October 21, 2020 by Peter B. Laird
Fighting Pancreatic Cancer With ‘Intra-arterial Chemotherapy’ Via Clinical Trial at Miami Cancer Institute
Challenging to diagnose and difficult to treat, pancreatic cancer is projected to become the second-leading cause of cancer-related deaths this year. The 5-year survival rate is just 10 percent, driving researchers to search for new and better treatments for the more than 57,000 people diagnosed each year.
Maria Elena Muntaner de Armas, 74, received her diagnosis last year on her 53rd wedding anniversary.
(Watch now: The Baptist Health Resource team hears from patient, Maria Elena Muntaner de Armas, and her medical oncologist, Antonio Ucar, M.D., of Miami Cancer Institute.)
“My life changed completely in a minute,” says Mrs. De Armas. She refused to let the news get her down, however. “I never, never ever was sad or depressed. I have seven kids, 17 grandkids. I have so many important things in my life going on that I wanted to live.”
Mrs. de Armas and her family turned to Miami Cancer Institute in their search for the most advanced treatment options. Her medical oncologist, Antonio Ucar, M.D., believed she was a good candidate for a new clinical trial at the Institute for patients with inoperable pancreatic tumors such as hers.
“We always feel it’s important to offer the patients the opportunity of receiving the latest therapy and achieving the best possible outcome,” Dr. Ucar says.
The phase III TIGeR-PaC clinical trial is investigating a new approach to treating pancreatic cancer with intra-arterial chemotherapy, a minimally invasive procedure that uses a catheter threaded through the patient’s arteries to deliver chemotherapy directly to the tumor. Ripal T. Gandhi, M.D., FSIR, FSVM, an interventional oncologist at Miami Cancer Institute and a vascular interventional radiologist at Miami Cardiac & Vascular Institute, is the co-principal investigator of the clinical trial in conjunction with Dr. Ucar at Miami Cancer Institute, the first center in Florida to perform these procedures.
“Pancreatic cancer tends to be resistant and often does not get enough chemotherapy when it is delivered via an intravenous approach,” Dr. Gandhi explains. “With the intra-arterial approach of administering high doses of chemotherapy directly to the pancreatic tumor, we have the potential to control the disease and improve survival — and we can improve the patient’s quality of life.”
Dr. Gandhi has a particular passion for treating pancreatic cancer. His uncle passed away from the disease years ago.
“I remember he really fought hard and struggled through a lot of the toxicities from the pancreatic cancer itself, from the pain, as well as from some of the therapies,” he recalls. “This drove me to see if we could come up with better therapies to improve survival and have less impact on patients’ quality of life.”
Dr. Gandhi points to two factors that make this clinical trial cutting-edge. “No. 1, this approach has not been tried in the past. No. 2, this is a specially designed catheter which has two balloons on it, and this allows us to deliver high doses of chemotherapy directly to where the cancer is. I think it’s very promising and the early studies have had very promising results as well.”
Patients in the study are randomized into two groups. One group receives the standard of care, which is intravenous chemotherapy and radiation. The second group, to which Mrs. De Armas was assigned, receives the standard treatment, plus the investigational intra-arterial therapy, which delivered in a series of procedures taking place over several months.
According to Dr. Ucar, tolerance to the treatment is excellent and side effects are minimal because the large majority of the chemotherapy goes into the tumor, instead of circulating widely through the body as in conventional intravenous chemotherapy.
Mrs. De Armas finished her treatments this summer and is now in a maintenance phase.
“Her performance status is excellent, the best possible, and she’s having an excellent quality of life and enjoying her family and her daily routine,” reports Dr. Ucar.
“It was not a piece of cake,” Mrs. De Armas adds. “But everyone there has been great to me. I had my husband and my kids by my side all the time, and the support of all these professionals. And now, day by day, I see that I’m able to do more things — like yesterday I was cleaning something in my kitchen and I was amazed because, before, I couldn’t even think about doing that.”
These days, traveling and cooking are on the agenda for Mrs. De Armas, but her top priority is dedicating time to her family because, in her words, “They still need me a lot.”
The clinical trial is ongoing at Miami Cancer Institute and other sites in the U.S. and Europe, with the goal of proving the effectiveness of this intra-arterial chemotherapy approach in improving overall survival.
Dr. Gandhi sees many potential benefits for patients participating in clinical trials.
“I think there are definitely misconceptions about clinical trials, but we have to remember that yesterday’s clinical trials are today’s standard of care,” Dr. Gandhi says. “I think that’s really critical. One of our primary drivers here is to institute new clinical trials to come up with new therapies and make advancements where they have not been made in the past.”
Visit https://baptisthealth.net/cancer-care/clinicaltrials for more information about clinical trials at Miami Cancer Institute.