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Locally advanced pancreatic cancer

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https://www.readbyqxmd.com/read/28210843/updated-results-from-gest-study-a-randomized-three-arm-phase-iii-study-for-advanced-pancreatic-cancer
#1
Takuji Okusaka, H Miyakawa, H Fujii, S Nakamori, T Satoh, Y Hamamoto, T Ito, H Maguchi, S Matsumoto, H Ueno, T Ioka, N Boku, S Egawa, T Hatori, J Furuse, K Mizumoto, S Ohkawa, T Yamaguchi, K Yamao, A Funakoshi, J S Chen, A L Cheng, A Sato, Y Ohashi, M Tanaka
PURPOSE: The GEST study showed non-inferiority of S-1 but not superiority of gemcitabine plus S-1 (GS) to gemcitabine alone for overall survival with the data by the cut-off date of 31st July in 2010 for chemo-naïve patients with advanced pancreatic cancer. We considered it important to determine whether S-1 maintains non-inferiority after a long-term follow-up in the GEST study and to obtain a firm positive conclusion. In addition, it may be an interesting challenge to explore the efficacious profile of GS in the long-term follow-up study...
February 16, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28202004/a-phase-ii-study-to-evaluate-ly2603618-in-combination-with-gemcitabine-in-pancreatic-cancer-patients
#2
Berta Laquente, Jose Lopez-Martin, Donald Richards, Gerald Illerhaus, David Z Chang, George Kim, Philip Stella, Dirk Richel, Cezary Szcylik, Stefano Cascinu, G L Frassineti, Tudor Ciuleanu, Karla Hurt, Scott Hynes, Ji Lin, Aimee Bence Lin, Daniel Von Hoff, Emiliano Calvo
BACKGROUND: The aim of this study was to determine whether checkpoint kinase 1 inihibitor (CHK1), LY2603618, and gemcitabine prolong overall survival (OS) compared to gemcitabine alone in patients with unresectable pancreatic cancer. METHODS: Patients with Stage II-IV locally advanced or metastatic pancreatic cancer were randomized (2:1) to either 230 mg of LY2603618/1000 mg/m(2) gemcitabine combined or 1000 mg/m(2) gemcitabine alone. OS was assessed using both a Bayesian augment control model and traditional frequentist analysis for inference...
February 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28190636/correlation-of-18-f-fluorodeoxyglucose-positron-emission-tomography-parameters-with-patterns-of-disease-progression-in-locally-advanced-pancreatic-cancer-after-definitive-chemoradiotherapy
#3
J M Wilson, S Mukherjee, T B Brunner, M Partridge, M A Hawkins
AIMS: A proportion of patients with pancreatic cancer never develop metastatic disease. We evaluated a role for (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in identifying a subset of patients with locally advanced pancreatic cancer (LAPC) who never develop metastatic disease and only experience local disease and may therefore benefit from local treatment intensification. MATERIAL AND METHODS: Patients with histologically confirmed LAPC entered a single-centre phase II study of definitive upfront chemoradiotherapy (CRT)...
February 9, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28187107/irreversible-electroporation-for-locally-advanced-pancreatic-cancer-where-do-we-stand-in-2017
#4
Jean Pierre Tasu, Guillaume Vesselle, Guillaume Herpe, Jean Pierre Richer, Samy Boucecbi, Stéphane Vélasco, Bertrand Debeane, Michel Carretier, David Tougeron
Pancreatic adenocarcinoma has a very poor prognosis. Complete surgical resection remains the only current curative treatment. Locally advanced pancreatic cancers are considered as unresectable because of involvement of celiac and/or mesenteric vessels. Irreversible electroporation has recently been introduced to induce permanent cell death by apoptosis. Irreversible electroporation is a nonthermal cell-destruction technique that was claimed to allow destruction of cancerous cells with less damage to surrounding supporting connective tissues with collagenic structure (such as nearby blood vessels, biliary ducts, and nerves) than other types of treatment...
March 2017: Pancreas
https://www.readbyqxmd.com/read/28185295/irreversible-electroporation-for-the-ablation-of-pancreatic-malignancies-a-patient-specific-methodology
#5
Eduardo L Latouche, Michael B Sano, Melvin F Lorenzo, Rafael V Davalos, Robert C G Martin
BACKGROUND AND OBJECTIVES: Irreversible Electroporation (IRE) is a focal ablation technique highly attractive to surgical oncologists due to its non-thermal nature that allows for eradication of unresectable tumors in a minimally invasive procedure. In this study, our group sought to address the challenge of predicting the ablation volume with IRE for pancreatic procedures. METHODS: In compliance with HIPAA and hospital IRB approval, we established a pre-treatment planning methodology for IRE procedures in pancreas, which optimized treatment protocols for individual cases of locally advanced pancreatic cancer (LAPC)...
