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Comparing our pancreatic cancer treatment with placebos

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Experimentally treating pancreatic cancer patients
James Black Scientist
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So this now led us into pancreatic cancer, apparently. In the foetal stage pancreatic tissue expresses gastrin receptors, then in the mature animal it doesn’t. But when the cancer phenotype develops it goes back to the more primitive stage and makes gastrin receptors, and so every time you eat, you’re stimulating this tumour with your elevated gastrin levels. And so, I remember we had a meeting in this room here with- At Kings College, we had one of the best liver units in the country, and a very common presentation to that liver unit are people with jaundice, they had no other symptoms, they just started to go yellow, and when they investigate them they find that they have a tumour in the head of the pancreas which presses on the bile duct and inhibits the release and so they get jaundiced. So, this is a subgroup of patients with pancreatic cancer who present with jaundice. Now, these tumours are all in the head of the pancreas, and usually that’s the first sign, so they haven’t lost their appetite or anything, so they’re, it’s fairly early in the lifecycle. Now, pancreatic cancer is called the dismal disease. Your life expectancy from diagnosis, for whatever reason, to death was a median survival of about 100 days, about three months. Now that meant that we got this, these characters down there from the liver unit and they said, well, you know, these tumours will double in size in about four weeks; we had four weeks’ toxicology. So, we set up a study and it was a study set up under something which no longer exists called the DDX Scheme, the Doctors and Dentists Exemption Scheme, which allowed a doctor to prescribe anything he wished for his patients, so we, he could do this study on his own recognisance. And, so we did that for four weeks, and after five patients it was plain that these tumours were not doubling in size in four weeks, but some of these patients had felt better. Their appetite had, one of the earliest signs is they lose appetite, and they put on weight in that, even in that four-week period. So, he, clinically, decided just to keep them on. So the net result is we had a group of patients who had a line in this subclavian vein and a pump round their waist and who were coming into Kings College twice a week to have the syringes changed, and they formed a little support group, chatting to each other. And, there were two research nurses that befriended them and looked after their ingrown toenail and every thing, so tremendous tender, loving care going on in this environment.

The late Scottish pharmacologist Sir James W Black (1924-2010) revolutionised medical treatment of hypertension and angina with his invention of propranolol, the first ever beta blocker. This and his synthesis of cimetidine, used for the treatment of peptic ulcers, earned him the Nobel Prize in Physiology or Medicine in 1988.

Listeners: William Duncan

After graduating with a BSc Bill Duncan went on to gain a PhD from Edinburgh University in 1956. He joined the Pharmaceuticals Division of ICI where he contributed to the development of a number of drugs. In 1958, he started a collaboration with Jim Black working on beta blockers and left ICI with him in 1963 to join the Research Institute of Smith Kline & French as Head of Biochemistry. He collaborated closely with Black on the H2 antagonist programme and this work continued when, in 1968, Duncan was appointed the Director of the Research Institute. In 1979, he moved back to ICI as Deputy Chairman (Technical), a post he occupied until 1986 when he became Chairman and CEO of Coopers Animal Health. He ‘retired’ in 1989 but his retirement was short-lived and he held a number of directorships in venture capital backed companies. One of his part-time activities was membership of the Bioscience Advisory Board of Johnson and Johnson who asked him to become Chairman of the Pharmaceutical Research Institute of Johnson and Johnson in New Jersey. For personal reasons he returned to the UK in 1999, but was retained by Johnson and Johnson until 2006 in a number of senior position in R&D working from the UK. From 1999 to 2007 he was a non-executive director of the James Black Foundation. He is now fully retired.

Tags: King's College London

Duration: 3 minutes, 23 seconds

Date story recorded: August 2006

Date story went live: 02 June 2008