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      Microencapsulated cell-mediated treatment of inoperable pancreatic carcinoma.

      Lancet
      Adenocarcinoma, diagnosis, mortality, therapy, Adult, Aged, Aged, 80 and over, Cell Transplantation, methods, Cytochrome P-450 CYP2B1, metabolism, Dose-Response Relationship, Drug, Drug Compounding, Drug Delivery Systems, Female, Follow-Up Studies, Genetic Therapy, Humans, Ifosfamide, administration & dosage, Male, Middle Aged, Palliative Care, Pancreatic Neoplasms, Survival Rate, Terminally Ill, Transfection, Transplantation, Homologous, Treatment Outcome

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          Abstract

          Pancreatic cancer can seldom be resected, and chemotherapy has only a limited effect on survival or tumour load. We did a phase I/II trial in 14 patients with pancreatic cancer to assess the safety of local activation of low-dose ifosfamide. We encapsulated genetically modified allogeneic cells, which expressed a cytochrome P450 enzyme, in cellulose sulphate and delivered them by supraselective angiography to the tumour vasculature. These cells locally activated systemically administered ifosfamide. The tumours of four patients regressed after treatment, and those of the other ten individuals who completed the study remained stable. Median survival was doubled in the treatment group by comparison with historic controls, and 1-year survival rate was three times better. Further studies of this cell-therapy-based treatment combined with chemotherapy for inoperable pancreatic cancer are warranted.

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