Maintenance chemo

[WifeampMum]

Hi everyone

I'm posting this in response to Jeni's comment on another thread today, that there's no evidence on the efficacy of maintenance chemo.

From my limited reading on this topic I think there may be growing evidence that maintenance chemo works for some.

For example, 3 articles (published 2015) about maintenance chemo for stage 4 disease:

http://hwmaint.meeting.ascopubs.org/cgi/content/abstract/33/15_suppl/4120

http://www.hindawi.com/journals/crionm/2015/659624/abs/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408451/

And here's a 2014 article about maintenance chemo for resected PC:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171974/

[Ruthus]

Wow Wife and Mum, I am very impressed with your research and knowledge, I think it's great. I've not had chance to read the articles as yet but I will later. My understanding is that in terms of research it takes time to build up evidence and will start with randomised control studies and then the more evidence which is gained this moves to meta studies (which collates all studies). I would see this as positive in that Folfirinox chemotherapy is still relatively new and maintenance chemo also new, so it will take time to gain results and build up data and evidence, so hopefully this may lead to more positive outcomes being found. It might be we just don't know that yet as data and outcomes still in process!

[Didge]

I was interested in the article about maintenance chemo for resected PC - my partner couldn't tolerate capecitabine unfortunately but the difference in survival length and length of time before recurrence seems huge so it looks the way to go. I always thought it seemed ridiculous with something as aggressive as PC to say 'ok, you seem well right now so we're going to do nothing until it comes back!'

[WifeampMum]

Ruthus

Thanks! We all have our coping strategies - mine are eating chocolate and searching the medical literature for recent PC studies. My husband has never been much of a reader so I do the reading and then share the positive stuff that I've found. I focus on scholarly articles, PC forum postings (UK and US based) and online news stories, spending probably 1-2 hours per day on it. Oddly I find it quite therapeutic and as they say, knowledge is power.

I also think that in a few years time there will be lots of positive data published about Folfirinox and maintenance chemo.

xx

[WifeampMum]

Didge,

I totally agree, doing nothing until PC recurs seems like a recipe for disaster. This approach may have been justified in the pre-Folfirinox, pre-Abraxane era, but not any more.

The doctors in the US seem to get this; I worry that the doctors in the UK don't.

[PCUK Nurse Jeni]

Thanks a lot for these, wife & mum.

Great to see these & certainly one for the way forward, hopefully.

There is scope for some patients/families to attend some of the upcoming Pancreatic Conferences, and an ideal place to pose these questions. I also wonder if something like this would be good to consider for the new NICE guidelines? Food for thought.

Link to conferences:

http://www.pancreaticcancer.org.uk/search?q=conferences

Thanks again for researching these. I personally think its definitely worth trying in practice, or at least having a clinical trial comparing it to intermittent chemo.

Jeni.