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Metastatic pancreatic cancer

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https://www.readbyqxmd.com/read/29235000/is-neoadjuvant-therapy-sufficient-in-resected-pancreatic-cancer-patients-a-national-study
#1
Susanna W L de Geus, Gyulnara G Kasumova, Mariam F Eskander, Sing Chau Ng, Tara S Kent, A James Moser, Alexander L Vahrmeijer, Mark P Callery, Jennifer F Tseng
BACKGROUND: Despite the increasing use of neoadjuvant treatment, the question of whether preoperatively treated, successfully resected patients should receive additional postoperative adjuvant treatment remains unanswered. We evaluate the impact of adjuvant therapy following neoadjuvant treatment and pancreatectomy in pancreatic cancer patients in a large national study. METHODS: We used the National Cancer Data Base between 2006 and 2013 to identify resected, non-metastatic pancreatic adenocarcinoma patients who received neoadjuvant chemo(radio)therapy followed by pancreatectomy...
October 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29232340/ablative-therapies-for-locally-advanced-pancreatic-cancer
#2
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/29228980/lipoxin-a4-reverses-mesenchymal-phenotypes-to-attenuate-invasion-and-metastasis-via-the-inhibition-of-autocrine-tgf-%C3%AE-1-signaling-in-pancreatic-cancer
#3
Liang Zong, Ke Chen, Zhengdong Jiang, Xin Chen, Liankang Sun, Jiguang Ma, Cancan Zhou, Qinhong Xu, Wanxing Duan, Liang Han, Jianjun Lei, Xuqi Li, Qingyong Ma, Zheng Wang
BACKGROUND: Pancreatic cancer is a lethal disease in part because of its potential for aggressive invasion and metastasis. Lipoxin A4 (LXA4) is one of the metabolites that is derived from arachidonic acid and that is catalyzed by 15-lipoxygenase (15-LOX), and it has recently been reported to exhibit anti-cancer effects. However, the role of LXA4 in pancreatic cancer remains to be elucidated. METHODS: Pancreatic cell lines were treated with vehicle or LXA4, and the invasive capacity was then assessed by Transwell assays...
December 11, 2017: Journal of Experimental & Clinical Cancer Research: CR
https://www.readbyqxmd.com/read/29228619/fibrin-bearing-microparticles-marker-of-thrombo-embolic-events-in-pancreatic-and-colorectal-cancers
#4
Diane Mege, Lydie Crescence, Mehdi Ouaissi, Igor Sielezneff, Regis Guieu, Françoise Dignat-George, Christophe Dubois, Laurence Panicot-Dubois
Background: Microparticles (MPs) are plasma membrane-derived extracellular vesicles present in the bloodstream. We have described a specific signature of MPs, called microparticulosome, in colorectal (CRC) and pancreatic (PC) cancers. We observed that levels of fibrin-bearing MPs were significantly increased in patients suffering from PC and CRC in comparison with control groups. Here, we hypothesised that fibrin-MPs may constitute a relevant biomarker of thrombosis associated with cancer...
November 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/29216749/impact-of-palliative-chemotherapy-and-travel-distance-on-hospice-referral-in-patients-with-stage-iv-pancreatic-cancer-a-retrospective-analysis-within-a-veterans-administration-medical-center
#5
Jennifer M Duff, Ryan M Thomas
BACKGROUND: Metastatic pancreatic ductal adenocarcinoma (mPDAC) has a poor prognosis despite chemotherapy advancements. Although hospice utilization has increased, timing of referral is not always optimal. AIM: To investigate whether palliative chemotherapy and travel distance to the treatment center impact hospice referral patterns in veterans of the US military in order to identify potential areas for improving referral timing. DESIGN: Demographic and clinical data were collected retrospectively according to the timing of hospice referral...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29216209/preliminary-study-of-tumor-heterogeneity-in-imaging-predicts-two-year-survival-in-pancreatic-cancer-patients
#6
Jayasree Chakraborty, Liana Langdon-Embry, Kristen M Cunanan, Joanna G Escalon, Peter J Allen, Maeve A Lowery, Eileen M O'Reilly, Mithat Gönen, Richard G Do, Amber L Simpson
Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers in the United States with a five-year survival rate of 7.2% for all stages. Although surgical resection is the only curative treatment, currently we are unable to differentiate between resectable patients with occult metastatic disease from those with potentially curable disease. Identification of patients with poor prognosis via early classification would help in initial management including the use of neoadjuvant chemotherapy or radiation, or in the choice of postoperative adjuvant therapy...
