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Locally advanced pancreatic cancer

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https://www.readbyqxmd.com/read/29348875/radiosensitization-of-the-pi3k-inhibitor-hs-173-through-reduction-of-dna-damage-repair-in-pancreatic-cancer
#1
Jung Hee Park, Kyung Hee Jung, Soo Jung Kim, Zhenghuan Fang, Hong Hua Yan, Mi Kwon Son, Juyoung Kim, Yeo Wool Kang, Ji Eun Lee, Boreum Han, Joo Han Lim, Soon-Sun Hong
Activation of PI3K/AKT pathway occurs frequently in tumors and is correlated with radioresistance. The PI3K/AKT pathway can be an important target for improvement of radiotherapy. Although adding of chemotherapy to radiation therapy regimen enhances survival in patients with locally advanced pancreatic cancer, more effective therapies for increasing radiosensitivity are urgently needed. In this study, we investigated whether the novel PI3K inhibitor HS-173 could attenuate radiation-induced up-regulation of DNA damage repair processes and assessed its efficacy as a radio- and chemo-sensitizer...
December 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/29340601/how-to-treat-borderline-resectable-pancreatic-cancer-current-challenges-and-future-directions
#2
Shinichiro Takahashi
Borderline resectable pancreatic cancer (BRPC) is an advanced tumor in contact with the surrounding major vessels, making R0 resection difficult to achieve. Neoadjuvant treatment is expected to provide substantial local control and prolong survival. However, there is no standard treatment. I therefore conducted a strategic literature search from January 2013 to September 2017 and identified 37 clinical studies of pancreatic cancer, including BRPC, to evaluate treatment interventions. Twenty (54%) studies were prospective...
January 11, 2018: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29335228/irreversible-electroporation-for-locally-advanced-pancreatic-cancer-through-a-minimally-invasive-surgery-supported-by-laparoscopic-ultrasound
#3
Ernesto Tartaglia, Massimiliano Fabozzi, Antonia Rizzuto, Anna Settembre, Roberta Abete, Ludovica Guerriero, Pasqualino Favoriti, Diego Cuccurullo, Francesco Corcione
INTRODUCTION: Pancreatic cancer is one of the most lethal cancers worldwide, with 5-years survival rate as low as 6%. The majority of pancreatic cancer patients present locally advanced or metastatic disease at diagnosis. Typically, patients affected by locally advanced pancreatic cancer (LAPC) do not undergo radical surgery but are treated with focal ablative therapies. However, a high rate of morbidity due to the heat sink effect has limited the application of ablative techniques on a routine basis in LAPC patients...
December 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29334562/is-a-pathological-complete-response-following-neoadjuvant-chemoradiation-associated-with-prolonged-survival-in-patients-with-pancreatic-cancer
#4
Jin He, Alex B Blair, Vincent P Groot, Ammar A Javed, Richard A Burkhart, Georgios Gemenetzis, Ralph H Hruban, Kevin M Waters, Justin Poling, Lei Zheng, Daniel Laheru, Joseph M Herman, Martin A Makary, Matthew J Weiss, John L Cameron, Christopher L Wolfgang
OBJECTIVES: To describe the survival outcome of patients with borderline resectable or locally advanced pancreatic ductal adenocarcinoma (BR/LA-PDAC) who have a pathologic complete response (pCR) following neoadjuvant chemoradiation. BACKGROUND: Patients with BR/LA-PDAC are often treated with neoadjuvant chemoradiation in an attempt to downstage the tumor. Uncommonly, a pCR may result. METHODS: A retrospective review of a prospectively maintained database was performed at a single institution...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29333119/phytotherapeutics-oridonin-and-ponicidin-show-additive-effects-combined-with-irradiation-in-pancreatic-cancer-in-vitro
#5
Jakob Liermann, Patrick Naumann, Franco Fortunato, Thomas E Schmid, Klaus-Josef Weber, Jürgen Debus, Stephanie E Combs
Background: Chemoradiation of locally advanced non-metastatic pancreatic cancer can lead to secondary operability by tumor mass reduction. Here, we analyzed radiomodulating effects of oridonin and ponicidin in pancreatic cancer in vitro. Both agents are ent-kaurane diterpenoids, extracted from Isodon rubescens, a plant that is well known in Traditional Chinese Medicine. Cytotoxic effects have recently been shown in different tumor entities for both agents. Materials and methods: Pancreatic cancer cell lines AsPC-1, BxPC-3, Panc-1 and MIA PaCa-2 were pretreated with oridonin or ponicidin and irradiated with 2 Gy to 6 Gy...
