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Locally advanced pancreatic cancer

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https://www.readbyqxmd.com/read/28544758/neoadjuvant-therapy-in-pancreatic-cancer-a-systematic-review-and-meta-analysis-of-prospective-studies
#1
Han-Xiang Zhan, Jian-Wei Xu, Dong Wu, Zhi-Yang Wu, Lei Wang, San-Yuan Hu, Guang-Yong Zhang
There is a strong rationale and many theoretical advantages for neoadjuvant therapy in pancreatic cancer (PC). However, study results have varied significantly. In this study, a systematic review and meta-analysis of prospective studies were performed in order to evaluate safety and effectiveness of neoadjuvant therapy in PC. Thirty-nine studies were selected (n = 1458 patients), with 14 studies focusing on patients with resectable disease (group 1), and 19 studies focusing on patients with borderline resectable and locally advanced disease (group 2)...
May 23, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28534517/prolonged-exposure-to-extracellular-lumican-restrains-pancreatic-adenocarcinoma-growth
#2
X Li, Y Kang, D Roife, Y Lee, M Pratt, M R Perez, B Dai, E J Koay, J B Fleming
We previously demonstrated that pancreatic stellate cells within pancreatic ductal adenocarcinoma (PDAC) stroma secrete lumican and its presence is associated with prolonged survival of patients with localized PDAC. Here, we observed that extracellular lumican decreases PDAC tumour cell growth in xenograft and syngeneic orthotopic animal models, and induces growth inhibition of low-passage human PDAC cells in a species-specific manner. PDAC cells grown in variant culture conditions and exposed to extracellular lumican display typical characterizations of cancer cell in a quiescent state, such as growth inhibition, apoptosis, G0/G1 arrest and chemoresistance...
May 22, 2017: Oncogene
https://www.readbyqxmd.com/read/28515255/active-systemic-treatment-of-pancreatic-cancer
#3
Margaret Tempero
By 2020, pancreatic cancer is expected to be the second most common cause of cancer-related death, exceeded only by lung cancer. During her presentation at the NCCN 22nd Annual Conference, Dr. Margaret Tempero offered an update on the current state of systemic treatment of pancreatic cancer, focusing on resectable/borderline resectable, locally advanced, and metastatic disease.
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28513899/surgical-strategies-and-novel-therapies-for-locally-advanced-pancreatic-cancer
#4
REVIEW
Jad Abou-Khalil, Flavio G Rocha
Many patients with pancreatic cancer are not candidates for surgical resection due to involvement of critical mesenteric vascular structures. We compare and contrast the commonly used classification systems for borderline resectable and locally advanced pancreatic cancer. We describe the current strategies in managing venous and arterial involvement, as well as the role of neoadjuvant chemotherapy and chemoradiation, before explanding on a novel clinical trial in this patient population.
May 17, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28493288/outcomes-for-patients-with-locally-advanced-pancreatic-adenocarcinoma-treated-with-stereotactic-body-radiation-therapy-versus-conventionally-fractionated-radiation
#5
Jim Zhong, Kirtesh Patel, Jeffrey Switchenko, Richard J Cassidy, William A Hall, Theresa Gillespie, Pretesh R Patel, David Kooby, Jerome Landry
BACKGROUND: As systemic therapy has improved for locally advanced pancreatic cancer (LAPC), efforts to improve local control with optimal radiotherapy may be critical. Although conventionally fractionated radiation therapy (CFRT) has more recently shown a limited role in LAPC, stereotactic body radiation therapy (SBRT) is an emerging approach with promising results. With no studies to date comparing SBRT with CFRT for LAPC, this study used the National Cancer Data Base (NCDB) to evaluate these 2 modalities...
May 10, 2017: Cancer
https://www.readbyqxmd.com/read/28486290/-radiological-and-surgical-implications-of-neoadjuvant-treatment-with-folfirinox-for-locally-advanced-and-borderline-resectable-pancreatic-cancer
#6
Satyajit Ashok Godhi, Kunal Parasar, Sundeep Saluja, Pramod Mishra
No abstract text is available yet for this article.