February 10, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28171697/eus-guided-tumor-ablation
#6
REVIEW
Sundeep Lakhtakia, Dong-Wan Seo
Real-time guidance of needle advancement has transformed Endoscopic Ultrasound from a diagnostic to an interventional procedure. EUS guided fine needle puncture has application in various interventional procedures (drainage of pseudocyst, biliary intervention, and injection of drugs). Celiac plexus or ganglion neurolysis for pain control is the major current EUS-guided fine-needle injection procedure. Feasibility and safety to accurately position needle devices and/or inject under real time EUS imaging with precise delivery of interventional agent have expanded the use of EUS to ablate tumor...
February 7, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28165150/everolimus-inhibits-growth-of-gemcitabine-resistant-pancreatic-cancer-cells-via-induction-of-caspase-dependent-apoptosis-and-g2-m-arrest
#7
Tao Peng, Q Ping Dou
Pancreatic cancer is the fourth leading cause of cancer-related death in the United States. While Gemcitabine-based chemotherapy is the first-line treatment for locally advanced pancreatic cancer, its resistance is a large obstacle in the field. Understanding the molecular basis of gemcitabine resistance is therefore critical for increasing the efficacy of gemcitabine-based chemotherapy and improving the survival rate of the cancer patients. Here, we investigated the sensitivity of a pair of established human pancreatic cancer cell lines, MIAPaCa-E (relatively sensitive to gemcitabine, called GS) and MIAPaCa-M (highly resistant to gemcitabine, called GR) to various inhibitors of EGFR or PI3K/AKT/mTOR pathways...
February 6, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28162818/efficacy-of-preoperative-immunonutrition-in-locally-advanced-pancreatic-cancer-undergoing-irreversible-electroporation-ire
#8
R C G Martin, S Agle, M Schlegel, T Hayat, C R Scoggins, K M McMasters, P Philips
BACKGROUND: Improved preoperative immunonutrition has been shown to decrease the length of stay (LOS) and complications among patients undergoing elective gastrointestinal cancer surgeries. The purpose of this study was to determine whether preoperative immunonutrition supplementation decreases postoperative LOS, infectious complications, and morbidity in patients undergoing irreversible electroporation (IRE) surgery for locally advanced pancreatic cancer (LAPC). METHODS: At a regional hepatopancreatobiliary referral center within an academic medical center 71 patients receiving IRE treatment of LAPC were included in the study...
January 19, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28161827/concurrent-chemotherapy-alone-versus-irreversible-electroporation-followed-by-chemotherapy-on-survival-in-patients-with-locally-advanced-pancreatic-cancer
#9
Giuseppe Belfiore, Maria Paola Belfiore, Alfonso Reginelli, Raffaella Capasso, Francesco Romano, Giovanni Pietro Ianniello, Salvatore Cappabianca, Luca Brunese
Pancreatic adenocarcinoma is one of the most fatal cancers, characterized by aggressive tumor growth and a short patient survival time between diagnosis and death. Safe and effective treatment options are limited, especially in cases when surgical resection is not possible. Irreversible electroporation (IRE) is a non-thermal ablation technique recently introduced in the treatment of pancreatic cancer. From 2013 to 2016, 29 cases of locally advanced pancreatic cancer (LAPC) treated with IRE were retrospectively analyzed and the median overall survival (OS) rates were compared with patients with the same diagnosis who received standard chemotherapy as reported in the literature...
March 2017: Medical Oncology
https://www.readbyqxmd.com/read/28160105/endoscopic-radiofrequency-ablation-of-the-pancreas
#10
REVIEW
Tarun Rustagi, Ankit Chhoda
Radiofrequency ablation (RFA) is a well-established technique to ablate dysplastic and neoplastic tissue via local thermal coagulative necrosis. Despite the widespread use in management of several cancers, the application of RFA in pancreas has been limited due to the increased risks of complications from the increased sensitivity of pancreatic tissue to thermal injury and proximity to vascular and biliary structures. RFA has been successfully used during laparotomy for locally advanced pancreatic carcinoma but requires an invasive approach...
