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Locally advanced pancreatic cancer

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https://www.readbyqxmd.com/read/28912804/assessment-of-nutritional-status-digestion-and-absorption-and-quality-of-life-in-patients-with-locally-advanced-pancreatic-cancer
#1
J E Witvliet-van Nierop, C M Lochtenberg-Potjes, N J Wierdsma, H J Scheffer, G Kazemier, K Ottens-Oussoren, M R Meijerink, M A E de van der Schueren
BACKGROUND AND AIM: To provide a comprehensive quantitative assessment of nutritional status, digestion and absorption, and quality of life (QoL) in patients with locally advanced pancreatic cancer (LAPC). METHODS: Sixteen patients with LAPC were prospectively assessed for weight loss (WL), body mass index (BMI), fat-free mass index (FFMI), handgrip strength (HGS), dietary macronutrient intake, serum vitamin levels, resting and total energy expenditure (REE and TEE, indirect calorimetry), intestinal absorption capacity and fecal losses (bomb calorimetry), exocrine pancreatic function (fecal elastase-1 (FE1)), and gastrointestinal quality of life (GIQLI)...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28904399/semaphorin-3%C3%A2-c-drives-epithelial-to-mesenchymal-transition-invasiveness-and-stem-like-characteristics-in-prostate-cells
#2
Kevin J Tam, Daniel H F Hui, Wilson W Lee, Mingshu Dong, Tabitha Tombe, Ivy Z F Jiao, Shahram Khosravi, Ario Takeuchi, James W Peacock, Larissa Ivanova, Igor Moskalev, Martin E Gleave, Ralph Buttyan, Michael E Cox, Christopher J Ong
Prostate cancer (PCa) is among the most commonly-occurring cancers worldwide and a leader in cancer-related deaths. Local non-invasive PCa is highly treatable but limited treatment options exist for those with locally-advanced and metastatic forms of the disease underscoring the need to identify mechanisms mediating PCa progression. The semaphorins are a large grouping of membrane-associated or secreted signalling proteins whose normal roles reside in embryogenesis and neuronal development. In this context, semaphorins help establish chemotactic gradients and direct cell movement...
September 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28895032/resection-of-locally-advanced-pancreatic-cancer-without-regression-of-arterial-encasement-after-modern-era-neoadjuvant-therapy
#3
Michael D Kluger, M Farzan Rashid, Vilma L Rosario, Beth A Schrope, Jonathan A Steinman, Elizabeth M Hecht, John A Chabot
INTRODUCTION: Modern-era systemic therapy for locally advanced pancreatic adenocarcinoma (LAPC) offers improved survival relative to historical regimens but not necessarily improved radiographic downstaging to allow more patients to undergo resection. The aim of this study was to evaluate the survival, progression, and pathologic outcomes after resection of LAPC that did not regress from > 180 degrees arterial encasement after neoadjuvant therapy. METHODS: Sixty-one LAPC patients were brought to the operating room after neoadjuvant therapy for NCCN-defined unresectable pancreatic cancer between 2012 and 2017...
September 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28890823/does-lymphocyte-to-monocyte-ratio-before-during-or-after-definitive-chemoradiation-for-locally-advanced-pancreatic-cancer-predict-for-clinical-outcomes
#4
Irene Giacomelli, Daniele Scartoni, Homan Mohammadi, William F Regine, Michael D Chuong
BACKGROUND: Elevated pre-treatment lymphocyte (L) to monocyte (M) ratio (LMR) in peripheral blood has been suggested to correlate with improved survival in some malignancies, but data in the context of pancreatic cancer (PC) is limited. The aim of this study was to evaluate the prognostic significance of LMR before, during and after definitive chemoradiotherapy (CRT) for locally advanced pancreatic cancer (LAPC). METHODS: We retrospectively reviewed 57 patients with LAPC treated with definitive CRT at a single institution from 2005 to 2013...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28890819/the-role-of-induction-chemotherapy-chemoradiotherapy-in-localised-pancreatic-cancer-initial-experience-in-scotland
#5
Derek Grose, David McIntosh, Nigel Jamieson, Ross Carter, Euan Dickson, David Chang, Husam Marashi, Christina Wilson, Mohammed Alfayez, Ashleigh Kerr, Roisin O'Donoghue, Lea Haskins, Fraser Duthie, Colin J McKay, Janet Graham
BACKGROUND: Despite being relatively rare pancreatic cancer is one of the highest causes of death. Even within the potentially resectable group outcomes are poor. We present our initial experiences utilising a neoadjuvant approach to localised pancreatic cancer, evaluating survival, response rates and tolerability. METHODS: This was a retrospective analysis of a prospectively maintained database. Patients from 2012 to 2015 referred to a busy regional Hepato-Pancreatic Biliary (HPB) MDT were included...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28888554/how-to-treat-pancreatic-adenocarcinoma-in-elderly-how-far-can-we-go-in-2017
#6
REVIEW
Marine Gilabert, Jean Luc Raoul, Frederique Rousseau
Pancreatic adenocarcinoma is one of the most fatal cancers that frequently affects older patients. Limited data suggest that older patients are as likely to benefit from surgery, radiation, and chemotherapy as younger patients. The only potentially curative approach for pancreatic cancer is surgery but this is only performed in less than 20% of patients considered resectable. With improvements in surgical techniques, older patients without major comorbidities show a course of disease after resection similar to that of younger patients...