June 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28482348/prolonged-neoadjuvant-therapy-for-locally-advanced-pancreatic-cancer
#7
Hidetoshi Eguchi, Daisaku Yamada, Yoshifumi Iwagami, Kunihito Gotoh, Koichi Kawamoto, Hiroshi Wada, Tadafumi Asaoka, Takehiro Noda, Yutaka Takeda, Masahiro Tanemura, Daisuke Sakai, Taroh Satoh, Toshihiro Kudo, Fumiaki Isohashi, Masaki Mori, Yuichiro Doki
PURPOSE: The purpose of this study was to investigate if prolonged neoadjuvant therapy, for locally advanced pancreatic cancer could be used to identify those patients who could benefit from resection surgery. METHODS: Thirty-four patients with locally advanced pancreatic cancer invading the adjacent major arteries underwent chemoradiotherapy, followed by 6 months of systemic chemotherapy, unless their tumor was already resectable. After this combination treatment, surgical resection was performed on those patients with tumors judged to be at least borderline resectable...
May 9, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28477059/change-in-carbohydrate-antigen-19-9-level-as-a-prognostic-marker-of-overall-survival-in-locally-advanced-pancreatic-cancer-treated-with-concurrent-chemoradiotherapy
#8
Yi-Jun Kim, Hyeon Kang Koh, Eui Kyu Chie, Do-Youn Oh, Yung-Jue Bang, Eun Mi Nam, Kyubo Kim
PURPOSE: To investigate the significance of carbohydrate antigen 19-9 (CA19-9) levels for survival in locally advanced pancreatic cancer (LAPC) treated with concurrent chemoradiotherapy (CCRT). METHODS/PATIENTS: We retrospectively reviewed data from 97 LAPC patients treated with CCRT between 2000 and 2013. CA19-9 levels (initial and post-CCRT) and their changes [{(post-CCRT CA19-9 level - initial CA19-9 level)/(initial CA19-9 level)} × 100] were analyzed for overall survival...
May 5, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28475814/multi-disciplinary-management-of-locally-advanced-pancreatic-cancer-with-irreversible-electroporation
#9
REVIEW
Robert C G Martin
The essential diagnosis for LAPC is based on high-quality cross-sectional imaging, which demonstrates tumor invasion into the celiac/superior mesenteric arteries and/or superior mesenteric/portal venous system that is not reconstructable. The optimal management of these patients is evolving quickly with the advent of newer chemotherapeutics, radiation, and non-thermal ablation modalities. This review will present the current status of initial chemotherapy, surgical therapy, ablative therapy, and radiation therapy for patients with nonmetastatic locally advanced unresectable pancreatic cancer...
May 5, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28472821/efficacy-and-safety-of-gemcitabine-plus-s-1-in-pancreatic-cancer-a-pooled-analysis-of-individual-patient-data
#10
Chikuma Hamada, Takuji Okusaka, Takaaki Ikari, Hiroyuki Isayama, Junji Furuse, Hiroshi Ishii, Yousuke Nakai, Shogo Imai, Shota Okamura
BACKGROUND: Three randomised trials (GEST, JACCRO PC-01, and GEMSAP) were conducted to evaluate the efficacy of gemcitabine plus S-1 (GS) vs gemcitabine alone in patients with advanced pancreatic cancer (PC). In this pooled analysis, the efficacy and safety of GS vs gemcitabine were evaluated. METHODS: Additional follow-up was conducted and survival data were updated in each study. A total of 770 patients (gemcitabine 389; GS 381) were included in the pooled analysis...
May 4, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28471824/early-detection-of-sporadic-pancreatic-cancer-time-for-change
#11
Přemysl Frič, Aleksi Šedo, Jan Škrha, Petr Bušek, Martin Laclav, Pavel Škrha, Miroslav Zavoral
Sporadic pancreatic cancer amounts to ∼90% of all pancreatic cancers. It is a gloomy, depressive disease: the formula describes well the behavior of many SPC patients, and the most recalcitrant malignancy, with a very low 5-year survival (3-6%). At present, diagnostic methods are commonly applied, as used half a century ago, after the appearance of local and systemic symptoms (abdominal and back pain, cholestasis, painless jaundice, fatigue, anorexia, weight loss, anemia, peripheral phlebitis, and cachexia)...