December 2017: Radiology and Oncology
https://www.readbyqxmd.com/read/29331400/locally-advanced-pancreas-cancer-staging-and-goals-of-therapy
#6
Nikolaos A Chatzizacharias, Susan Tsai, Michael Griffin, Parag Tolat, Paul Ritch, Ben George, Chad Barnes, Mohammed Aldakkak, Abdul H Khan, William Hall, Beth Erickson, Douglas B Evans, Kathleen K Christians
BACKGROUND: Patients with locally advanced pancreatic cancer have historically been considered inoperable. The purpose of this report was to determine resectability rates for patients with locally advanced pancreatic cancer based on our recently described definitions of type A and type B locally advanced pancreatic cancer. METHODS: An institutional prospective pancreas cancer database was queried for consecutive patients with locally advanced pancreatic cancer treated between January 2009 and June 2017...
January 10, 2018: Surgery
https://www.readbyqxmd.com/read/29328487/combination-of-gemcitabine-and-erlotinib-inhibits-recurrent-pancreatic-cancer-growth-in-mice-via-the-jak-stat-pathway
#7
Liwen Chen, Ding'an Zhou, Zhehao Liu, Xinhao Huang, Qianfan Liu, Yiping Kang, Zili Chen, Yuntao Guo, Haitao Zhu, Chengyi Sun
Compared to single gemcitabine treatment, the combination of gemcitabine and erlotinib has shown effective response in patients with locally advanced or metastatic pancreatic cancer. However, the combination therapy has not proven effective in patients with pancreatic cancer after R0 or R1 resection. In the present study, a nude mice model of orthotopic xenotransplantation after tumor resection was established using pancreatic cancer cell lines, BxPC-3 and PANC‑1. Mice were divided in four groups (each with n=12) and were treated as follows: the control group received a placebo via intraperitoneal injection (i...
January 8, 2018: Oncology Reports
https://www.readbyqxmd.com/read/29327180/chemotherapy-with-or-without-definitive-radiation-therapy-in-inoperable-pancreatic-cancer
#8
Jim Zhong, Jeffrey Switchenko, Madhusmita Behera, David Kooby, Shishir K Maithel, Mark W McDonald, Jolinta Y Lin, Richard J Cassidy, Bassel El-Rayes, Jerome Landry, Pretesh R Patel
BACKGROUND: The LAP07 randomized trial calls into question the role of radiation therapy (RT) in the modern treatment of locally advanced pancreatic cancer (LAPC). However, advances in chemotherapy and RT limit application of the LAP07 results to current clinical practice. Here we utilize the National Cancer Database (NCDB) to evaluate the effects of RT in patients receiving chemotherapy for LAPC. METHODS: Using the NCDB, patients with American Joint Committee on Cancer (AJCC) clinical stage T2-4, N0-1, M0 adenocarcinoma of the pancreas from 2004 to 2014 were analyzed...
January 11, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29326012/stereotactic-body-radiotherapy-sbrt-for-patients-with-locally-advanced-pancreatic-cancer-a-single-center-experience
#9
Raphaël Jumeau, Guila Delouya, David Roberge, David Donath, Dominic Béliveau-Nadeau, Marie-Pierre Campeau
INTRODUCTION: Despite advances in treatment, notably in systemic therapy, the prognosis of pancreatic adenocarcinoma (PADC) remains dismal. Stereotactic body radiotherapy (SBRT) is an emerging tool in the complex management of PADC. We review outcomes of SBRT for PADC at our institution. METHODS: We reviewed patients treated with SBRT for either unresectable PADC or locally recurrent PADC after surgery. Treatment was delivered using a robotic radiosurgery system with respiratory tracking...
December 21, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29320420/locally-advanced-pancreatic-cancer-a-review-of-local-ablative-therapies
#10
REVIEW
Alette Ruarus, Laurien Vroomen, Robbert Puijk, Hester Scheffer, Martijn Meijerink
Pancreatic cancer is typically characterized by its aggressive tumor growth and dismal prognosis. Approximately 30% of patients with pancreatic cancer present with locally advanced disease, broadly defined as having a tumor-to-artery interface >180°, having an unreconstructable portal vein or superior mesenteric vein and no signs of metastatic disease. These patients are currently designated to palliative systemic chemotherapy, though median overall survival remains poor (approximately 11 months). Therefore, several innovative local therapies have been investigated as new treatment options for locally advanced pancreatic cancer (LAPC)...
