{"id":32221,"date":"2020-06-01T16:39:23","date_gmt":"2020-06-01T22:39:23","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=32221"},"modified":"2021-09-07T20:06:47","modified_gmt":"2021-09-08T02:06:47","slug":"blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\/","title":{"rendered":"Can a blood pressure drug help fight pancreatic cancer?"},"content":{"rendered":"
<\/div>

Could a drug used by many people to control high blood pressure play a role in the fight against pancreatic cancer? That\u2019s the question posed by a study now underway at six clinical sites, including the University of Colorado Cancer Center<\/a> on the Anschutz Medical Campus<\/a>.<\/p>\n

The drug in question is losartan, a hypertension medication that lowers blood pressure by preventing blood vessels from narrowing. Animal studies over the past decade have shown that losartan could similarly help increase blood flow into cancerous tumors. That, in turn, might improve the delivery of cancer-fighting, tumor-shrinking chemotherapy drugs.<\/p>\n

\"man,
Tom Fattor with granddaughter Cata. Tom enrolled in a clinical trial at UCHealth that tests the effectiveness of a blood pressure drug to fight pancreatic cancer. Photo courtesy of Tom Fattor.<\/figcaption><\/figure>\n

Blood pressure drug to fight pancreatic cancer<\/strong><\/h3>\n

The target of the current study<\/a> is pancreatic cancer, and with good reason, said Dr. Wells Messersmith<\/a>, \u00a0head of the Division of Medical Oncology<\/a> at the University of Colorado School of Medicine<\/a>. Messersmith is the Cancer Center\u2019s principal investigator for the trial, which is sponsored by Massachusetts General Hospital.<\/p>\n

Messersmith noted that pancreatic tumors are typically rock hard because they are bolstered by stromal cells, the ones that produce connective tissue. The stromal cells help to make the tumors protective fortresses for the cancerous cells within.<\/p>\n

\u201cThe concern is that no matter what drugs we give, not much gets into the tumor,\u201d Messersmith said. He compared the problem to attempting to force a solid rock to absorb water. The trial investigates whether losartan could decrease that resistance and increase the volume of drugs penetrating the tumor and attacking cancer cells.<\/p>\n

Losartan as a multipronged attack<\/strong><\/h3>\n

Losartan is only one element of the randomized trial, which has four treatment arms. All patients receive a four-month regimen of FOLFIRINOX, which is a \u00a0combination of four chemotherapy drugs<\/a>; short-course precision radiation therapy<\/a> that spares healthy tissue; and surgery to remove the tumor and clean out any remaining cancer cells. The control arm gets no additional therapy. The experimental arms include patients who add losartan; patients who add nivolumab, an immunotherapy drug that targets cancer cells; and patients who add both losartan and nivolumab.<\/p>\n

The study\u2019s primary comparison is the percentage of patients in each group who have cancer-free margins of tissue around the surgically removed tumor.<\/p>\n

\"profile
Dr. Wells Messersmith leads the study at UCHealth. Photo by UCHealth.<\/figcaption><\/figure>\n

The sequence of the treatments is another important feature of the trial, Messersmith said. Patients with pancreatic cancer typically undergo surgery before getting chemotherapy and\/or radiation. But up to two-thirds of patients who have their pancreatic tumors cut out see their cancer recur, Messersmith said. That\u2019s because legions of rogue cells have spread undetected to other parts of the body.<\/p>\n

\u201cIf you have pancreatic cancer, the tumor itself won\u2019t kill you,\u201d Messersmith said. \u201cIt\u2019s the spread of it.\u201d<\/p>\n

The last shall be first in pancreatic cancer treatment<\/strong><\/h3>\n

With that in mind, the trial moves the chemotherapy treatment to the front of the line, followed by radiation to \u201csterilize the field\u201d before surgery, as Messersmith put it. \u201cThe idea is to address the killer as soon as you can instead of waiting until after surgery,\u201d he said. He noted patients may take two months to recover from surgery \u2013 a potentially dangerous window for remaining cancer cells to spread, if surgery is done first.<\/p>\n

The approach could also save some patients from unnecessary surgery, Messersmith added. For example, a patient who gets little or no help from the initial chemotherapy regimen has little chance of a cure, he said. \u201cFor that rare patient whose tumor spreads and grows despite chemo, we\u2019re probably sparing them from surgery that wasn\u2019t going to help them.\u201d<\/p>\n

The treatment sequence relies on the development of more effective chemotherapy drugs. FOLFIRINOX, first developed in France, nearly doubled survival<\/a> in patients with pancreatic cancer after surgery, Messersmith said. \u201cIt crosses the threshold of feeling comfortable delaying surgery until after chemotherapy. Without the proven efficacy of FOLFIRINOX, we wouldn\u2019t do the trial.\u201d<\/p>\n