May 3, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28464997/dose-escalation-in-locally-advanced-pancreatic-cancer-patients-receiving-chemoradiotherapy
#12
Seung Yeun Chung, Jee Suk Chang, Byung Min Lee, Kyung Hwan Kim, Kyong Joo Lee, Jinsil Seong
PURPOSE: To investigate whether radiotherapy (RT) dose escalation would improve treatment outcomes without increasing severe toxicity in locally advanced pancreatic cancer patients. METHODS: From 2005 to 2015, 497 locally advanced pancreatic cancer patients who received neoadjuvant or definitive chemoradiotherapy (CCRT) were included. Patients were divided according to the total dose (TD). Overall survival (OS), progression-free survival (PFS), local failure-free rate (LFFR), distant failure-free rate (DFFR), and toxicity rates were compared between <61Gy (n=345) and ≥61Gy groups (n=152)...
April 29, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28460245/3rd-st-gallen-eortc-gastrointestinal-cancer-conference-consensus-recommendations-on-controversial-issues-in-the-primary-treatment-of-pancreatic-cancer
#13
REVIEW
Manfred P Lutz, John R Zalcberg, Michel Ducreux, Daniela Aust, Marco J Bruno, Markus W Büchler, Jean-Robert Delpero, Beat Gloor, Rob Glynne-Jones, Werner Hartwig, Florence Huguet, Pierre Laurent-Puig, Florian Lordick, Patrick Maisonneuve, Julia Mayerle, Marc Martignoni, John Neoptolemos, Andrew D Rhim, Bruno M Schmied, Thomas Seufferlein, Jens Werner, Jean-Luc van Laethem, Florian Otto
The primary treatment of pancreatic cancer was the topic of the 3rd St. Gallen Conference 2016. A multidisciplinary panel reviewed the current evidence and discussed controversial issues in a moderated consensus session. Here we report on the key expert recommendations. It was generally accepted that radical surgical resection followed by adjuvant chemotherapy offers the only evidence-based treatment with a chance for cure. Initial staging should classify localised tumours as resectable or unresectable (i.e...
April 28, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28459988/what-treatment-in-2017-for-inoperable-pancreatic-cancers
#14
J Taieb, A-L Pointet, J L Van Laethem, B Laquente, S Pernot, F Lordick, M Reni
Pancreatic adenocarcinoma (PA) is a frequent and severe disease, either diagnosed as metastatic pancreatic adenocarcinoma (MPA) or as locally advanced pancreatic carcinoma (LAPC). Though no improvement in patients outcome have been made between 1996 and 2011, since 5 years new treatment options have become available to treat our patients. New standard first line regimens, such as FOLFIRINOX and gemcitabine combined with nab-paclitaxel, have improved overall survivals and second line treatments have been tested and validated...
April 27, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28451833/phase-1b-study-of-galunisertib-in-combination-with-gemcitabine-in-japanese-patients-with-metastatic-or-locally-advanced-pancreatic-cancer
#15
Masafumi Ikeda, Hideaki Takahashi, Shunsuke Kondo, Michael Mauritius Fabio Lahn, Ken Ogasawara, Karim A Benhadji, Hisaki Fujii, Hideki Ueno
PURPOSE: Transforming growth factor-beta inhibitors may enhance the antitumor activity of gemcitabine with acceptable safety and tolerability. This open-label, multicenter, non-randomized phase 1b study assessed the safety/tolerability, pharmacokinetics, and tumor response of galunisertib plus gemcitabine in Japanese patients with advanced or metastatic pancreatic cancer. METHODS: During each 28-day cycle, galunisertib 150 mg was administered orally twice daily (300 mg/day) for 14 days, followed by 14 days of rest...
June 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28446717/gemcitabine-induced-heparanase-promotes-aggressiveness-of-pancreatic-cancer-cells-via-activating-egfr-signaling
#16
Jin-Wen Song, Ying-Xia Tan, Su-Bo Li, Shi-Kun Zhang, Lu-Ming Wan, Shou-Ping Ji, Hong Zhou, Zhi-Hang Zhou, Feng Gong
Pancreatic cancer (PC), characterized by aggressive local invasion and metastasis, is one of the most malignant cancers. Gemcitabine is currently used as the standard drug for the treatment of advanced and metastatic PC, but with limited efficacy. In this study, we demonstrated that gemcitabine increased the expression of heparanase (HPA1), the only known mammalian endoglycosidase capable of cleaving heparan sulfate, both in vitro and in vivo. Furthermore, overexpression of HPA1 in PC cell lines enhanced proliferation and invasion, accompanied with elevated phosphorylation of EGFR...
