Image by Getty Images via @daylife
There’s endless debate in the blogosphere about whether Apple should disclose more details about Steve Jobs’ illness. I think the whole debate is silly because statistics for this type of rare cancer are limited, and are likely to be of poor predictive value for an individual. The Apple honcho has advanced cancer. The symptoms require him to take medical leave. What more do people need to know?
Amidst all the doom and gloom, here’s some good news for Steve Jobs: treatment for the type of cancer he has is improving rapidly. it is a rare type of cancer called pancreatic neuroendocrine tumor that afflicts the hormone producing islet cells in the pancreas. there have been precious few treatments–until now.
“This is a field where major advances are being made,” says M.D. Anderson Cancer Center oncologist James Yao. “The options [for patients] are increasing.”
Two new targeted drugs can dramatically slow the growth of the disease, according to trials presented this year. Both are used now for kidney cancer, but have shown powerful promise in delaying the growth of nasty neuroendocrine tumors.
Novartis’ drug Afinitor more than doubled the time neuroendocrine patients survived without the disease progressing, to 11 months from 4.6 months, according to results of a big trial presented by Dr. Yao in Barcelona this summer. The effect was highly statistically significant. The drug works by hitting a key growth-promoting node involved in cell growth called mTOR that may go out of control in neuroendocrine cancers. Novartis is applying for regulatory approval based on the result.
A second drug that has shown similar promising results is Pfizer’s Sutent kidney cancer drug. Pfizer recently snagged European approval for the drug in treating the pancreatic tumors and said it was applying for U.S. approval.
What about getting a liver transplant as a treatment for neuroendocrine tumor that has spread, as Mr. Jobs appears to have had? it is nonstandard treatment, says Dr. Yao, and there are not reliable statistics on how well it works. Yet what little data we have indicate that the odds of long term survival after such a transplant are substantial.
For what it is worth, recently published German study looked at 69 such patients who had received liver transplants as treatments for advanced pancreatic neuroendorine tumors. 44% survived five years, and and even better 60% of patients who were younger and had other favorable prognostic factors survived five years. Like all cancer survival statistics, these numbers are historical and backwards looking. The odds may very well have improved since then.
That’s not to say Mr. Jobs doesn’t have a very serious disease. He does. The good news for him is that prospects for patients like him are on the upswing.