2017: PloS One
https://www.readbyqxmd.com/read/29199014/microrna-regulation-of-k-ras-in-pancreatic-cancer-and-opportunities-for-therapeutic-intervention
#7
REVIEW
Saswati Karmakar, Garima Kaushik, Ramakrishna Nimmakayala, Satyanarayana Rachagani, Moorthy P Ponnusamy, Surinder K Batra
The Ras family of GTPases is involved in cell proliferation, cell survival, and angiogenesis. It is upregulated in several cancers, including pancreatic cancer (PC) and leads to uncontrolled growth and aggressiveness. PC is well known to be a lethal disease with poor prognosis, plagued by limited therapeutic modalities. MicroRNAs (miRNAs), which are short non-coding RNA molecules, have recently emerged as regulators of signaling networks and have shown potential to target pathway components for therapeutic use in several malignancies...
November 30, 2017: Seminars in Cancer Biology
https://www.readbyqxmd.com/read/29192278/profiling-of-different-pancreatic-cancer-cells-used-as-models-for-metastatic-behaviour-shows-large-variation-in-their-n-glycosylation
#8
Stephanie Holst, Ana I Belo, Elisa Giovannetti, Irma van Die, Manfred Wuhrer
To characterise pancreatic cancer cells from different sources which are used as model systems to study the metastatic behaviour in pancreatic ductal adenocarcinoma (PDAC), we compared the N-glycan imprint of four PDAC cells which were previously shown to differ in their galectin-4 expression and metastatic potential in vivo. Next to the sister cell lines Pa-Tu-8988S and Pa-Tu-8988T, which were isolated from the same liver metastasis of a PDAC, this included two primary PDAC cell cultures, PDAC1 and PDAC2. Additionally, we extended the N-glycan profiling to a normal, immortalized pancreatic duct cell line...
November 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29191278/timing-of-pancreatic-resection-and-patient-outcomes-is-there-a-difference
#9
REVIEW
Timothy J Vreeland, Mathew H G Katz
Rates of long-term survival after treatment of pancreatic cancer remain low, in part because most patients are still treated with primary resection. This approach is often inadequate because of early local control failures, early manifestation of metastatic disease because of the unrecognized and untreated systemic component of this disease, and because half of patients never receive multimodal therapy. Preoperative therapy can be used to improve local control and treat the systemic nature of pancreatic cancer while also selecting for patients who benefit from a morbid operation...
February 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29189332/clinical-management-metastatic-disease
#10
Andrew H Ko
Most patients with pancreatic cancer either present with or eventually develop metastatic disease during the course of their illness. For such individuals, systemic therapy, namely, cytotoxic therapy, represents the mainstay of treatment and is administered with noncurative intent. Of the various chemotherapy options now available for treating metastatic pancreatic cancer, 2 combination regimens, FOLFIRINOX (infusional 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and the doublet of gemcitabine and albumin-bound paclitaxel, have emerged as frontline standards of care, based on phase III studies demonstrating a significant survival benefit compared with single-agent gemcitabine...
November 2017: Cancer Journal
https://www.readbyqxmd.com/read/29189327/the-pancreatic-cancer-microenvironment
#11
Stephanie K Dougan
Pancreatic ductal adenocarcinoma (PDAC) is composed of a minority of malignant cells within a microenvironment of extracellular matrix, fibroblasts, endothelial cells, and immune cells. Therapeutic failures of chemotherapy, targeted therapy, and immunotherapy have all been attributed to the PDAC microenvironment. In this review, we dissect the components of the microenvironment and explain how each cell type contributes to form a highly immunosuppressive, hypoxic, and desmoplastic cancer. New efforts in single-cell profiling will enable a better understanding of the composition of the microenvironment in primary and metastatic PDAC, as well as an understanding of how the microenvironment may respond to novel therapeutic approaches...