September 6, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28886941/should-functional-renal-scans-be-obtained-prior-to-upper-abdominal-imrt-for-pancreatic-cancer
#7
Grace C Blitzer, William A Hall, Susan Tsai, Mohammed Aldakkak, Robert S Hellman, Douglas B Evans, Kathleen K Christians, Ben George, Paul S Ritch, Beth A Erickson
BACKGROUND: Upper abdominal irradiation for pancreatic cancer is administered in close proximity to the radiation-sensitive kidneys. There is difficulty in defining dose-volume parameters to predict late renal toxicity after partial kidney irradiation. Less than 10% of the general population is estimated to have asymmetrical kidney function; however, there are no studies that examine this in patients with pancreatic cancer. The primary purpose of this study was to determine the prevalence of asymmetrical kidney function in patients with pancreatic cancer...
June 29, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28881737/galeterone-and-its-analogs-inhibit-mnk-eif4e-axis-synergize-with-gemcitabine-impede-pancreatic-cancer-cell-migration-invasion-and-proliferation-and-inhibit-tumor-growth-in-mice
#8
Andrew K Kwegyir-Afful, Francis N Murigi, Puranik Purushottamachar, Vidya P Ramamurthy, Marlena S Martin, Vincent C O Njar
Survival rate for pancreatic cancer (pancreatic ductal adenocarcinoma, PDAC) is poor, with about 80% of patients presenting with the metastatic disease. Gemcitabine, the standard chemotherapeutic agent for locally advanced and metastatic PDAC has limited efficacy, attributed to innate/acquired resistance and activation of pro-survival pathways. The Mnk1/2-eIF4E and NF-κB signaling pathways are implicated in PDAC disease progression/metastasis and also associated with gemcitabine-induced resistance in PDAC...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28877836/efficacy-of-gemcitabine-and-s-1-for-patients-with-advanced-pancreatic-cancer
#9
Yue-Juan Cheng, Chang-Ting Meng, Ya-Juan Shao, Ning-Ning Li, Na Zhou, Xiao-Yan Yan, Xin Gao, Jian-Feng Zhou, Chun-Mei Bai
Objective To explore the efficacy and toxicities of gemcitabine combined with S-1 in treating locally advanced and metastatic pancreatic ductal adenocarcinoma and prognostic factors. Methods We retrospectively analyzed the clinical data of patients with locally advanced and metastatic pancreatic cancer receiving gemcitabine and S-1 as first-line therapy in the Department of Medical Oncology,Peking Union Medical College Hospital from January 2014 to January 2017.Gemcitabine was administered at a dose of 1000 mg/m(2) over 30 min-utes on days 1 and 8,and oral S-1 at a dose of 40-60 mg twice daily from days 1 to 14,repeated every 3 weeks...
August 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28867179/rage-maintains-high-levels-of-nf%C3%AE%C2%BAb-and-oncogenic-kras-activity-in-pancreatic-cancer
#10
Nancy Azizan, Melissa A Suter, Yan Liu, Craig D Logsdon
Oncogenic KRas activity is central to several cancer types including pancreatic ductal adenocarcinoma (PDAC) but has been determined to be "undruggable". Recent studies have indicated that oncogenic KRas is not constitutively active but relies on a feed-forward stimulatory mechanism involving NFκB mediated inflammation. In the current study, we investigated the role of the receptor for advanced glycation end-products (RAGE) in maintaining oncogenic signaling in PDAC. We observed that there was a shift in the levels of specific RAGE isoforms and altered cellular localization in PDAC...
