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Locally advanced pancreatic cancer

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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
#1
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-australian-gastrointestinal-trials-group-with-invited-international-faculty
#2
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 18, 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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28778024/a-combination-of-radiation-and-the-hypoxia-activated-prodrug-evofosfamide-th-302-is-efficacious-against-a-human-orthotopic-pancreatic-tumor-model
#7
Carla Hajj, James Russell, Charles P Hart, Karyn A Goodman, Maeve A Lowery, Adriana Haimovitz-Friedman, Joseph O Deasy, John L Humm
This study was designed to investigate the effect of single-dose radiation therapy (RT) in combination with evofosfamide (TH-302), a hypoxia-activated prodrug, in a pre-clinical model of pancreatic cancer. AsPC1 tumors were implanted orthotopically in the pancreas of nude mice. Tumors were treated with 15 Gy of RT, using a 1 cm diameter field, and delivered as a continuous arc. Image-guidance to center the field on the tumor was based on CT imaging with intraperitoneal contrast. Evofosfamide (100 mg/kg, i.p...
July 21, 2017: Translational Oncology
https://www.readbyqxmd.com/read/28768698/the-future-advances-in-therapeutic-approach-and-management-strategies-for-men1
#8
Rachel S van Leeuwaarde, Joanne M de Laat, Carolina R C Pieterman, Koen M A Dreijerink, Menno Vriens, Gerlof D Valk
Multiple endocrine neoplasia type 1 is a rare autosomal inherited disorder associated with a high risk for patients to simultaneously develop tumours of the parathyroid glands, duodeno-pancreatic neuroendocrine tumors and tumors of the anterior pituitary gland. Early identification of MEN1 in patients enables presymptomatic screening of manifestations which makes timely interventions possible with the intention to prevent morbidity and mortality. Causes of death nowadays have shifted towards local or metastatic progression of malignant neuro endocrine tumors...
August 2, 2017: Endocrine-related Cancer
https://www.readbyqxmd.com/read/28765698/early-radiological-assessment-of-locally-advanced-pancreatic-cancer-treated-with-electrochemotherapy
#9
Vincenza Granata, Roberta Fusco, Sergio Venanzio Setola, Mauro Piccirillo, Maddalena Leongito, Raffaele Palaia, Francesco Granata, Secondo Lastoria, Francesco Izzo, Antonella Petrillo
AIM: To report early imaging assessment of ablated area post electrochemotherapy (ECT) in patients with locally advanced pancreatic cancer (LAPC). METHODS: ECT was performed in 19 LAPC patients enrolled in an approved ongoing clinical phase I/II study. Before and after ECT, 18 patients underwent computed tomography (CT) scan, 11 patients underwent morphological and functional magnetic resonance (MR) scan (dynamic contrast enhanced-MRI) calculating wash-in slope (WIS) and wash-out slope (WOS); diffusion weighted imaging calculating pseudo-diffusivity (Dp), perfusion fraction (fp) and tissue diffusivity (Dt); 10 patients underwent positron emission tomography (PET)...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28761731/health-related-quality-of-life-in-a-randomised-phase-iii-study-of-gemcitabine-plus-s-1-s-1-alone-and-gemcitabine-alone-for-locally-advanced-or-metastatic-pancreatic-cancer-gest-study
#10
Yasuhiro Hagiwara, Yasuo Ohashi, Takuji Okusaka, Hideki Ueno, Tatsuya Ioka, Narikazu Boku, Shinichi Egawa, Takashi Hatori, Junji Furuse, Kazuhiro Mizumoto, Shinichi Ohkawa, Taketo Yamaguchi, Kenji Yamao, Akihiro Funakoshi, Ann-Lii Cheng, Kiyohiro Kihara, Atsushi Sato, Masao Tanaka
OBJECTIVE: This study was performed to compare health-related quality of life (HRQOL) of gemcitabine plus S-1 (GS), S-1 alone and gemcitabine alone as first-line chemotherapy for locally advanced or metastatic pancreatic cancer in the GEST (Gemcitabine and TS-1 Trial) study and to assess the impacts of adverse events and tumour response on HRQOL. METHODS: Patients were randomly assigned to receive gemcitabine alone (1000 mg/m(2) weekly for 3 of 4 weeks), S-1 alone (80, 100 or 120 mg/day twice daily for 4 of 6 weeks) or GS (gemcitabine at 1000 mg/m(2) weekly plus S-1 at 60, 80 or 100 mg/day twice daily for 2 of 3 weeks)...
