Ruxolitinib Plus Capecitabine Improves Survival in Metastatic Pancreatic Cancer Patients with Local and Systemic Inflammation

Posted on June 2nd, 2014 by

In a study presented at the 2014 ASCO meeting and published in the Journal of Clinical Oncology, researchers reported that treatment with ruxolitinib plus capecitabine improved overall survival and progression-free survival in metastatic pancreatic cancer patients with local and systemic inflammation (INFL).

INFL is a common marker of cancer that is associated with adverse prognoses in pancreatic cancer. The JAK-STAT pathway—instrumental in inflammation—is a chemical signaling system that transmits chemical information from outside the cell to effect DNA activity inside the cell. Researchers in this study were interested in exploring whether the drug ruxolitinib, which comprises enzymes that inhibit the JAK-STAT pathway, would improve overall survival and progression-free survival.

One hundred twenty-seven metastatic pancreatic cancer patients who had progressed after gemcitabine treatment were recruited for this study. One cohort of 64 was given capecitabine plus ruxolitinib, while a second group of 63 was given capecitabine plus a placebo. The primary endpoint was overall survival; secondary endpoints were progression-free survival and overall response rate.

The overall response rate (ORR) for the combination therapy group (RUX) was 7.8%, as compared to 0% for the placebo group. In the randomized population, overall survival (OS) and progression-free survival (PFS) also favored the RUX group.

Patients with INFL showed a significant benefit from RUX: 3-month survival for the RUX group was 48%, while that of the placebo group was 29%. The corresponding results for 6-month survival were 42% and 11%. In patients without INFL, there was no significant benefits observed.

Overall, the regimen of ruxolitinib and capecitabine was well tolerated by the patients.

Reference: Herbert et alA randomized double blind phase 2 study of ruxolitinib or placebo with capecitabine as second-line therapy in patients with metastatic pancreatic cancer. Presented at the 2014 ASCO Meeting. J Clin Oncol 32:5s, 2014 (suppl; abstr 4000).

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