January 10, 2018: Cancers
https://www.readbyqxmd.com/read/29298798/phase-1-trial-of-m7824-msb0011359c-a-bifunctional-fusion-protein-targeting-pd-l1-and-tgf-%C3%AE-in-advanced-solid-tumors
#11
Julius Strauss, Christopher Heery, Jeffrey Schlom, Ravi A Madan, Liang Cao, Zhigang Kang, Elizabeth Lamping, Jennifer L Marte, Renee N Donahue, Italia Grenga, Lisa M Cordes, Olaf Christensen, Lisa Mahnke, Christoph Helwig, James L Gulley
PURPOSE: M7824 (MSB0011359C) is an innovative first-in-class bifunctional fusion protein composed of a monoclonal antibody against programmed death ligand 1 (PD-L1) fused to a transforming growth factor-β (TGF-β) "trap." Experimental DesignIn the 3+3 dose-escalation component of this phase 1 study (NCT02517398), eligible patients with advanced solid tumors received M7824 at 1, 3, 10, or 20 mg/kg once-every-2-weeks until confirmed progression, unacceptable toxicity, or trial withdrawal; additionally, a cohort received an initial 0...
January 3, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29290916/neoadjuvant-therapy-for-resectable-pancreatic-cancer
#12
REVIEW
Sheikh Hasibur Rahman, Robin Urquhart, Michele Molinari
The use of neoadjuvant therapies has played a major role for borderline resectable and locally advanced pancreatic cancers (PCs). For this group of patients, preoperative chemotherapy or chemoradiation has increased the likelihood of surgery with negative resection margins and overall survival. On the other hand, for patients with resectable PC, the main rationale for neoadjuvant therapy is that the overall survival with current strategies is unsatisfactory. There is a consensus that we need new treatments to improve the overall survival and quality of life of patients with PC...
December 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29282264/comparing-the-diagnostic-accuracy-of-five-common-tumour-biomarkers-and-ca19-9-for-pancreatic-cancer-a-protocol-for-a-network-meta-analysis-of-diagnostic-test-accuracy
#13
Long Ge, Bei Pan, Fujian Song, Jichun Ma, Dena Zeraatkar, Jianguo Zhou, Jinhui Tian
INTRODUCTION: Surgical resection is the only curative treatment for patients with resectable pancreatic cancer. Unfortunately, 80%-85% of patients present with locally advanced or metastatic unresectable pancreatic cancer at the time of diagnosis. Detection of pancreatic cancer at early stages remains a great challenge due to lack of accurate detection tests. Recommendations in existing clinical practice guidelines on early diagnosis of pancreatic cancer are inconsistent and based on limited evidence...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29282139/effective-radiotherapeutic-treatment-intensification-in-patients-with-pancreatic-cancer-higher-doses-alone-higher-rbe-or-both
#14
REVIEW
Constantin Dreher, Daniel Habermehl, Oliver Jäkel, Stephanie E Combs
Pancreatic cancer, especially in case of locally advanced stage has a poor prognosis. Radiotherapy in general can lead to tumor volume reduction, but further improvements, such as ion beam therapy have to be promoted in order to enable dose escalation, which in turn results in better local control rates and downsizing of the tumor itself. Ion beam therapy with its highly promising physical properties is also accompanied by distinct inter- and intrafractional challenges in case of robustness. First clinical results are promising, but further research in motion mitigation and biological treatment planning is necessary, in order to determine the best clinical rationales and conditions of ion beam therapy of pancreatic cancer...
December 27, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/29278340/microwave-ablation-of-pancreatic-tumors
#15
Thomas J Vogl, Bita Panahi, Moritz H Albrecht, Nagy Naguib Naeem Naguib, Nour-Eldin A Nour-Eldin, Tatjana Gruber-Rouh, Zachary M Thompson, Lajos M Basten
OBJECTIVES: To evaluate the clinical performance of percutaneous microwave ablation (MWA) for treatment of locally-advanced-pancreatic-cancer (LAPC). MATERIAL AND METHODS: Twenty-two MWA sessions (August 2015-March 2017) in 20 patients with primary pancreatic cancer (13 men, 7 women, mean-age: 59.9 ± 8.6 years, range: 46-73 years), who had given informed consent, were retrospectively evaluated. All procedures were performed percutaneously under CT-guidance using the same high-frequency (2...