2017: ESMO Open
https://www.readbyqxmd.com/read/28751626/lncrna-malat1-hottip-and-pvt1-as-predictors-for-predicting-the-efficacy-of-gem-based-chemotherapy-in-first-line-treatment-of-pancreatic-cancer-patients
#11
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...
July 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28746215/s-1-monotherapy-versus-s-1-combination-therapy-in-gemcitabine-refractory-advanced-pancreatic-cancer-a-meta-analysis-prisma-of-randomized-control-trials
#12
REVIEW
Sheng Zhong, Shuai Qie, Liu Yang, Qi Yan, Linna Ge, Zhongfeng Wang
BACKGROUND: Pancreatic cancer (PC) is one of the most lethal digestive system tumors. Most new cases are diagnosed based on metastasis or local aggression and are known as "advanced PC." Recently, studies investigating S-1 have indicated that it has a better clinical curative effect on PC. We conducted a meta-analysis to evaluate the efficacy and safety of S-1 monotherapy compared with S-1 combination regimens in patients with gemcitabine (GEM)-refractory PC. METHODS: Trials published between 1978 and 2016 were identified by an electronic search of public databases (Medline, Embase, and the Cochrane Library)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28742542/clinical-practice-guidelines-for-cryosurgery-of-pancreatic-cancer-a-consensus-statement-from-the-china-cooperative-group-of-cryosurgery-on-pancreatic-cancer-international-society-of-cryosurgery-and-asian-society-of-cryosurgery
#13
Lihua He, Lizhi Niu, Nikolai N Korpan, Sajio Sumida, Yueyong Xiao, Jiaping Li, Barlian Sutedja, Youyong Lu, Jiansheng Zuo, Jianguo Liu, Kecheng Xu
Pancreatic cancer (PC), one of the most lethal malignancies, accounts for 8% to 10% of digestive system cancers, and the incidence is increasing. Surgery, chemotherapy, and radiotherapy have been the main treatment methods but are not very effective. Cryosurgery was first used in 1984 for treatment of locally advanced PC and has since become a considerable treatment for most cases of unresectable PC. During the past decade, cryosurgery has been applied in some hospitals in China, and the newly developed technique of computed tomography- and/or ultrasound-guided percutaneous cryosurgery has shown better results than chemotherapy in cases of unresectable locally advanced PC, with the 1-year survival rate reported to be more than 50%...
July 24, 2017: Pancreas
https://www.readbyqxmd.com/read/28736643/comparison-of-efficacy-and-toxicity-of-folfirinox-and-gemcitabine-with-nab-paclitaxel-in-unresectable-pancreatic-cancer
#14
Tetsuhito Muranaka, Masaki Kuwatani, Yoshito Komatsu, Kentaro Sawada, Hiroshi Nakatsumi, Yasuyuki Kawamoto, Satoshi Yuki, Yoshimasa Kubota, Kimitoshi Kubo, Shuhei Kawahata, Kazumichi Kawakubo, Hiroshi Kawakami, Naoya Sakamoto
BACKGROUND: Irinotecan, oxaliplatin and leucovorin-modulated fluorouracil (FOLFIRINOX) and the combination regimen of gemcitabine and nanoparticle albumin-bound paclitaxel (GnP) (nab-PTX) improve the prognosis of patients with metastatic pancreatic cancer. However, no study has compared the efficacy of the two regimens. We compared retrospectively the efficacy and safety of the two regimens in patients with unresectable pancreatic cancer. METHODS: Thirty-eight patients with unresectable locally advanced or metastatic pancreatic cancer received FOLFIRINOX or GnP as first-line chemotherapy between December 2013 and September 2015...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28730577/a-case-of-successful-conversion-from-everolimus-to-surgical-resection-of-a-giant-pancreatic-neuroendocrine-tumor
#15
Asahi Sato, Toshihiko Masui, Nao Sankoda, Kenzo Nakano, Yuichiro Uchida, Takayuki Anazawa, Kyoichi Takaori, Yoshiya Kawaguchi, Shinji Uemoto
BACKGROUND: Although pancreatic neuroendocrine tumors generally have a far better prognosis relative to pancreatic cancer, the varied manifestations lead to treatment-related challenges. Everolimus therapy is generally recommended for patients with advanced pancreatic neuroendocrine tumors; however, its efficacy in a neoadjuvant setting remains unclear. Here we present a case of a giant pancreatic neuroendocrine tumor with a portal tumor thrombus that became resectable after everolimus therapy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28724893/the-effect-of-metformin-on-survival-of-patients-with-pancreatic-cancer-a-meta-analysis
