaliplatin) to 5-FU, increased survival from 7 months to 11
months compared to treatment with Gemzar alone, though
patients experienced more toxicity from this combination,
including chemotherapy-related infections.
“These options took an average patient who would die
in three to four months and doubled survival to eight to
10 months,” says medical oncologist Elizabeth M. Jaffee,
who studies new treatments for patients with pancreatic
cancer at the Johns Hopkins Kimmel Cancer Center in
Baltimore. She notes that many patients taking these
drugs live more than a year, which gives them more time
to avail themselves of experimental therapies.
For example, researchers are using genomic analysis of
pancreatic cancer tumor samples to guide new treatment
choices. (See “Analyzing Tumor Tissue” on pg. 53.) Molecular
biologist Lynn Matrisian estimates that approximately 25
percent of pancreatic cancer patients have tumors with
genetic mutations that could respond to targeted drugs.
“This gives us additional guidance as to what might
work for that patient, and that’s better than not knowing
anything or saying [to a patient], ‘There isn’t anything
“Nobody should be told
‘We can’t do anything
about pancreatic cancer.’”
Michael Landon appears on The Tonight Show
Starring Johnny Carson in the mid-1970s.
Landon and Carson were friends, and Landon
talked about his cancer diagnosis during his
last appearance on the show in 1991.