Vaccine in University Hospitals clinical trial offers flutter of hope against deadly pancreatic cancer

By Robert Higgs
April 07, 2009, 6:45AM

Patrick Swayze has it.

Supreme Court Justice Ruth Bader Ginsburg has it.

Myles Brand, president of the National Collegiate Athletic Association, has it.

And Sara Kubankin of Salem, Ohio, has it, too.

Last summer, after weeks of battling terrible nausea, constant fevers and fatigue so extreme that it was slowing her at her job as a postal carrier, Kubankin found out that she had Stage II-B pancreatic ductal adenocarcinoma-- cancer of the pancreas. A CT scan and blood test helped uncover the disease.

At 40, Kubankin is decades younger than typical patients.

Pancreatic cancer, the fourth-leading cause of cancer death in the United States, is more visible than ever with each new diagnosis of a high-profile person. Yet very little progress has been made in the survival rate during the past 20 years; less than 5 percent of people diagnosed with pancreatic cancer survive five years.

In September, surgeons at University Hospitals Case Medical Center removed a cancerous tumor from Kubankin's pancreas. Today, there is no evidence of cancer, but the prognosis Kubankin received when she was diagnosed -- just 16 to 20 months to live -- has not changed. That's the average amount of time that people with her medical condition have lived beyond their diagnosis.

It's likely that there are cancerous cells in Kubankin that aren't easily detected, said Dr. Jeffrey Hardacre, Kubankin's surgeon.

Even with almost six months' worth of chemotherapy and radiation treatments (she'll finish up chemo at the end of the month), long-term survival is probably not in the cards.

When she got the news, Kubankin was shocked and scared.

" 'Dang, lie or something!' " she recalled telling Hardacre at one point. But she has since accepted it, for the most part.

"For a while, I was stuck on two years," she said, referring to the best-case scenario for her survival, which would rob her of a long life with her husband, Victor, and their blended family of three children and four grandchildren.

Now Kubankin tries not to dwell on the length of time doctors say she has left.

Instead, she focuses on spending time with friends and family, many who have stuck by her side during her ordeal.

After her diagnosis, and before her surgery, Kubankin traveled to Salamanca, N.Y., with her husband and mother for a quick gambling getaway. The threesome went through a thousand bucks and didn't win anything.

She hopes that a clinical trial she joined in October at UH's Ireland Cancer Center will give her better odds at fighting the cancer.

Kubankin is the first patient at UH to enroll in the study, which is testing a vaccine designed to strengthen a patient's immune system. Since the beginning of March, two others -- a 75-year-old man and a 68-year-old man -- also have begun getting the vaccine shots at UH.

UH is one of eight sites in seven states with the clinical trial, the goal of which is to stimulate a patient's immune system so that it can more effectively fight the cancer -- and give patients like Kubankin more time to live.

Hardacre said national study coordinators hope to enroll 70 patients, with plans to eventually broaden the size of the study.

"What we're trying to do is attack cancer from another angle," Hardacre said. "Pancreatic cancer cells are not as sensitive to chemotherapy and radiation therapy as are other kinds of cancer cells."

Since October, Kubankin regularly has made the 90-minute trip back and forth from her home to UH for treatments, including the vaccine, which she started receiving six weeks after her surgery.

The first set of shots "hurt so bad, like a bumblebee sting, times 1000," she said. The shots are still painful -- she'll have had 14 sets, six shots in each set, over the course of the trial-- but not as much as that first time.

"I have no other option," Kubankin said as she received chemo before getting another round of the vaccine shots. "It's a really hard cancer to fight."

Kubankin's cancer is the deadliest and the most common type of pancreatic cancer, accounting for roughly 90 percent of the cases.

But her cancer was caught relatively early, which made surgery -- the only hope for long-term survival and a potential cure -- an option.

Actor Patrick Swayze, on the other hand, was diagnosed at a more advanced stage, when his cancer already had spread to his liver. Since his diagnosis in March 2008, his treatment has included aggressive chemotherapy and vatalanib, an experimental drug, but no surgery.

People diagnosed with pancreatic endocrine tumors, such as Apple Inc. founder and CEO Steve Jobs, who was diagnosed in 2004, have a much better prognosis. That type of cancer grows more slowly and tends to spread later, if at all.

Kubankin is fighting on. With just three more chemo sessions and two more sets of vaccine shots, Kubankin said last week: "I see a light at the end of the tunnel. Finally!"

She will still need CT scans and blood work every three to four months to see if her cancer recurs.

"It [the study] may not help me, but maybe it will help a lot of people in the future," she said.