#16
Xiaogang Li, Tong Li, Zhiqiang Liu, Shanmiao Gou, Chunyou Wang
We conducted a meta-analysis to analyse the effect of metformin on survival of pancreatic cancer patients at various stages. We performed a systematic search of PubMed, Embase, Cochrane, and Web of Science to identify all relevant studies. Summary hazard ratios (HR) of survival and 95% confidence intervals (95% CI) were calculated with a fixed or random effects model according to inter-study heterogeneity. Nine retrospective cohort studies and two randomized controlled trials (RCTs) were eligible. There was a significant improvement in survival (HR = 0...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28708232/primary-signet-ring-cell-carcinoma-of-the-pancreas-with-a-good-response-to-chemotherapy-case-report-and-literature-review
#17
Milan Radojkovic, Dragana Ilic, Ivan Ilic
PURPOSE: Although pancreatic cancer is a common malignancy, signet ring cell carcinoma of the pancreas is a very rare histologic type with only 6 cases reported so far. We present a patient with primary signet ring cell carcinoma of the pancreas and a good response to neoadjuvant chemotherapy. CASE REPORT: A 67-year-old woman presented at a regional hospital with a 2-week history of painless progressive jaundice. Abdominal computed tomography showed a tumor in the head of the pancreas, 4...
July 5, 2017: Tumori
https://www.readbyqxmd.com/read/28707545/diagnostic-evaluation-of-simulation-ct-images-for-adjuvant-radiotherapy-in-pancreatic-adenocarcinoma
#18
Bohyun Kim, Young Chul Kim, O Kyu Noh, Jaesung Heo, Hyun Woo Lee, Ji Hoon Kim, Jei Hee Lee, Jai Keun Kim, Oyeon Cho, Young-Taek Oh, Mison Chun
OBJECTIVE: The purpose of this study is to review simulation CT scans and evaluate their diagnostic value in patients treated with adjuvant radiation therapy for pancreatic adenocarcinoma. MATERIALS AND METHODS: Seventy-three patients who had undergone simulation CT scans for adjuvant radiation therapy in pancreatic adenocarcinoma were reviewed. All simulation CT scans were reviewed by professional abdominal radiologists, who compared the images with corresponding prior CT scans to identify new lesions...
July 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28705005/radiation-therapy-in-the-management-of-pancreatic-adenocarcinoma-review-of-current-evidence-and-future-opportunities
#19
Tyler P Robin, Karyn A Goodman
The role of radiation therapy for pancreatic cancer is rapidly evolving in every stage of this disease. In resectable disease, there is conflicting evidence for adjuvant therapy, but an ongoing randomized cooperative group trial is attempting to define the role of adjuvant chemoradiation with modern systemic therapies and radiation techniques with an emphasis on radiation quality assurance. In borderline resectable pancreatic cancer (BRPC), there is an emerging body of literature demonstrating the success of neoadjuvant stereotactic body radiation therapy (SBRT) and a randomized cooperative group trial is actively accruing...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28700995/extended-pancreatectomy-does-it-have-a-role-in-the-contemporary-management-of-pancreatic-adenocarcinoma
#20
Joerg Kaiser, Thilo Hackert, Markus W Büchler
BACKGROUND: Pancreatic cancer is a low-incident but highly mortal disease. Surgery is still the preferred treatment option for resectable pancreatic cancer as it offers the only realistic chance for cure. As many patients present with locally advanced disease, which is generally considered as not amenable to surgical treatment, it is important to know the limits of surgical therapy in this disease. METHODS: In this review, the indication and outcomes of extended pancreatectomies as well as the alternative treatment options for locally advanced pancreatic cancer are described...
July 13, 2017: Digestive Surgery
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