December 26, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/29232340/ablative-therapies-for-locally-advanced-pancreatic-cancer
#16
Rupen Shah, Katherine T Ostapoff, Boris Kuvshinoff, Steven N Hochwald
The vast majority of patients who present with pancreatic adenocarcinoma have locally advanced or metastatic disease at the time of presentation without possibility of cure. Although in recent years there have been some new promising chemotherapy regimens that improve overall survival by a few months, the prognosis remains dismal. There is, however, a subset of patients who experience durable stable disease or partial responses after initial courses of chemotherapy with locally advanced disease. In these select patients, there remains interest in local ablative therapy with or without resection as a means for local control, palliation of symptoms, and possible improved survival...
January 2018: Pancreas
https://www.readbyqxmd.com/read/29227344/predictors-of-resectability-and-survival-in-patients-with-borderline-and-locally-advanced-pancreatic-cancer-who-underwent-neoadjuvant-treatment-with-folfirinox
#17
Theodoros Michelakos, Ilaria Pergolini, Carlos Fernández-Del Castillo, Kim C Honselmann, Lei Cai, Vikram Deshpande, Jennifer Y Wo, David P Ryan, Jill N Allen, Lawrence S Blaszkowsky, Jeffrey W Clark, Janet E Murphy, Ryan D Nipp, Aparna Parikh, Motaz Qadan, Andrew L Warshaw, Theodore S Hong, Keith D Lillemoe, Cristina R Ferrone
OBJECTIVE: The aim of this study was to determine (1) whether preoperative factors can predict resectability of borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant FOLFIRINOX, (2) which patients might benefit from adjuvant therapy, and (3) survival differences between resected BR/LA patients who received neoadjuvant FOLFIRINOX and upfront resected patients. BACKGROUND: Patients with BR/LA PDAC are often treated with FOLFIRINOX to obtain a margin-negative resection, yet selection of patients for resection remains challenging...
December 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29221115/lncrna-malat1-hottip-and-pvt1-as-predictors-for-predicting-the-efficacy-of-gem-based-chemotherapy-in-first-line-treatment-of-pancreatic-cancer-patients
#18
Cui-Juan Wang, Sheng-Bin Shi, Jing Tian, Jun Xu, Zuo-Xing Niu
This study evaluated the lnc-RNAs as biomarker to predict efficacy of gemcitabine (GEM) based chemotherapy as the first-line treatment for locally advanced or advanced pancreatic cancer patients. We selected 62 patients with GEM based chemotherapy and divided two groups according to the PFS. We found that the expression of MALAT1, HOTTIP, and PVT1 in serum had a significant difference among the two groups. Furthermore, we estimated the PFS and response rate based on the expression levels of MALAT1, HOTTIP and PVT1...
November 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29214453/neoadjuvant-therapy-versus-upfront-resection-for-pancreatic-cancer-the-actual-spectrum-and-clinical-burden-of-postoperative-complications
#19
Giovanni Marchegiani, Stefano Andrianello, Chiara Nessi, Marta Sandini, Laura Maggino, Giuseppe Malleo, Salvatore Paiella, Enrico Polati, Claudio Bassi, Roberto Salvia
BACKGROUND: Neoadjuvant therapy (NAT) is used for borderline-resectable or locally advanced pancreatic cancer (PDAC) and exhibits promising results in terms of pathological outcomes. However, little is known about its effect on surgical complications. METHODS: We analyzed 445 pancreatic resections for PDAC from 2014 to 2016 at The Pancreas Institute, Verona University Hospital. The Modified Accordion Severity Grading System and average complication burden (ACB) were used to compare patients treated with NAT with patients who underwent upfront surgery (UFS)...
December 6, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29212734/predictors-of-response-and-survival-in-locally-advanced-adenocarcinoma-of-the-pancreas-following-neoadjuvant-gtx-with-or-without-radiation-therapy
#20
William H Sherman, Elizabeth Hecht, David Leung, Kyung Chu
LESSONS LEARNED: There is no presenting parameter that predicts the success of neoadjuvant therapy for pancreatic cancer.Despite the images on scans following neoadjuvant therapy, all patients should be evaluated, because inflammation following radiation therapy (RT) may overstate the extent of tumor and vascular involvement. BACKGROUND: In patients presenting with locally advanced pancreatic adenocarcinoma deemed unresectable by two pancreatic cancer surgeons, we analyzed presenting tumor size, extent of vascular involvement, tumor markers, response to neoadjuvant gemcitabine (G), docetaxel (T), and capecitabine (X) with or without additional chemoradiotherapy with GX on R0 resection rates (≥2 mm margins), and survival...
December 6, 2017: Oncologist
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