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Fighting Pancreatic Cancer With ‘Intra-arterial Chemotherapy’ Via Clinical Trial at Miami Cancer Institute

Challenging to diagnose and difficult to treat, pancreaticcancer is projected to become the second-leading cause of cancer-related deathsthis year. The 5-year survival rate is just 10 percent, driving researchers tosearch for new and better treatments for the more than 57,000 people diagnosedeach year.

Maria Elena Muntaner de Armas, 74, received her diagnosis lastyear 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 sador depressed. I have seven kids, 17 grandkids. I have so many important thingsin my life going on that I wanted to live.”

Mrs. de Armas and her family turned to Miami Cancer Institute intheir search for the most advanced treatment options. Her medical oncologist, AntonioUcar, M.D., believed she was a good candidate for a new clinical trial atthe Institute for patients with inoperable pancreatic tumors such as hers.

“We always feel it’s important to offer the patients theopportunity of receiving the latest therapy and achieving the best possibleoutcome,” Dr. Ucar says.

The phase III TIGeR-PaC clinical trial is investigating anew approach to treating pancreatic cancer with intra-arterial chemotherapy, a minimallyinvasive procedure that uses a catheter threaded through the patient’s arteriesto deliver chemotherapy directly to the tumor. RipalT. Gandhi, M.D., FSIR, FSVM, an interventional oncologist at Miami Cancer Institute and a vascularinterventional radiologist at MiamiCardiac & Vascular Institute, isthe co-principal investigator of the clinical trial in conjunction with Dr.Ucar at Miami Cancer Institute, the first center in Florida to perform theseprocedures. 

“Pancreatic cancer tends to be resistant and often does notget enough chemotherapy when it is delivered via an intravenous approach,” Dr.Gandhi explains. “With the intra-arterial approach of administering high dosesof chemotherapy directly to the pancreatic tumor, we have the potential tocontrol the disease and improve survival — and we can improve the patient’squality of life.”

Dr. Gandhi has a particular passion for treating pancreaticcancer. His uncle passed away from the disease years ago.

“I remember he really fought hard and struggled through alot of the toxicities from the pancreatic cancer itself, from the pain, as wellas from some of the therapies,” he recalls. “This drove me to see if we couldcome up with better therapies to improve survival and have less impact onpatients’ quality of life.”

Dr. Gandhi points to two factors that make this clinicaltrial 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 thisallows us to deliver high doses of chemotherapy directly to where the canceris. I think it’s very promising and the early studies have had very promisingresults as well.”

Patients in the study are randomized into two groups. Onegroup receives the standard of care, which is intravenous chemotherapy andradiation. The second group, to which Mrs. De Armas was assigned, receives thestandard treatment, plus the investigational intra-arterial therapy, which deliveredin 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 nowin a maintenance phase.

“Her performance status is excellent, the best possible, andshe’s having an excellent quality of life and enjoying her family and her dailyroutine,” reports Dr. Ucar.

“It was not a piece of cake,” Mrs. De Armas adds. “Buteveryone there has been great to me. I had my husband and my kids by my sideall 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 cleaningsomething in my kitchen and I was amazed because, before, I couldn’t even thinkabout 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 herwords, “They still need me a lot.”

The clinical trial is ongoing at Miami Cancer Institute andother sites in the U.S. and Europe, with the goal of proving the effectivenessof this intra-arterial chemotherapy approach in improving overall survival.

Dr. Gandhi sees many potential benefits for patientsparticipating in clinical trials.

“I think there are definitely misconceptions aboutclinical trials, but we have to remember that yesterday’s clinical trials aretoday’s standard of care,” Dr. Gandhi says. “I think that’s really critical. Oneof our primary drivers here is to institute new clinical trials to come up withnew 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.

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