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pancreatic adenocarcinoma chemotherapy

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https://www.readbyqxmd.com/read/28640192/pancreatic-ductal-adenocarcinoma-current-and-evolving-therapies
#1
REVIEW
Aleksandra Adamska, Alice Domenichini, Marco Falasca
Pancreatic ductal adenocarcinoma (PDAC), which constitutes 90% of pancreatic cancers, is the fourth leading cause of cancer-related deaths in the world. Due to the broad heterogeneity of genetic mutations and dense stromal environment, PDAC belongs to one of the most chemoresistant cancers. Most of the available treatments are palliative, with the objective of relieving disease-related symptoms and prolonging survival. Currently, available therapeutic options are surgery, radiation, chemotherapy, immunotherapy, and use of targeted drugs...
June 22, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28639410/long-term-survival-benefit-of-upfront-chemotherapy-in-patients-with-newly-diagnosed-borderline-resectable-pancreatic-cancer
#2
Bikram Shrestha, Yifei Sun, Farzana Faisal, Victoria Kim, Kevin Soares, Alex Blair, Joseph M Herman, Amol Narang, Avani S Dholakia, Lauren Rosati, Amy Hacker-Prietz, Linda Chen, Daniel A Laheru, Ana De Jesus-Acosta, Dung T Le, Ross Donehower, Nilofar Azad, Luis A Diaz, Adrian Murphy, Valerie Lee, Elliot K Fishman, Ralph H Hruban, Tingbo Liang, John L Cameron, Martin Makary, Matthew J Weiss, Nita Ahuja, Jin He, Christopher L Wolfgang, Chiung-Yu Huang, Lei Zheng
The use of neoadjuvant chemotherapy or radiation for borderline resectable pancreatic adenocarcinoma (BL-PDAC) is increasing. However, the impact of neoadjuvant chemotherapy and radiation therapy on the outcome of BL-PDAC remains to be elucidated. We performed a retrospective analysis of 93 consecutive patients who were diagnosed with BL-PDAC and primarily followed at Johns Hopkins Hospital between February 2007 and December 2012. Among 93 patients, 62% received upfront neoadjuvant chemotherapy followed by chemoradiation, whereas 20% received neoadjuvant chemoradiation alone and 15% neoadjuvant chemotherapy alone...
June 21, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28639051/adjuvant-treatment-for-pancreatic-ductal-carcinoma
#3
REVIEW
T Macarulla, T Fernández, M E Gallardo, O Hernando, A M López, M Hidalgo
Pancreatic ductal adenocarcinoma (PDAC) is a tumor with a very poor prognosis. Most of the patients are diagnosed in advanced stages of the disease, and 5-year survival rates in these patients remains <10%. Surgery still remains the only radical treatment option, although only 15-20% of patients are candidates for surgical resection at the time of the diagnosis. Patients who undergo radical surgery still have a limited survival rate, being the average of 23 months. Three clinical trials have shown that adjuvant chemotherapy therapy after surgery may improve survival: CONKO-1, ESPAC-3, and ESPAC-4...
June 21, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28623515/pancreatic-ductal-adenocarcinoma-metastatic-disease
#4
REVIEW
A J Muñoz Martín, J Adeva, J Martínez-Galán, J J Reina, M Hidalgo
The treatment of choice of metastatic PADC is systemic chemotherapy. In the last decade, there have been significant advances in this area. New combination poli-chemotherapy schemes have shown a significant increase in overall survival and progression-free survival without impairing quality of life. In addition, the value of second-line chemotherapy treatment has consolidated and a new concept called "therapeutic sequencing" has also emerged. The aim of this article is to review the different therapeutic options in metastatic PDAC based on patient's characteristics...
June 16, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28618958/current-and-future-biomarkers-for-pancreatic-adenocarcinoma
#5
Sven H Loosen, Ulf P Neumann, Christian Trautwein, Christoph Roderburg, Tom Luedde
Although pancreatic cancer is only the twelfth most common type of cancer in the world, it features a very unfavorable prognosis. The mortality rate almost equals the incidence rate, corroborating the very poor prognosis of pancreatic cancer. The 5-year survival rate for all stages of pancreatic ductal adenocarcinoma is only 7%. Surgical resection represents the only potentially curative treatment option for pancreatic ductal adenocarcinoma patients but is often not feasible due to the advanced stage of the disease upon diagnosis...
