Abraxane boosts pancreatic cancer survival, but not as much as hoped

The combination of Celgene's ($CELG) Abraxane with gemcitabine has improved survival in advanced pancreatic cancer by almost two months--a statistically significant amount--but this isn't as much as some doctors were hoping for, according to a report in The New York Times.

Abraxane is a formulation of paclitaxel with albumin nanoparticles, using Celgene's patented nab (nanoparticle albumin bound) technology to improve its delivery and cut side effects. In the Phase III study, known as MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial), 861 treatment-naïve patients with metastatic pancreatic cancer were given the Abraxane and gemcitabine combo.

The patients on the combination therapy lived for an extra 1.8 months (median). At the end of one year, adding in Abraxane increased one-year survival from 22% to 35%, and more than doubled survival at two years, from 4% to 9%. It also cut the risk of progression or death, and increased the time to treatment failure. While on their own these figures seem pretty small, advanced pancreatic cancer is a very tough to treat disease, with a 5-year survival rate of less than 2%, and patients often living only around 6 months after diagnosis.

"It was not the breakthrough we were anticipating," Andrea Wang-Gillam of Washington University in St. Louis, who was not involved in the trial, told the Times. Wang-Gilliam added that, however, at this stage of advances in pancreatic cancer treatment, any improvement is welcome.

The company says the MPACT results are clinically meaningful and statistically significant. It will present the results at the American Society of Clinical Oncology's (ASCO) Gastrointestinal Cancers Symposium on Friday in San Francisco, and use them as part of the submission for marketing approval for this indication. Look out for applications in the U.S. and Europe during the first half of the year, and in other countries during the second half of the year.

In November, analysts predicted major sales for Abraxane in pancreatic cancer. Celgene may have a fight on its hands, however, once it hits the pancreatic cancer market. It is more expensive than the combination treatment Folfirinox, and may not be as effective, though its trump card could be that it is better tolerated and does not require patients to wear an infusion pump.

"The simplicity of Abraxane plus gemcitabine may be attractive to physicians and patients," Neal J. Meropol of University Hospitals and Case Western Reserve University in Cleveland told The New York Times.

Abraxane has been on the market for the treatment of metastatic breast cancer since 2005, and as of October 2012 is also available in the U.S. for advanced or metastatic non-small cell lung cancer.

- read the press release
- see the abstract
- check out the article in The New York Times