August 31, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28838632/the-triangle-operation-radical-surgery-after-neoadjuvant-treatment-for-advanced-pancreatic-cancer-a-single-arm-observational-study
#11
Thilo Hackert, Oliver Strobel, Christoph W Michalski, André L Mihaljevic, Arianeb Mehrabi, Beat Müller-Stich, Christoph Berchtold, Alexis Ulrich, Markus W Büchler
BACKGROUND: Neoadjuvant therapy is an important strategy for locally advanced pancreatic cancer (PDAC) as resection rates increase with modern chemotherapy regimens even in patients with arterial tumor encasement. The aim of this study is the description of technique and initial outcomes of a new type of radical and arterial-sparing resection after neoadjuvant treatment for locally advanced PDAC. METHODS: The surgical technique and perioperative results of a new type of operation are described, comprising radical tumor removal by sharp dissection along the celiac axis and the superior mesenteric artery with complete dissection of all soft tissue between both - arteries and superior mesenteric/portal vein (TRIANGLE operation)...
August 21, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28836239/-reconsideration-of-hot-topics-on-laparoscopic-radical-gastrectomy
#12
Lu Zang, Junjun Ma, Minhua Zheng
Laparoscopic radical gastrectomy(LRG) has been popularized with the development of laparoscopic surgical techniques. As a result of the requirement of surgical skill of LRG, the evidence is always highly demanded. The surgical safety and radical resection of tumor is one of the most important principles. Based on published studies and authors' own experience, this article discusses the following topics on laparoscopic gastrectomy: (1)Indications of surgery: Laparoscopic gastrectomy for early gastric cancer is accepted all over the world...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28835777/current-status-on-the-place-of-folfirinox-in-metastatic-pancreatic-cancer-and-future-directions
#13
REVIEW
Aurélien Lambert, Céline Gavoille, Thierry Conroy
Pancreatic cancer (PC) incidence rates are rapidly increasing in developed countries, with half the patients being metastatic at diagnosis. For decades, fluorouracil, then gemcitabine regimens were the preferred palliative first-line options for fit patients with metastatic PC. FOLFIRINOX (a combination of bolus and infusional fluorouracil, leucovorin, irinotecan and oxaliplatin) was introduced to clinical practice in 2010 due to the results of the phase II/III trial (PRODIGE 4/ACCORD 11) comparing FOLFIRINOX with single-agent gemcitabine as first-line treatment for patients with MPC...
August 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28834410/prognostic-role-of-stereotactic-body-radiation-therapy-for-elderly-patients-with-advanced-and-medically-inoperable-pancreatic-cancer
#14
Xiaofei Zhu, Fuqi Li, Xiaoping Ju, Fei Cao, Yangsen Cao, Fang Fang, Shuiwang Qing, Yuxin Shen, Zhen Jia, Huojun Zhang
The role of stereotactic body radiation therapy for the elderly with advanced or medically inoperable pancreatic cancer was still debated. Therefore, we evaluated the value of stereotactic body radiation therapy and its association with survival of those patients. A total of 417 elderly patients were retrospectively reviewed from 2012 to 2015. Overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and toxicities were analyzed. Prescription doses ranged from 30-46...
August 23, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28819385/a-randomized-open-label-safety-and-exploratory-efficacy-study-of-kanglaite-injection-klti-plus-gemcitabine-versus-gemcitabine-in-patients-with-advanced-pancreatic-cancer
#15
Lee S Schwartzberg, Francis P Arena, Bryan J Bienvenu, Edward H Kaplan, Luis H Camacho, Luis T Campos, J Paul Waymack, Mary A Tagliaferri, Michael M Chen, Dapeng Li
Background: This study was designed to assess the safety and preliminary efficacy of KLTi plus gemcitabine in patients with locally advanced or metastatic pancreatic cancer. Methods: In a randomized, open-label study, patients with locally advanced or metastatic pancreatic cancer were randomized 2:1 to receive KLTi plus gemcitabine or gemcitabine monotherapy. Three sequential cohorts were tested at 30 g/day, 50 g/day, and 30 g/day. Gemcitabine was administered at 1000 mg/m(2) on days 1, 8 and 15 of each 28 day cycle...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28817982/current-challenges-in-optimizing-systemic-therapy-for-patients-with-pancreatic-cancer-expert-perspectives-from-the-australasian-gastrointestinal-trials-group-agitg-with-invited-international-faculty
#16
Eva Segelov, Florian Lordick, David Goldstein, Lorraine A Chantrill, Daniel Croagh, Ben Lawrence, Dirk Arnold, Ian Chau, Radka Obermannova, Timothy Jay Price
Despite recent progress, the outlook for most patients with pancreatic cancer remains poor. There is variation in how patients are managed globally due to differing interpretations of the evidence, partly because studies in this disease are challenging to undertake. This article collates the evidence upon which current best practice is based and offers an expert opinion from an international faculty on how latest developments should influence current treatment paradigms. Areas covered: Optimal chemotherapy for first and subsequent lines of therapy; optimal management of locally advanced, non-metastatic cancer including the role of neoadjuvant chemo(radio)therapy, current evidence for adjuvant chemotherapy, major advances in pancreatic cancer genomics and challenges in supportive care particularly relevant to patients with pancreatic cancer...