June 2017: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
https://www.readbyqxmd.com/read/28612203/neoadjuvant-treatment-for-borderline-and-resectable-pancreatic-ductal-adenocarcinoma
#6
REVIEW
R Álvarez, I Alés, R Díaz, B G de Paredes, M Hidalgo
Nowadays and given the improvement in response rate with the new schemes of treatment with chemotherapy, the interest in neoadjuvant treatment for pancreatic ductal adenocarcinoma, allowing the early application of systemic therapies, has also increased. However, treatment selection fundamentally depends on decisions taken by multidisciplinary committees due to the absence of randomized trials on this indication and because the available evidence is based primarily on small studies. The present manuscript tries to establish recommendations based on the available evidence and expert opinion to correctly select the indication, the type of treatment, as well as its duration and how to correctly follow-up patients during treatment with chemotherapy...
June 13, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28612202/management-of-unresectable-locally-advanced-pancreatic-adenocarcinoma
#7
REVIEW
M Salgado, S Arévalo, O Hernando, A Martínez, R Yaya, M Hidalgo
The diagnosis of unresectable locally advanced pancreatic adenocarcinoma (LAPC) requires confirmation, through imaging tests, of the unfeasibility of achieving a complete surgical resection, in the absence of metastatic spread. The increase in overall survival (OS), together with an appropriate symptom management is the therapeutic target in LAPC, maintaining an acceptable quality of life and, if possible, increasing the time until the appearance of metastasis. Chemoradiation (CRT) improves OS compared to best support treatment or radiotherapy (RT) but with greater toxicity...
June 13, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28612201/supportive-care-in-pancreatic-ductal-adenocarcinoma
#8
REVIEW
B Laquente, A Calsina-Berna, A Carmona-Bayonas, P Jiménez-Fonseca, I Peiró, A Carrato
Pancreatic ductal adenocarcinoma (PDAC) is one of the cancers with poorest prognosis and represents the third leading cause of cancer-related deaths in Western countries. Despite advances in diagnostic procedures and treatment, diagnosis is made in most cases when the disease is locally advanced or metastatic. Supportive care aims to improve symptoms, reduce hospital admission rates, and preserve quality of life. Proper symptomatic management is critical to allow administration of chemotherapy and radiotherapy...
June 13, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28612015/oligometastatic-disease-in-pancreatic-cancer-how-to-proceed
#9
REVIEW
Bernhard W Renz, Stefan Boeck, Falk Roeder, Christoph Trumm, Volker Heinemann, Jens Werner
BACKGROUND: Pancreatic cancer is a highly aggressive malignancy and will become the second leading cause of cancer-related death in the USA and also in Germany by 2030. Furthermore, the majority of patients with pancreatic ductal adenocarcinoma (PDAC) will present with distant metastases, limiting surgical management in this population as there is little evidence available to support surgical or ablative treatment options for advanced-stage disease. However, highly selected patients suffering from synchronous and metachronous oligometastatic PDAC may potentially benefit from a surgical resection with an acceptable morbidity...
March 2017: Visceral Medicine
https://www.readbyqxmd.com/read/28611425/pancreatic-adenocarcinoma-response-to-chemotherapy-enhanced-with-non-invasive-radio-frequency-evaluated-via-an-integrated-experimental-computational-approach
#10
Matthew J Ware, Louis T Curtis, Min Wu, Jason C Ho, Stuart J Corr, Steven A Curley, Biana Godin, Hermann B Frieboes
Although chemotherapy combined with radiofrequency exposure has shown promise in cancer treatment by coupling drug cytotoxicity with thermal ablation or thermally-induced cytotoxicity, limited access of the drug to tumor loci in hypo-vascularized lesions has hampered clinical application. We recently showed that high-intensity short-wave capacitively coupled radiofrequency (RF) electric-fields may reach inaccessible targets in vivo. This non-invasive RF combined with gemcitabine (Gem) chemotherapy enhanced drug uptake and effect in pancreatic adenocarcinoma (PDAC), notorious for having poor response and limited therapeutic options, but without inducing thermal injury...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28611107/il-6-receptor-blockade-enhances-chemotherapy-efficacy-in-pancreatic-ductal-adenocarcinoma
#11
Kristen B Long, Graham Tooker, Evan Tooker, Santiago Lombo Luque, Jae W Lee, Xiaoqing Pan, Gregory L Beatty
Inflammation mediated by activation of Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling is a major cause of chemotherapy resistance in cancer. We studied the impact of selectively blocking the IL-6 receptor (IL6R) as a strategy to inhibit IL-6-induced STAT activation and to overcome chemoresistance in pancreatic ductal adenocarcinoma (PDAC). To do this, STAT activation was investigated in tumors arising spontaneously in LSL-Kras(G12D/+);LSL-Trp53(R172H/+);Pdx-1Cre (KPC) mice...
