Two Drugs Are Effective Against Rare Cancer Steve Jobs Had, Studies Find

Two oral cancer drugs -- Sutent from Pfizer (PFE) and Afinitor from Novartis (NVS) -- have been found to be effective against the rare form of pancreatic cancer that Apple (AAPL) CEO Steve Jobs was diagnosed with in 2004, according to a pair of studies published in the New England Journal of Medicine.

Pancreatic neuroendocrine tumors arise from endocrine cells of the pancreas and are quite unusual, representing just 1.3% of pancreatic cancer cases. In the U.S., there were an estimated 43,140 cases of pancreatic cancer in 2010, according to the National Cancer Institute.

But the incidence of pancreatic neuroendocrine tumors is increasing, researchers note, and the 5-year survival rate is below 43%. Meanwhile, there are limited number of effective treatment options.

Pfizer's Sutent and Novartis's Afinitor are both drugs used to treat kidney cancer. But studies conducted from 2007 to 2009 show that both more than doubled the time that patients lived without their pancreatic neuroendocrine tumors spreading.

For Afinitor, the median time patients lasted before their tumors spread was 11 months, as compared with 4.6 months for those taking a placebo. Nearly three-quarters of the patients in the placebo group crossed over and started taking Afinitor, making it hard for researchers to examine the drug's overall survival effect. Afinitor's most common side effect was stomatitis. Researchers concluded that Afinitor significantly prolonged progression-free survival.

For Sutent, the median time patients lasted before their tumors spread was 11.4 months, as compared with 5.5 months for those taking a placebo. Sutent also exhibited favorable overall survival effects and tumor response. Its most common side effects were diarrhea and nausea. Researchers concluded that taking Sutent resulted in clinically meaningful improvements in patients. The study was halted early because of ethical issues arising from more deaths and serious adverse events in the placebo group.

"These studies provide optimism regarding the treatment of malignant pancreatic neuroendocrine tumors because both drugs are effective at improving disease-free survival," authors of the accompanying NEJM editorial wrote. But there are still unanswered questions. Both drugs primarily stabilize, rather than cure, the disease, and its is unclear what the possible side effects from long-term use might be. These, they say, "make the optimism guarded."

Back in 2004, Jobs was diagnosed with pancreatic neuroendocrine cancer. He had surgery to remove the tumor and returned to work at the helm of the Cupertino, Calif.-based tech giant. In 2009, Jobs took a second medical leave of absence and underwent a liver transplant: The form of cancer he had most commonly metastasizes to the liver. According to Fortune, Jobs spent part of 2009 at a hospital in Basel, Switzerland, seeking treatment for neuroendocrine cancer. He returned to his post within six months.

In January, Jobs, 55, announced he was taking his third medical leave. He didn't say why.

"I heard from news that Steve Jobs may have been suffering or may still have this particular disease, although I don't know what stage," said Dr. Eric Raymond head of the Laboratoire de Pharmacobiologie des Anticancereux at the University of Paris, France, who led the research into Sutent with colleagues. "In any case, [Sutent] may be an option for [a] patient like him and it's offering hopes for prolonging [patients'] overall and disease-free survival without much affecting quality of life and social life ... I sincerely expect this may [help him] in living longer, keeping good and active life, as he demonstrated so far."


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