Pancreas cancer, carried out in chemotherapy treatment thanks to the results of an all -Italian study

The results of the Cassandra project – A clinical study conceived and coordinated by Professor Michele Reniprimary of oncology and director of **Pancreas center ** ofIRCCS San Raffaele Hospital of Milan – marks a point of carried out in the treatment of pancreas cancer. The study, presented these days in Chicago during the annual congress of theAmerican Society of Clinical Oncologywas conducted on 260 patients in 17 Italian centers and was entirely financed by patient associationsan extraordinary fact that underlines the value of independent research and collaboration between science and civil society.

«The Cassandra study was born from the need for improve the prognosis of patients without worsening their quality of life compared to the current standard», Says Professor Michele Reni and adds:” We are faced with a historical step in the fight against pancreas cancer for the extent of the difference observed compared to what, to date, the most effective therapeutic pattern in this disease was considered by many “.

Cassandra project, what emerged highly significant

The Cassandra project has shown the superiority of the Paxg chemiotherapy treatmentdeveloped at San Raffaele, compared to the Mfolfirinox international standard, when administered before the surgery in the patients with ductal adenocarcinoma of non -metastatic pancreas.

The study, born with the goal of Improve therapeutic results in patients candidates for surgical removal of a ductal adenocarcinoma of the pancreasspecifically compared the effectiveness of the two chemotherapy schemes administered before the intervention. The data obtained showed that i patients treated with PAXG – A new combination of chemotherapy drugs created at San Raffaele in 2012 and authorized by AIFA in January 2020 for use in patients with metastatic or advanced pancreas cancer – they recorded one survival – free from unfavorable events – superior Compared to those subjected to Mfolfirinox, the therapy adopted according to international standards.
“These results show how innovative therapeutic strategies can concretely improve the life prospect of the patients, opening the way to a possible updating of the guidelines for the treatment of this neoplasm”, says Professor Massimo Falconi, primary ofPancreas surgery unitdirector of Pancreas Translational & Clinical Research Center of the IRCCS San Raffaele Hospital, Professor of Surgery at the Vita-Salute University of San Raffaele and co-co-responsible for the study.

Ductal Pancreatic adenocarcinoma (PDAC), the most common malignant tumor of the Pancreas

THE’Ductal adenocarcinoma (PDAC) It is the most common type of malignant tumor of the pancreas and represents 95% of all malignant pancreatic neoplasms. Every year it constitutes about the 3% of new cases of canceris the Third main cause of cancer death and presents the Worst survival rate at 5 years between solid tumors.

The disease originates from the esocrine cells of the pancreatic gland, responsible for the production of digestive enzymes, which grow in an uncontrolled way spreading rapidly to other organs forming metastases. Is often diagnosed in advanced phase e Only 10-20% of patients can be subjected to surgery. However, in over 90% of patients with disease apparently located at pancreas, there are microscopic metastases, which cannot be documented with existing diagnostic tools. From this the need to intervene through peri-operative chemotherapy that allows to obtain healing more often and to prolong the lives of patients compared to post-operative chemotherapy, the use of which is among other things hindered by the slow and difficult recovery of clinical conditions after a very demanding intervention.

The fundamental role of patient associations

The strong peculiarity of the Cassandra project is that it is a study entirely financed by 5 patient associations: My Everest, Viola Code, Life Association, Natalucci and beyond researchdemonstrating the crucial role that these realities, and the citizens themselves, may have in the progress of scientific research.
“Without their support, this study would not have been possible,” underlines Professor Reni. «We are deeply grateful to the associations of patients who believed in our ideas allowing us to carry out this work. Their commitment and trust were a decisive viaticum to take a step forward in the treatment of pancreas cancer, a pathology for which many answers are still needed. This study shows that the independent research, supported by the community, can really make a difference ».

Future perspectives

The data presented open new perspectives in the treatment of pancreas cancer, laying the foundations for a Possible updating of global guidelines and for the start of further clinical studies.

In this context, the Pancreas center of the IRCCS San Raffaele Hospital, which enrolled about 50% of the patients of the study, confirms its role of reference at national and international level in the diagnosis and treatment of pancreatic pathologies, thanks to an integrated model that involves Specialists in oncology, surgery, radiology, gastroenterology, radiotherapy, pathological anatomy, nuclear medicine, clinical nutrition, psychology, diabetology and translation researchAnd. The center is configured as a pole of excellence and clinical innovation inor perfectly with the Comprehensive Cancer Center of San Raffaele directed by Professor Fabio Ciceriprimary of the Unit of Etamology bone marrow transplantation of the IRCCS San Raffaele Hospital and Professor of Hematology at the University of Vita -Silute San Raffaele, benefiting from multidisciplinary collaboration and shared resources, With the aim of developing increasingly effective and personalized therapeutic strategies in order to improve the survival and quality of life of patients.

Meanwhile, the research continues. And the next results could further refine the therapeutic approach for the care of this complicated neoplasm.