June 13, 2017: Molecular Cancer Therapeutics
https://www.readbyqxmd.com/read/28607950/chemovirotherapy-of-pancreatic-adenocarcinoma-by-combining-oncolytic-vaccinia-virus-glv-1h68-with-nab-paclitaxel-plus-gemcitabine
#12
Eike Binz, Susanne Berchtold, Julia Beil, Martina Schell, Christine Geisler, Irina Smirnow, Ulrich M Lauer
Oncolytic viruses have proven their therapeutic potential against a variety of different tumor entities both in vitro and in vivo. Their ability to selectively infect and lyse tumor cells, while sparing healthy tissues, makes them favorable agents for tumor-specific treatment approaches. Particularly, the addition of virotherapeutics to already established chemotherapy protocols (so-called chemovirotherapy) is of major interest. Here we investigated the in vitro cytotoxic effect of the oncolytic vaccinia virus GLV-1h68 combined with dual chemotherapy with nab-paclitaxel plus gemcitabine in four human pancreatic adenocarcinoma cell lines (AsPc-1, BxPc-3, MIA-PaCa-2, and Panc-1)...
September 15, 2017: Molecular Therapy Oncolytics
https://www.readbyqxmd.com/read/28602164/second-line-chemotherapy-for-advanced-pancreatic-cancer-which-is-the-best-option
#13
REVIEW
Giuseppe Aprile, Francesca V Negri, Francesco Giuliani, Elisa De Carlo, Davide Melisi, Francesca Simionato, Nicola Silvestris, Oronzo Brunetti, Francesco Leone, Donatella Marino, Daniele Santini, Emanuela Dell'Aquila, Tea Zeppola, Marco Puzzoni, Mario Scartozzi
Despite recent biological insight and therapeutic advances, the prognosis of advanced pancreatic cancer still remains poor. For more than 15 years, gemcitabine monotherapy has been the cornerstone of first-line treatment. Recently, prospective randomized trials have shown that novel upfront combination regimens tested in prospective randomized trials have resulted in improved patients' outcome increasing the proportion of putative candidate to second-line therapy. There is no definite standard of care after disease progression...
July 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28601189/has-survival-improved-following-resection-for-pancreatic-adenocarcinoma
#14
REVIEW
Kenneth Luberice, Darrell Downs, Benjamin Sadowitz, Sharona Ross, Alexander Rosemurgy
INTRODUCTION: This study was undertaken to determine if survival after resection of pancreatic adenocarcinoma has improved over the past two decades. METHODS: The SEER database was queried for patients who underwent pancreatectomy for pancreatic adenocarcinoma from 1992 to 2010. AJCC Stage and survival were determined for patients. Data were analyzed using Mantel-Cox test and linear regression. RESULTS: 15,604 patients underwent pancreatectomy from 1992 to 2010...
June 3, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28600474/use-of-angiotensin-system-inhibitors-is-associated-with-immune-activation-and-longer-survival-in-non-metastatic-pancreatic-ductal-adenocarcinoma
#15
Hao Liu, Kamila Naxerova, Matthias Pinter, Joao Incio, Hang Lee, Kohei Shigeta, William W Ho, Jonathan A Crain, Alex Jacobson, Theodoros Michelakos, Daniella Dias-Santos, Andrea Zanconato, Theodore S Hong, Jeffrey W Clark, Janet E Murphy, David P Ryan, Vikram Deshpande, Keith D Lillemoe, Carlos Fernandez-Del Castillo, Michael Downes, Ronald M Evans, James Michaelson, Cristina R Ferrone, Yves Boucher, Rakesh K Jain
Angiotensin system inhibitors (ASIs) can improve prognosis in multiple cancer types, including pancreatic ductal adenocarcinoma (PDAC). However, no study has examined the effect of ASIs alone or combined with adjuvant chemotherapy in resected PDAC patients.<br /><br />Experimental Design: We performed an analysis of the records of ASI users and non-user patients with PDAC seen at Massachusetts General Hospital between January 2006 and December 2010. To identify mechanisms of ASIs in PDAC, we performed RNA-Seq of resected primary lesions...
