Executive summary
* This note was inspired by last week’s review of a gamechanger drug (daraxonrasib) for pancreatic cancer. Daraxonrasib was tested against chemotherapy. Median survival times were 13.2 months with daraxonrasib and 6.7 months with chemotherapy.
* The high incidence of serious adverse effects raised the question, were the extra months a gift of life quality or just more time for pancreatic cancer to be endured?
* Last week’s review made me think that, if I were diagnosed with something as brutal as pancreatic cancer, I would like to know what will happen if I do nothing instead of doing chemotherapy.
* Once a standard of care (SOC) treatment has been established, any new treatment is measured against the SOC. The SOC in pancreatic cancer is chemotherapy.
* I thought for chemotherapy to have been established as the SOC, it must have been trialled against ‘do nothing’ at some stage – to establish the survival time and adverse effects of doing something vs doing nothing. I was wrong.
* This note goes through the history of pancreatic cancer treatment generally (back to 1942 and then the 1950s) and a drug called 5-FU specifically. Drugs used for pancreatic cancer are used for other cancers, so this research has wider applicability.
* I was shocked by the lack of evidence for 5-FU, which has been used for 70 years and is used for many cancers today. It wasn’t tested against do nothing. It wasn’t tested for survival time. This note details the trials that were done for 5-FU and successive chemotherapy drugs.
Zoe
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