November 2017: Cancer Journal
https://www.readbyqxmd.com/read/29185014/characterizing-indeterminate-liver-lesions-in-patients-with-localized-pancreatic-cancer-at-the-time-of-diagnosis
#12
Manav Bhalla, Mohammed Aldakkak, Naveen M Kulkarni, Stacy D O'Connor, Michael O Griffin, Kathleen K Christians, Douglas B Evans, Susan Tsai, Parag P Tolat
BACKGROUND: In patients with newly diagnosed pancreatic cancer, the classification of indeterminate liver lesions is an unanswered clinical dilemma as misclassification of these lesions can impact the assignment of clinical stage and subsequent treatment planning. Our objective was to design a standardized classification system to more accurately define the risk of malignancy in indeterminate liver lesions. METHODS: In this retrospective study, patients with localized, non-metastatic pancreatic cancer were identified and pre-treatment computed tomography (CT) scans were evaluated for the presence or absence of liver lesions...
November 28, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29184680/stereotactic-body-radiotherapy-for-locally-advanced-unresectable-pancreatic-cancer-patterns-of-care-and-overall-survival
#13
Michael J Dohopolski, Scott M Glaser, John A Vargo, Goundappa K Balasubramani, Sushil Beriwal
Background: Unresectable pancreatic cancer remains a challenging disease to treat. Stereotactic body radiotherapy (SBRT) allows for a higher biologically equivalent dose in an abbreviated course more convenient for patients and the integration of systemic therapy. We sought to investigate utilization trends and survival outcomes for patients treated with pancreatic SBRT versus conventionally fractionated radiotherapy (CFRT). Methods: We engaged the National Cancer Database (NCDB) from 1998-2012 and identified locally-advanced unresectable patients with histologically confirmed, non-metastatic, pancreatic adenocarcinoma who received radiotherapy...
October 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29183764/clinical-outcome-of-portal-vein-thrombosis-in-patients-with-digestive-cancers-a-large-ageo-multicenter-study
#14
Hélène Regnault, Sheik Emambux, Thierry Lecomte, Solene Doat, Marion Dhooge, Marie Besson, Olivier Dubreuil, Frederic Moryoussef, Christine Silvain, Jean-Baptiste Bachet, David Tougeron
INTRODUCTION: Management of portal vein thrombosis (PVT) in cancer patients remains discussed. AIMS: The objective of this multicenter retrospective study was to investigate the management and outcome of PVT in patients with digestive cancers other than hepatocellular carcinoma (HCC). METHOD: Main inclusion criteria were trunk or branch PVT in patients with locally advanced or metastatic digestive cancers. Predictive factors of bleeding and overall survival (OS) were evaluated in univariate and multivariate analysis...
November 16, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29179494/combinatorial-effects-of-an-epigenetic-inhibitor-and-ionizing-radiation-contribute-to-targeted-elimination-of-pancreatic-cancer-stem-cell
#15
Hyun-Mi Kwon, Eun-Jin Kang, Keunsoo Kang, Sung-Dae Kim, Kwangmo Yang, Joo Mi Yi
Pancreatic cancer is associated with a high mortality rate, owing to de novo and acquired drug resistance, thereby leading to highly invasive and metastatic pancreatic cancer cells. Therefore, targeting pancreatic cancer stem cells (CSCs) may be a novel therapeutic strategy for the treatment of pancreatic cancer. Here, we combined a DNA methylation inhibitor (5-aza-2'-deoxycytidine; 5-aza-dC) and ionizing radiation (IR) to improve anti-cancer effects by inhibiting growth and proliferation and promoting apoptosis of pancreatic cancer cells in vitro and in vivo...
