The prognosis for patients with unresectable pancreatic cancer is very poor.
The 1-year survival rate is less than 10%, and the 5-year survival rate is 5%.
The current fist line therapy is gemcitabine, but recently a new class of chemotherapy treatments has developed - the matrix metalloproteinase inhibitors. Marimastat is the first of these new agents to be studied.
Dr S Bramhall, of the Queen Elizabeth Hospital in Birmingham, England, and colleagues compared the efficacy of marimastat with gemcitabine.
The primary end-point of the study was survival, but patient benefit and safety were also considered.
414 patients were randomized to receive either marimastat 5, 10, or 25 mg twice daily or gemcitabine.
1-year survival rates were 14%, 14%, 20% and 19% respectively.
There was a significant difference in survival rates between marimastat at the two lower doses and gemcitabine.
However, 25 mg marimastat given twice daily was equally as successful as gemcitabine.
Importantly, marimastat seemed to be better tolerated than gemcitabine. Grade 3 or 4 toxicities were reported in 22% of patients treated with gemcitabine, compared with only 12% of patients receiving the new treatment.
Dr Bramhall concludes, "The 1-year survival rate for patients receiving marimastat 25 mg was similar to that of patients receiving gemcitabine.
"In view of the manageable tolerability of marimastat and its ease of administration, further studies are warranted."