Trial of blood pressure drug could yield helpful insight into pancreatic cancer treatment<\/strong><\/h3>\n

The trial, which received important funding assistance from <\/span>Wings of Hope for Pancreatic Cancer Research<\/a>, a local nonprofit that supports the Cancer Center\u2019s research, could show that the experimental treatments don\u2019t improve patient outcomes, Messersmith emphasized.\u00a0 <\/span><\/p>\n

\u201cWe have no idea if they will actually help or not,\u201d he said. Even a \u201cclear winner\u201d in a trial that aims to enroll 160 patients won\u2019t \u201ctotally answer the question\u201d of whether a particular treatment can be a proven pancreatic cancer fighter. It could, however, provide \u201cinitial signals that inform a larger, national trial\u201d that further tests the hypothesis, Messersmith said.<\/p>\n

He added that a randomized study from geographically and demographically diverse institutions that pits four different approaches against one another could yield valuable information, regardless of the direct data from the trial. For example, study researchers will analyze tissue samples from study patients, looking for patterns in those who do especially well or poorly after treatment and then seeking explanations. Tumor cells could also be used to grow miniature versions of tumors in petri dishes, allowing for testing of new drugs in a controlled environment.<\/p>\n

Subtle signals of pancreatic cancer<\/strong><\/h3>\n

Late last year, Tom Fattor, 78, from Broomfield, didn\u2019t think about the challenges of pancreatic cancer, much less consider joining a clinical trial. Although there is pancreatic cancer in his family, Fattor had never experienced any serious health issues. A certified public accountant by trade and self-described workaholic, Fattor cheerfully admits to sticking to a resolutely unhealthy diet over the years, invariably choosing hamburgers, hotdogs, popcorn, ice cream and beer over leafy green vegetables. You couldn\u2019t argue with the results, he said, noting his weight stayed at a consistent 160 pounds.<\/p>\n

\u201cI\u2019d go to my physician for my annual physical and he\u2019d come back and say, \u2018I don\u2019t know what you\u2019re doing, but keep it up,\u2019\u201d Fattor joked.<\/p>\n

His relative health and steady work routine helped him ignore a persistent pain below his stomach that began midway through 2019. The discomfort stretched from his left side to his right \u201clike a big old smile\u201d for a few months, Fattor said, but he shrugged it off.<\/p>\n

\u201cIf I get into my work, I really don\u2019t feel any physiologic signals,\u201d he said. As time went on, his wife, Kris, urged him to see a physician, but he didn\u2019t do it. \u201cI decided it was too vague,\u201d Fattor said. \u201cI told myself, \u2018You\u2019re 77. Get over it,\u2019.\u201d<\/p>\n

\"wife
Tom gets support from his wife Kris during the tough study treatment regimen, which is testing the effectiveness of a blood pressure drug to fight pancreatic cancer. Photo courtesy of Tom Fattor.<\/figcaption><\/figure>\n

A mass on the pancreas<\/strong><\/h3>\n

That changed in mid-November 2019. He was at a Denver Broncos game when pain that felt like a red-hot poker struck him between his stomach and ribs. He thought he was having a heart attack. With that, Kris convinced him to seek help at a local hospital, where he got imaging tests that revealed a mass on his pancreas.<\/p>\n

Given his family history, Fattor said he was well aware that he was a risk for cancer. Still, the news caught him off guard. He remembers feeling as if he left his body and watched the scene unfold from afar. The physician who delivered the news wasn\u2019t sure if it had registered with him.<\/p>\n

\u201cIt knocked me back pretty far,\u201d Fattor said.<\/p>\n

It turned out the tumor had closed his bile duct. He had surgery to implant a stent, which relieved the pain. Fattor stopped working for a month and a half as he made a series of physician and emergency room visits and took medications to manage his condition and the pain. Then he decided to take his life back.<\/p>\n

\u201cI figured they hadn\u2019t told me I was going to die right away, so I might as well go back to work,\u201d Fattor said. \u201cIt also gave me a chance to talk to people about having a life as well as a disease.\u201d<\/p>\n

Seeking expert cancer help from a high school friend<\/strong><\/h3>\n

Fattor also had an important conversation with a high school friend. Dr. Martin J. Murphy<\/a> and Fattor were classmates at the now-closed Abbey High School in Can\u00f5n City, Colorado. Fattor recalls accompanying Murphy to the school\u2019s biology lab and doing his homework while his friend built the groundwork for a distinguished career in cancer research. He\u2019s currently chief executive officer and co-founder of the CEO Roundtable on Cancer<\/a>, a non-profit devoted to spearheading cancer-fighting initiatives on multiple fronts.<\/p>\n