August 28, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28811038/fast-and-robust-online-adaptive-planning-in-stereotactic-mr-guided-adaptive-radiation-therapy-smart-for-pancreatic-cancer
#17
O Bohoudi, A M E Bruynzeel, S Senan, J P Cuijpers, B J Slotman, F J Lagerwaard, M A Palacios
BACKGROUND AND PURPOSE: To implement a robust and fast stereotactic MR-guided adaptive radiation therapy (SMART) online strategy in locally advanced pancreatic cancer (LAPC). MATERIAL AND METHODS: SMART strategy for plan adaptation was implemented with the MRIdian system (ViewRay Inc.). At each fraction, OAR (re-)contouring is done within a distance of 3cm from the PTV surface. Online plan re-optimization is based on robust prediction of OAR dose and optimization objectives, obtained by building an artificial neural network (ANN)...
August 12, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28808501/evolving-treatment-landscape-for-early-and-advanced-pancreatic-cancer
#18
REVIEW
Sally C Lau, Winson Y Cheung
Pancreatic ductal adenocarcinoma is an infrequent cancer with a high disease related mortality rate, even in the context of early stage disease. Until recently, the rate of death from pancreatic cancer has remained largely similar whereby gemcitabine monotherapy was the mainstay of systemic treatment for most stages of disease. With the discovery of active multi-agent chemotherapy regimens, namely FOLFIRINOX and gemcitabine plus nab-paclitaxel, the treatment landscape of pancreatic cancer is slowly evolving...
July 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28806620/a-novel-intestinal-rotation-method-for-digestive-reconstruction-after-combined-pancreaticoduodenectomy-and-extended-right-hemicolectomy-a-case-report-and-surgical-technique
#19
Kosei Takagi, Takahito Yagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kenjiro Kumano, Takeshi Kojima, Takuro Fushimi, Toshiyoshi Fujiwara
INTRODUCTION: Pancreaticoduodenectomy (PD) combined with extended right hemicolectomy (RH) is a challenging procedure for locally advanced malignancies. However, information concerning the reconstruction method of the digestive system is limited. Here, we present a case and surgical technique of a novel intestinal rotation method for digestive reconstruction after PD combined with RH. PRESENTATION OF CASE: A 62-year-old man with locally advanced pancreatic cancer received conversion surgery combined with PD and RH after preoperative chemotherapy...
August 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28782087/germline-brca-mutations-in-asian-patients-with-pancreatic-adenocarcinoma-a-prospective-study-evaluating-risk-category-for-genetic-testing
#20
Kyoungmin Lee, Changhoon Yoo, Kyu-Pyo Kim, Kyoung-Jin Park, Heung-Moon Chang, Tae Won Kim, Jae-Lyun Lee, Woochang Lee, Sang Soo Lee, Do Hyun Park, Tae Jun Song, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Sang Hyun Shin, Dae Wook Hwang, Ki Byung Song, Jae Hoon Lee, Song Cheol Kim, Baek-Yeol Ryoo
Introduction Germline BRCA mutations may have therapeutic implications as surrogate markers of DNA-damage repair status in pancreatic ductal adenocarcinoma (PDAC). We performed a prospective study to evaluate the efficiency of risk criteria based on personal or family history of breast and ovarian cancer for determining germline BRCA mutations in PDAC patients with Asian ethnicity. Methods Between November 2015 and May 2016, we screened consecutive PDAC patients with locally advanced unresectable or metastatic disease who were referred for systemic chemotherapy...
August 7, 2017: Investigational New Drugs
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