April 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28445400/targeting-the-epidermal-growth-factor-receptor-in-addition-to-chemotherapy-in-patients-with-advanced-pancreatic-cancer-a-systematic-review-and-meta-analysis
#17
REVIEW
Jaseela Chiramel, Alison C Backen, Rille Pihlak, Angela Lamarca, Melissa Frizziero, Noor-Ul-Ain Tariq, Richard A Hubner, Juan W Valle, Eitan Amir, Mairéad G McNamara
Overexpression of epidermal growth factor receptors (EGFR) occurs in >90% of pancreatic ductal adenocarcinomas (PDACs) and is associated with a poorer prognosis. A systematic review of electronic databases identified studies exploring the addition of EGFR-targeted treatment to chemotherapy in patients with locally advanced (LA)/metastatic PDAC. Efficacy, safety and tolerability of EGFR-targeted therapy were explored using meta-analysis of randomised controlled trials (RCTs). Meta-regression was utilised to explore factors associated with improved prognosis (all studies) and benefit from EGFR-targeted therapy (RCTs)...
April 26, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28437190/consuming-a-ketogenic-diet-while-receiving-radiation-and-chemotherapy-for-locally-advanced-lung-cancer-and-pancreatic-cancer-the-university-of-iowa-experience-of-two-phase-1-clinical-trials
#18
Amir Zahra, Melissa A Fath, Emyleigh Opat, Kranti A Mapuskar, Sudershan K Bhatia, Daniel C Ma, Samuel N Rodman Iii, Travis P Snyders, Catherine A Chenard, Julie M Eichenberger-Gilmore, Kellie L Bodeker, Logan Ahmann, Brian J Smith, Sandy A Vollstedt, Heather A Brown, Taher Abu Hejleh, Gerald H Clamon, Daniel J Berg, Luke I Szweda, Douglas R Spitz, John M Buatti, Bryan G Allen
Ketogenic diets are low in carbohydrates and high in fat, which forces cells to rely more heavily upon mitochondrial oxidation of fatty acids for energy. Relative to normal cells, cancer cells are believed to exist under a condition of chronic mitochondrial oxidative stress that is compensated for by increases in glucose metabolism to generate reducing equivalents. In this study we tested the hypothesis that a ketogenic diet concurrent with radiation and chemotherapy would be clinically tolerable in locally advanced non-small cell lung cancer (NSCLC) and pancreatic cancer and could potentially exploit cancer cell oxidative metabolism to improve therapeutic outcomes...
April 24, 2017: Radiation Research
https://www.readbyqxmd.com/read/28422841/evaluation-of-gemcitabine-efficacy-after-the-folfirinox-regimen-in-patients-with-advanced-pancreatic-adenocarcinoma
#19
Marine Gilabert, Brice Chanez, Young Soo Rho, Marc Giovanini, Olivier Turrini, Gerald Batist, Petr Kavan, Jean Luc Raoul
To evaluate gemcitabine efficacy in advanced pancreatic cancer patients after the FOLFIRINOX regimen.Patients with locally-advanced or metastatic pancreatic adenocarcinoma from French and Canadian centers, who were treated with the first-line FOLFIRINOX regimen (FFX L1), followed by gemcitabine monotherapy as a second-line treatment (GEM L2), were retrospectively evaluated. Statistical analyses were performed on the demographic, toxicity, and response rate data. Overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan-Meier method...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28418365/-surgical-strategy-for-locally-advanced-right-sided-colonic-cancer
#20
M I Davydov, Yu I Patyutko, A O Rasulov, A G Kotel'nikov, I A Fainshtein, M G Abgaryan, V A Aliev, N E Kudashkin
AIM: To present early and remote surgical outcomes in patients with locally-advanced right-sided colonic cancer, invasion of pancreatic head and/or duodenal wall. MATERIAL AND METHODS: Early and remote surgical outcomes were analyzed in 27 patients who underwent gastropancreatoduodenectomy combined with right-sided hemicolectomy (ileotransversostomy extirpation) for locally-advanced right-sided colonic cancer. RESULTS: Mean time of surgery was 300 (240-460) minutes, intraoperative blood loss - 2000 (500-7200) ml...
2017: Khirurgiia
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