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Locally advanced pancreatic cancer

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https://www.readbyqxmd.com/read/28346421/serpinb2-regulates-stromal-remodelling-and-local-invasion-in-pancreatic-cancer
#1
N L E Harris, C Vennin, J R W Conway, K L Vine, M Pinese, M J Cowley, R F Shearer, M C Lucas, D Herrmann, A H Allam, M Pajic, J P Morton, A V Biankin, M Ranson, P Timpson, D N Saunders
Pancreatic cancer has a devastating prognosis, with an overall 5-year survival rate of ~8%, restricted treatment options and characteristic molecular heterogeneity. SerpinB2 expression, particularly in the stromal compartment, is associated with reduced metastasis and prolonged survival in pancreatic ductal adenocarcinoma (PDAC) and our genomic analysis revealed that SERPINB2 is frequently deleted in PDAC. We show that SerpinB2 is required by stromal cells for normal collagen remodelling in vitro, regulating fibroblast interaction and engagement with collagen in the contracting matrix...
March 27, 2017: Oncogene
https://www.readbyqxmd.com/read/28345594/serum-lactate-dehydrogenase-predicts-prognosis-and-correlates-with-systemic-inflammatory-response-in-patients-with-advanced-pancreatic-cancer-after-gemcitabine-based-chemotherapy
#2
Shu-Lin Yu, Li-Tao Xu, Qi Qi, Ya-Wen Geng, Hao Chen, Zhi-Qiang Meng, Peng Wang, Zhen Chen
Serum lactate dehydrogenase (LDH) concentrations correlate with tumor progression and poor outcome. We evaluated the predictive value of serum LDH level for overall survival (OS) of patients with advanced pancreatic cancer after gemcitabine-based chemotherapy. We retrospectively enrolled 364 patients with locally advanced or metastatic pancreatic adenocarcinoma who were then allocated to training (n = 139) and validation cohorts (n = 225). We evaluated the association between serum LDH levels and OS as well as with markers of systemic inflammation, including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and lymphocyte/monocyte ratio (LMR)...
March 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28344661/liposomal-irinotecan-in-gemcitabine-refractory-metastatic-pancreatic-cancer-efficacy-safety-and-place-in-therapy
#3
REVIEW
Emma Kipps, Kate Young, Naureen Starling
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. The majority of patients are diagnosed with locally advanced or metastatic disease with a prognosis of short months. Therapeutic options are limited and until recently, there was no standard second-line chemotherapy option. Liposomal constructs have been engineered to encapsulate chemotherapy thereby preventing premature metabolism, improving distribution and minimizing toxicity. Favourable preclinical data on liposomal irinotecan and early phase trials, led to a recently published phase III trial of liposomal irinotecan in combination with fluorouracil and folinic acid in patients with metastatic PDAC, who progressed after gemcitabine-based chemotherapy...
March 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/28324747/optimal-dose-reduction-of-folfirinox-for-preserving-tumour-response-in-advanced-pancreatic-cancer-using-cumulative-relative-dose-intensity
#4
Jong-Chan Lee, Jin Won Kim, Soyeon Ahn, Hyoung Woo Kim, Jongchan Lee, Young Hoon Kim, Kyu-Hyun Paik, Jaihwan Kim, Jin-Hyeok Hwang
BACKGROUND: FOLFIRINOX has increased efficacy but also toxicity. Despite various modified FOLFIRINOX regimens, how much reduction is acceptable remains unclear. This study aimed to find the optimal relative dose intensity (RDI, %) of FOLFIRINOX that preserves tumour responses in patients with advanced pancreatic cancer (PC). METHODS: We reviewed 201 patients with PC treated with first-line FOLFIRINOX during 2012-2015. We established a modified Hryniuk model (http://www...
March 16, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28286568/immunotherapy-in-pancreatic-cancer-treatment-a-new-frontier
#5
REVIEW
Komal Thind, Leslie J Padrnos, Ramesh K Ramanathan, Mitesh J Borad
Pancreatic cancer is a highly aggressive and lethal cancer characterized by high invasiveness, local and extensive dissemination at time of diagnosis and resistance to treatment. Few therapies have shown efficacy in the past and even standard of care therapies yield only modest improvements in the mortality of patients with advanced or metastatic disease. Efforts have been undertaken to study the pancreatic tumor microenvironment and have established its complex and immunosuppressive nature which could explain the high resistance to chemotherapy...