October 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/29179479/splenectomy-is-associated-with-an-aggressive-tumor-growth-pattern-and-altered-host-immunity-in-an-orthotopic-syngeneic-murine-pancreatic-cancer-model
#16
Ho Kyoung Hwang, Takashi Murakami, Tasuku Kiyuna, Se Hoon Kim, Sung Hwan Lee, Chang Moo Kang, Robert M Hoffman, Michael Bouvet
The purpose of this study was to investigate whether splenectomy influences the tumor growth and metastatic pattern in an orthotopic syngeneic murine pancreatic cancer model. Murine pancreatic cancer cells (PAN02) were subcutaneously injected into the flanks of nude mice. A small tumor fragment (3 mm2), harvested from a subcutaneous tumor. was orthotopically implanted in the tail of the pancreas of C57/BL6 mice without splenectomy (control group, n=15) or with simultaneous splenectomy (splenectomy group, n=15)...
October 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/29178100/-lymph-node-metastasis-regularity-and-risk-factors-in-768-cardiac-carcinoma-patients
#17
Jie Yue, Xiaofeng Duan, Lei Gong, Jianguo Zhang, Zhentao Yu
OBJECTIVE: To investigate the regularity of lymph node metastasis in cardiac carcinoma and its risk factors. METHOD: Complete clinicopathological data of 768 cardiac carcinoma patients undergoing radical resection and lymph node dissection were collected. A retrospective cohort study was performed to analyze the distribution of lymph node metastasis (lymph node metastasis rate=number of patients with lymph node metastasis/number of patients with lymph node dissection; lymph node metastasis frequency=number of metastatic lymph node/number of total resected lymph node) and the influence of clinicopathological factors on lymph node metastasis...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29178025/pegylated-liposomal-irinotecan-hydrochloride-trihydrate-for-treating-pancreatic-cancer-after-gemcitabine-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#18
REVIEW
Nigel Fleeman, Ahmed Abdulla, Adrian Bagust, Sophie Beale, Marty Richardson, Angela Stainthorpe, Angela Boland, Eleanor Kotas, Joanne McEntee, Daniel Palmer
The National Institute for Health and Care Excellence (NICE) invited the manufacturer (Shire Pharmaceuticals) of pegylated liposomal irinotecan hydrochloride trihydrate (liposomal irinotecan) to submit clinical and cost-effectiveness evidence for its use in combination with 5-fluorouracil (5-FU) and folic acid/leucovorin (LV) for treating patients with pancreatic cancer following prior treatment with gemcitabine as part of the institute's Single Technology Appraisal process. The Liverpool Reviews and Implementation Group at the University of Liverpool was commissioned to act as the Evidence Review Group (ERG)...
November 24, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/29177608/identification-of-educational-gaps-among-oncologists-who-manage-patients-with-pancreatic-cancer
#19
Justin A Barnes, Melissa L Ellis, Sharon Hwang, Joan Emarine, Patti Merwin, Gregory D Salinas, Benjamin L Musher
INTRODUCTION: Pancreatic ductal adenocarcinoma (PDA) is associated with poor outcomes and presents oncologists with a myriad of clinical challenges. This study was conducted to assess oncologists' practice patterns and to identify the greatest areas of need for future PDA continuing medical education (CME) programs. METHODS: Case vignettes have been validated as an effective tool to assess how physicians approach and treat a wide array of diseases. In order to assess practice patterns for resectable, locally advanced unresectable, and metastatic PDA, an online case vignette survey was distributed to practicing medical oncologists...
November 27, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/29169392/prognostic-role-of-nodal-ratio-lodds-pn-in-patients-with-pancreatic-cancer-with-venous-involvement
#20
Giovanni Ramacciato, Giuseppe Nigri, Niccolo' Petrucciani, Antonio Daniele Pinna, Matteo Ravaioli, Elio Jovine, Francesco Minni, Gian Luca Grazi, Piero Chirletti, Giuseppe Tisone, Fabio Ferla, Niccolo' Napoli, Ugo Boggi
BACKGROUND: The UICC/AJCC TNM staging system classifies lymph nodes as N0 and N1 in pancreatic cancer. Aim of the study is to determine whether the number of examine nodes, the nodal ratio (NR) and the logarithm odds of positive lymph nodes (LODDS) may better stratify the prognosis of patients undergoing pancreatectomy combined with venous resection for pancreatic cancer with venous involvement. METHODS: A multicenter database of 303 patients undergoing pancreatectomy in 9 Italian referral centers was analyzed...
November 23, 2017: BMC Surgery
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