February 3, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28156557/a-pilot-trial-of-early-specialty-palliative-care-for-patients-with-advanced-pancreatic-cancer-challenges-encountered-and-lessons-learned
#11
Nathan Bahary, Rene Claxton, Julie Childers, Dio Kavalieratos, Linda King, Barry C Lembersky, Seo Young Park, Greer A Tiver, Robert Arnold
: 110 Background: Palliative care trials face implementation barriers. We describe challenges encountered in a pilot trial of early specialty palliative care for patients with pancreatic cancer. METHODS: We conducted a mixed-methods pilot randomized controlled trial of early specialty physician-led palliative care in advanced pancreatic cancer. Recently diagnosed patients with borderline, locally-advanced, or metastatic pancreatic cancer and their caregivers (total N=60) were recruited from clinic at a comprehensive cancer center and randomized (2:1) to receive monthly specialty palliative care visits for 3 months in addition to standard oncology care vs...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144084/should-every-patient-with-pancreatic-cancer-receive-perioperative-neoadjuvant-therapy
#12
REVIEW
Ulrich Nitsche, Bo Kong, Alexander Balmert, Helmut Friess, Jörg Kleeff
Pancreatic ductal adenocarcinoma is a highly aggressive disease, and medical as well as surgical therapeutic options are limited. This article reviews stage dependent treatment options, with a special focus on the current controversy of perioperative treatment regimens in initially borderline resectable or locally advanced patients. Neoadjuvant treatment can potentially increase the rate of complete tumor resection and may be more effective than adjuvant systemic therapy. Further, in the case of disease progression during or after neoadjuvant therapy, patients can be spared extensive surgery...
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28139684/feasibility-of-alternating-induction-and-maintenance-chemotherapy-in-pancreatic-cancer
#13
Alexander Hann, Wolfram Bohle, Jan Egger, Wolfram Zoller
Chemotherapy regimens for pancreatic ductal adenocarcinoma (PDAC) have changed since the introduction of FOLFIRINOX. Due to toxicity, dosage and number of applied cycles are limited. In analogy to chemotherapy strategies in colon cancer we used a scheme of induction, maintenance and re-induction therapy in PDAC to alleviate such toxicities and increase the number of applied cycles. Here we report first experiences with this approach. Data of all patients who received FOLFIRINOX for metastatic or locally advanced PDAC in our center using induction chemotherapy followed by maintenance therapy from 2011 until November 2016 was collected and analyzed retrospectively...
January 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28134673/tolerability-and-long-term-outcomes-of-dose-painted-neoadjuvant-chemoradiation-to-regions-of-vessel-involvement-in-borderline-or-locally-advanced-pancreatic-cancer
#14
Jennifer Y Wo, Andrzej Niemierko, David P Ryan, Lawrence S Blaszkowsky, Jeffrey W Clark, Eunice L Kwak, Keith D Lillemoe, Lorraine N Drapek, Andrew X Zhu, Jill N Allen, Jason E Faris, Janet E Murphy, Ryan Nipp, Carlos Fernandez-Del Castillo, Cristina R Ferrone, Theodore S Hong
PURPOSE: We reviewed our experience involving patients with borderline resectable or locally advanced pancreatic cancer, treated with the dose-painted (DP) boost technique to regions of vessel involvement which preclude upfront surgical resection. We evaluated patient outcomes with respect to tolerability and treatment outcomes. MATERIALS AND METHODS: We retrospectively reviewed 99 patients with borderline resectable (n=25) or locally advanced pancreatic cancer (n=74) treated with DP-neoadjuvant chemoradiation from 2010 to 2015...