January 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28282277/role-of-stereotactic-body-radiotherapy-in-the-treatment-of-elderly-and-poor-performance-status-patients-with-pancreatic-cancer
#6
Lauren M Rosati, Joseph M Herman
Literature on the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have poor performance status is sparse. The median survival of this unique cohort of patients is < 6 months, and most patients are only offered single-agent gemcitabine or supportive care. Recently, adding nanoparticle albumin-bound paclitaxel to gemcitabine was shown to improve survival of patients with metastatic disease with Eastern Cooperative Group performance status of 2. Although standard chemoradiotherapy provides long-term locoregional control in locally advanced pancreatic cancer, it is difficult for this group of patients to tolerate 6 weeks of therapy...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28280649/first-case-of-foot-drop-associated-with-capecitabine-in-a-patient-with-thymidylate-synthase-polymorphism
#7
Andrew B Wilks, Muhammad W Saif
Capecitabine, an oral prodrug of 5-FU, has been approved by the FDA for use in patients with breast and colon cancers. In addition, capecitabine is commonly used in patients with other malignancies such as pancreatic, gastroesophageal, and hepatobiliary tract cancers. Though cerebellar toxicity is a rare but well-known side effect of intravenous 5-FU therapy, peripheral neuropathy with capecitabine has only been described in rare cases. In this case report, we describe a 79-year-old patient with locally advanced adenocarcinoma of the pancreas undergoing chemoradiation therapy with capecitabine who developed peripheral sensorimotor neuropathy...
January 24, 2017: Curēus
https://www.readbyqxmd.com/read/28278561/the-role-of-surgical-clips-in-the-evaluation-of-interfractional-uncertainty-for-treatment-of-hepatobiliary-and-pancreatic-cancer-with-postoperative-radiotherapy
#8
Jin Suk Bae, Dong Hyun Kim, Won Taek Kim, Yong Ho Kim, Dahl Park, Yong Kan Ki
Purpose: To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Methods and Materials: Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy...
March 10, 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/28274396/assessing-local-progression-after-stereotactic-body-radiation-therapy-for-unresectable-pancreatic-adenocarcinoma-ct-versus-pet
#9
Diego A S Toesca, Erqi L Pollom, Peter D Poullos, Lesley Flynt, Yi Cui, Andrew Quon, Rie von Eyben, Albert C Koong, Daniel T Chang
PURPOSE: Evaluation of local tumor progression (LP) has typically been defined by contrast-enhanced computed tomography (CT) imaging after stereotactic body radiation therapy (SBRT) for locally advanced pancreatic cancer (PDAC). The purpose of this study is to determine the benefit of adding 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging to CT for LP assessment of PDAC after SBRT. METHODS AND MATERIALS: We retrospectively reviewed pretreatment, follow-up images, and outcomes of all patients treated with definitive SBRT for unresectable PDAC between December 2002 and December 2015 at our institution...
March 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28259610/vandetanib-plus-gemcitabine-versus-placebo-plus-gemcitabine-in-locally-advanced-or-metastatic-pancreatic-carcinoma-vip-a-prospective-randomised-double-blind-multicentre-phase-2-trial
#10
Gary Middleton, Daniel H Palmer, William Greenhalf, Paula Ghaneh, Richard Jackson, Trevor Cox, Anthony Evans, Victoria E Shaw, Jonathan Wadsley, Juan W Valle, David Propper, Harpreet Wasan, Stephen Falk, David Cunningham, Fareeda Coxon, Paul Ross, Srinivasan Madhusudan, Nick Wadd, Pippa Corrie, Tamas Hickish, Eithne Costello, Fiona Campbell, Charlotte Rawcliffe, John P Neoptolemos
BACKGROUND: Erlotinib is an EGFR tyrosine kinase inhibitor that has shown a significant but only marginally improved median overall survival when combined with gemcitabine in patients with locally advanced and metastatic pancreatic cancer. Vandetanib is a novel tyrosine kinase inhibitor of VEGFR2, RET, and EGFR, all of which are in involved in the pathogenesis of pancreatic cancer. We investigated the clinical efficacy of vandetanib when used in combination with gemcitabine in patients with advanced pancreatic cancer...