It turned out that Murphy knows Messersmith, and he let Fattor know about the losartan trial. Fattor said that while Murphy emphasized that the decision was completely personal, he urged him to consider enrolling in the trial at the Cancer Center. Fattor decided to do that and quickly got a referral from Kaiser Permanente. He was randomized to the losartan\/nivolumab arm, began his chemotherapy treatments in January and in early March was halfway through the regimen.<\/p>\n

The first round was especially rough, Fattor admitted, but with the second round, the Infusion Center gave him anti-anxiety and anti-nausea medications that have helped considerably. He also battled dehydration \u2013 he said he has had a hard time drinking water \u2013 but addresses that with intravenous fluids after each infusion.<\/p>\n

He\u2019s learning as he goes. \u201cAs a CPA, everything is process. I\u2019m pretty optimistic about the remaining [infusions].\u201d He added that he benefits emotionally from the upbeat professionalism of the Infusion Center staff.<\/p>\n

The challenge<\/strong>s of a clinical trial<\/strong><\/h3>\n

Messersmith said he and his team are sympathetic to the many challenges for patients considering participating in the trial. Some, for example, may not want to delay surgical treatment. The trial requires patients to travel to the Anschutz Medical Campus for treatment at UCHealth University of Colorado Hospital<\/a>. That\u2019s difficult for the significant number of patients who live well outside the Denver area.<\/p>\n

\u201cTraveling to campus every two weeks for chemo can be hard,\u201d Messersmith said. \u201cWe\u2019ll take care of you no matter what and we totally understand if you don\u2019t want to do this trial.\u201d<\/p>\n

Tom Fattor understands. He considered doing nothing after his diagnosis. \u201cI\u2019ve done everything I want to do in life,\u201d he said. Then he considered the older of his two granddaughters (now 14) and how much he\u2019d like to be there for her wedding someday. He thought of Martin Murphy\u2019s contributions to medical science and how much his longtime friend has done to help people. He understands that the trial promises nothing, but he decided nonetheless to move ahead.<\/p>\n

\u201cI thought that this is the right thing to do,\u201d Fattor said. \u201cMaybe it will help somebody.\u201d<\/p>\n

For more information on the trial, contact Wells Messersmith: <\/em>wells.messersmith@cuanschutz.edu<\/em><\/a>.<\/em><\/p>\n

\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Could a drug used by many people to control high blood pressure play a role in the fight against pancreatic cancer? That\u2019s the question posed by a study now underway at six clinical sites, including the University of Colorado Cancer Center on the Anschutz Medical Campus. The drug in question is losartan, a hypertension medication […]<\/p>\n","protected":false},"author":2143,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[28,49,167],"class_list":["post-32221","post","type-post","status-publish","format-standard","hentry","category-innovative-care","tag-cancer-care-oncology","tag-cancer-treatment","tag-clinical-trials"],"acf":[],"yoast_head":"\nCan a blood pressure drug help fight pancreatic cancer? - UCHealth Today<\/title>\n<meta name=\"description\" content=\"A nationwide trial underway at six clinical sites, including at UCHealth, tests the effectiveness of a blood pressure drug to help fight pancreatic cancer.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Can a blood pressure drug help fight pancreatic cancer?\" \/>\n<meta property=\"og:description\" content=\"A nationwide trial underway at six clinical sites, including at UCHealth, tests the effectiveness of a blood pressure drug to help fight pancreatic cancer.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.uchealth.org\/today\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\/\" \/>\n<meta property=\"og:site_name\" content=\"UCHealth Today\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/uchealthorg\/\" \/>\n<meta property=\"article:published_time\" content=\"2020-06-01T22:39:23+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-09-08T02:06:47+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.uchealth.org\/today\/wp-content\/uploads\/sites\/6\/2020\/06\/Losartan-Trial-1-Tom-Fattor-and-Cata-tiny.jpg\" \/>\n<meta name=\"author\" content=\"Tyler Smith\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@uchealth\" \/>\n<meta name=\"twitter:site\" content=\"@uchealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Tyler Smith\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"9 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\\\/\"},\"author\":{\"name\":\"Tyler Smith\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/person\\\/98c85c0e40c4933eedcec2cd054f349d\"},\"headline\":\"Can a blood pressure drug help fight pancreatic cancer?\",\"datePublished\":\"2020-06-01T22:39:23+00:00\",\"dateModified\":\"2021-09-08T02:06:47+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\\\/\"},\"wordCount\":1860,\"publisher\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2020\\\/06\\\/Losartan-Trial-1-Tom-Fattor-and-Cata-tiny.jpg\",\"keywords\":[\"Cancer care\",\"Cancer treatment\",\"Clinical trials\"],\"articleSection\":[\"Innovative care\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\\\/\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/blood-pressure-drug-to-fight-pancreatic-cancer-trial-underway\\\/\",\"name\":\"Can a blood pressure drug help fight pancreatic cancer? 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