June 9, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28599496/use-of-gemcitabine-as-a-second-line-treatment-following-chemotherapy-with-folfirinox-for-metastatic-pancreatic-adenocarcinoma
#16
Matthieu Sarabi, Laetitia Mais, Nadia Oussaid, Françoise Desseigne, Pierre Guibert, Christelle De La Fouchardiere
There is a lack of prospective data about second-line treatments for metastatic pancreatic ductal adenocarcinoma patients. This is partially due to recent changes in first-line chemotherapy treatments. Despite this dearth of information, 50.0% of the patients who experience failure with first-line folinic acid, 5-fluorouracil, irinotecan and oxaliplatin (folfirinox) treatment are eligible for additional chemotherapy. In this setting, gemcitabine is widely used without any standard recommendations available...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28594388/gene-therapy-for-pancreatic-cancer-specificity-issues-and-hopes
#17
REVIEW
Marie Rouanet, Marine Lebrin, Fabian Gross, Barbara Bournet, Pierre Cordelier, Louis Buscail
A recent death projection has placed pancreatic ductal adenocarcinoma as the second cause of death by cancer in 2030. The prognosis for pancreatic cancer is very poor and there is a great need for new treatments that can change this poor outcome. Developments of therapeutic innovations in combination with conventional chemotherapy are needed urgently. Among innovative treatments the gene therapy offers a promising avenue. The present review gives an overview of the general strategy of gene therapy as well as the limitations and stakes of the different experimental in vivo models, expression vectors (synthetic and viral), molecular tools (interference RNA, genome editing) and therapeutic genes (tumor suppressor genes, antiangiogenic and pro-apoptotic genes, suicide genes)...
June 8, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28589527/targeting-the-tumor-stroma-the-biology-and-clinical-development-of-pegylated-recombinant-human-hyaluronidase-pegph20
#18
REVIEW
Kit Man Wong, Kathryn J Horton, Andrew L Coveler, Sunil R Hingorani, William P Harris
The tumor stroma is increasingly recognized as a key player in tumorigenesis through its effects on cell signaling, immune responses, and access of therapeutic agents. A major component of the extracellular matrix is hyaluronic acid (HA), which raises the interstitial gel fluid pressure within tumors and reduces drug delivery to malignant cells, and has been most extensively studied in pancreatic ductal adenocarcinoma (PDA). Pegylated recombinant human hyaluronidase (PEGPH20) is a novel agent that degrades HA and normalizes IFP to enhance the delivery of cytotoxic agents...
July 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28588713/neoadjuvant-chemotherapy-in-borderline-resectable-pancreatic-cancer-a-case-report
#19
Maria Celeste Palmarocchi, Ruben Carlo Balzarotti Canger, Piercarlo Saletti
Pancreatic cancer is the fourth leading cause of cancer mortality and is associated with a poor overall survival even when diagnosed early and considered resectable. Complete surgical removal with negative histological margins is an independent predictor of survival and remains the only potential curative treatment. In borderline resectable pancreatic adenocarcinoma (BRPAC), preoperative systemic therapy may increase resectability and margin-negative resection rate. There is no current consensus on the optimal chemotherapy regimen for BRPAC...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28582436/is-hyaluronan-deposition-in-the-stroma-of-pancreatic-ductal-adenocarcinoma-of-prognostic-significance
#20
Florian Gebauer, Marius Kemper, Guido Sauter, Peter Prehm, Udo Schumacher
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis and the number of PDAC-related deaths is rising. Recently the tumour stroma and in particular one of its main components, hyaluronan (HA), have attracted considerable attention as intravenous hyaluronidase treatment together with conventional chemotherapy considerably prolonged survival in HA-rich PDA patients. We therefore wanted to investigate the prognostic significance of HA deposition in PDA using both antibodies to HA and hyaluronan binding protein (HABP)...
2017: PloS One
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