March 1, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28251282/multicenter-randomized-open-label-phase-ii-study-comparing-s-1-alternate-day-oral-therapy-with-the-standard-daily-regimen-as-a-first-line-treatment-in-patients-with-unresectable-advanced-pancreatic-cancer
#11
Hiroki Yamaue, Atsushi Shimizu, Yasuhiro Hagiwara, Masayuki Sho, Hiroaki Yanagimoto, Shoji Nakamori, Hideki Ueno, Hiroshi Ishii, Masayuki Kitano, Kazuya Sugimori, Hiroyuki Maguchi, Shinichi Ohkawa, Hiroshi Imaoka, Daisuke Hashimoto, Kazuki Ueda, Hiroko Nebiki, Tatsuya Nagakawa, Hiroyuki Isayama, Isao Yokota, Yasuo Ohashi, Tetsuhiko Shirasaka
PURPOSE: Non-inferiority for overall survival (OS) following alternate-day treatment with the oral anticancer drug S-1 compared with standard daily treatment was assessed in Japanese patients with unresectable advanced pancreatic cancer in a multicenter, randomized, phase II study. This trial was registered at the UMIN Clinical Trials Registry (no. 000008604). METHODS: Chemotherapy-naïve patients with locally advanced or metastatic pancreatic cancer were randomly assigned 2:1 to treatment with alternate-day (twice daily on alternate days from days 1 through 42 of a 42-day cycle) or daily (twice daily on days 1 through 28 of a 42-day cycle) treatment with S-1...
March 1, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28250896/endoscopy-guided-ablation-of-pancreatic-lesions-technical-possibilities-and-clinical-outlook
#12
REVIEW
Marianna Signoretti, Roberto Valente, Alessandro Repici, Gianfranco Delle Fave, Gabriele Capurso, Silvia Carrara
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for locally advanced pancreatic cancer (LAPC), pancreatic neuroendocrine tumours (PNETs), and pancreatic cystic lesions (PCLs). The advantages of treatment under endoscopic control are the real-time imaging guidance and the possibility to reach a deep target like the pancreas. Currently, radiofrequency probes specifically designed for ERCP or EUS ablation are available as well as hybrid cryotherm probe combining radiofrequency with cryotechnology...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28240915/quantitative-proteomic-analysis-of-serum-exosomes-from-patients-with-locally-advanced-pancreatic-cancer-undergoing-chemoradiotherapy
#13
Mingrui An, Ines Lohse, Zhijing Tan, Jianhui Zhu, Jing Wu, Himabindu Kurapati, Meredith A Morgan, Theodore S Lawrence, Kyle C Cuneo, David M Lubman
Pancreatic cancer is the third leading cause of cancer-related death in the USA. Despite extensive research, minimal improvements in patient outcomes have been achieved. Early identification of treatment response and metastasis would be valuable to determine the appropriate therapeutic course for patients. In this work, we isolated exosomes from the serum of 10 patients with locally advanced pancreatic cancer at serial time points over a course of therapy, and quantitative analysis was performed using the iTRAQ method...
March 8, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/28223678/-conversion-surgery-for-initially-unresectable-locally-advanced-pancreatic-cancer-following-gemcitabine-plus-nab-paclitaxel-a-case-report
#14
Shuji Nakamoto, Ryo Nishiyama, Takayoshi Kaneda, Mitsuo Yokota, Hiroshi Kawamata, Hiroshi Tajima, Takashi Kaizu, Yusuke Kumamoto, Hiroshi Yamauchi, Kosuke Okuwaki, Tomohisa Iwai, Hiroshi Imaizumi, Erina Suzuki, Atsuko Hara, Masaaki Ichinoe, Mitsuhiro Kida, Masahiko Watanabe
We report a case of unresectable locally advanced pancreatic cancer successfully resected after gemcitabine(GEM)plus nab-paclitaxel(PTX)treatment. A 68-year-old man was referred to our institution with jaundice. We diagnosed pancreatic head cancer using computed tomography(CT)and endoscopic retrograde cholangiopancreatography. We initially diagnosed it as locally advanced unresectable pancreatic cancer because of extensive invasion to the portal vein. GEM plus nab- PTX was administered to the patient as systemic chemotherapy...
February 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28210843/updated-results-from-gest-study-a-randomized-three-arm-phase-iii-study-for-advanced-pancreatic-cancer
#15
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
#16
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
#17
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
#18
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
#19
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/endoscopic-ultrasonography-guided-tumor-ablation
#20
REVIEW
Sundeep Lakhtakia, Dong-Wan Seo
Real-time guidance of needle advancement has transformed endoscopic ultrasound (EUS) 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 tumors...
February 7, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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