January 27, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28133225/-a-case-of-curative-resection-for-advanced-pancreatic-acinar-cell-carcinoma-with-liver-metastasis-and-involvement-of-the-superior-mesenteric-artery-after-chemoradiotherapy-following-systemic-chemotherapy
#15
Hiroko Toda, Hiroshi Kurahara, Kosei Maemura, Yuko Mataki, Yota Kawasaki, Masahiko Sakoda, Satoshi Iino, Shinichi Ueno, Hiroyuki Shinchi, Kanro Makisumi, Shoji Natsugoe
A 52-year-old man was initially diagnosed with an unresectable acinar cell carcinoma of the pancreas with liver metastasis and involvement of the superior mesenteric artery. After 5 courses of systemic chemotherapy(gemcitabine and S-1), the size of the pancreatic tumor had decreased from 31mm to 19mm and the liver metastasis had disappeared. We initiated chemoradiotherapy( CRT: S-1+56 Gy)for further local treatment. After CRT the size of the pancreatic tumor decreased to 13mm and his serum CA 19-9 level decreased from 677...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133224/-a-case-of-curatively-resected-locally-advanced-cancer-of-the-pancreatic-body-treated-by-distal-pancreatectomy-with-en-bloc-celiac-axis-resection-after-preoperative-intensive-treatment
#16
Yongkook Kim, Hiromitsu Hoshino, Naruyasu Kakita, Masaru Yamasaki, Yohei Hosoda, Masaya Nishino, Miho Okano, Junji Kawada, Masaki Okuyama, Toshimasa Tsujinaka
A 70-year-old woman with locally advanced pancreatic body cancer invading the celiac axis underwent 4 courses of preoperative chemotherapy consisting of gemcitabine(GEM)plus nab-paclitaxel(nab-PTX)on days 1, 8, and 15 every 4 weeks, followed by radiation therapy(CRT; 50.4Gy delivered in 28 daily fractions). The tumor size was greatly diminished and levels of all tumor markers were decreased. R0resection by distal pancreatectomy with en bloc celiac axis resection(DP-CAR)was performed. The histopathologic findings showed that the effect of CRT was grade 2b(Evans' classification), and the surgical margins were histologically clear...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133196/-a-case-of-remnant-pancreatic-cancer-after-pancreatoduodenectomy-successfully-treated-using-chemotherapy-and-carbon-ion-radiotherapy
#17
Tatsuhito Yamamoto, Kazuhisa Tokunou, Hisato Yamamoto, Ryoji Kamei, Yoshinori Kitamura, Seiichirou Ando
We report a case of remnant pancreatic cancer after pancreatoduodenectomy that was successfully treated using chemotherapy and carbon-ion radiotherapy. A 68-year-old woman received SSPPD for pancreatic head cancer. Gemcitabine(GEM) was administered for a year as postoperative chemotherapy. One year 8 months after surgery, abdominal CT showed a 20 mm solid mass in the stump of the remnant pancreas and dilation of the distal pancreatic duct. FDG-PET revealed a solitary tumor without any recurrence. We diagnosed the patient with a solitary recurrence of pancreatic cancer...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133097/-a-study-of-gemctabine-plus-nab-paclitaxel-therapy-for-advanced-local-progressive-pancreatic-cancer
#18
Yutaka Itoh, Hiroyuki Saito, Shunsuke Yamagishi, Yuki Suematsu, Miyuki Takahashi, Mao Nakayama, Michiko Fukabori, Akihiko Morita, Kazuhiko Wakabayashi
We studied the significance of gemcitabine plus nab-paclitaxel(GnP)therapy for locally progressive pancreatic cancer. We enrolled 10 patients with local progression without distant metastasis. We used GnP therapy for the ablative borderline resectable(BR)and unresectable(UR)cases based on images that followed NCCN pancreatic cancer treatment guidelines. In 1 case of resectable(R)pancreatic cancer, the tumor was located in the pancreas body but we determined that surgery was impossible because of the underlying disease detected on imaging analysis...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133090/-successful-treatment-of-local-recurrence-of-advanced-gastric-cancer-using-curative-gastrectomy-via-distal-pancreatectomy-after-chemoradiotherapy
#19
Kenji Sakai, Teruyuki Kobayashi, Masaya Higashiguchi, Takashi Doi, Taichi Koyama, Minako Hoshi, Hirokazu Taniguchi, Masakazu Murakami, Kimimasa Ikeda, Eiji Kurokawa, Itsuko Nakamichi
The patient was a 65-year-old woman. She was diagnosed with advanced gastric cancer with liver invasion. After receiving systemic chemotherapy(S-1 plus PTX)for 3 months, she underwent total gastrectomy and partial hepatectomy in May 2008. Because she developed celiac artery circumference lymph node recurrence in November 2010 during postoperative adjuvant chemotherapy consisting of S-1 plus PTX, we changed her chemotherapy regimen to CPT-11 plus CDDP. We observed an increase in the size of the lymph nodes in August 2013 and the response was poor even after switching to DOC...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28125024/interstitial-photodynamic-therapy-a-focused-review
#20
REVIEW
Gal Shafirstein, David Bellnier, Emily Oakley, Sasheen Hamilton, Mary Potasek, Karl Beeson, Evgueni Parilov
Multiple clinical studies have shown that interstitial photodynamic therapy (I-PDT) is a promising modality in the treatment of locally-advanced cancerous tumors. However, the utilization of I-PDT has been limited to several centers. The objective of this focused review is to highlight the different approaches employed to administer I-PDT with photosensitizers that are either approved or in clinical studies for the treatment of prostate cancer, pancreatic cancer, head and neck cancer, and brain cancer. Our review suggests that I-PDT is a promising treatment in patients with large-volume or thick tumors...
January 24, 2017: Cancers
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