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pancreatic adenocarcinoma chemotherapy

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https://www.readbyqxmd.com/read/28722678/optimal-adjuvant-chemotherapy-for-resected-pancreatic-adenocarcinoma-a-systematic-review-and-network-meta-analysis
#1
Jian-Bo Xu, Bin Jiang, Ya Chen, Fu-Zhen Qi, Jian-Huai Zhang, Hang Yuan
Adjuvant chemotherapy improves survival in patients with resected pancreatic cancer but the optimal regimen remains unclear. We aim to compare all possible adjuvant chemotherapy in terms of overall survival and toxic effects. Pubmed, Trial registries and Cochrane library databases for randomized controlled trials were searched until November 2016. Thirteen trials were included for network analysis and the hazard ratios (HRs) for survival and odds ratios for toxic effects were assessed via Aggregate Data Drug Information System software...
July 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28718038/reappraisal-of-staging-laparoscopy-for-patients-with-pancreatic-adenocarcinoma-a-contemporary-analysis-of-1001-patients
#2
Zhi Ven Fong, Donna Marie L Alvino, Carlos Fernández-Del Castillo, Winta T Mehtsun, Ilaria Pergolini, Andrew L Warshaw, David C Chang, Keith D Lillemoe, Cristina R Ferrone
BACKGROUND: Recent advances in imaging and the increasing use of neoadjuvant therapy puts the contemporary utility of staging laparoscopy for patients with pancreatic adenocarcinoma (PDAC) into question. This study aimed to develop a prognostic score to optimize prevention of an unnecessary laparotomy and minimize the rate for unnecessary laparoscopy. METHODS: Clinicopathologic data were evaluated for all patients undergoing surgical intervention for PDAC between 2001 and 2015, who were stratified into group 1 (2001-2008) and group 2 (2009-2014)...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28716115/resectable-adenocarcinoma-developing-in-the-remnant-pancreas-7%C3%A2-years-after-partial-pancreatoduodenectomy-for-invasive-ductal-adenocarcinoma-of-the-pancreas-a-case-report
#3
Lina Frei, Ruedi Stieger, Christian Bayerl, Stefan Breitenstein, Ralph F Staerkle
BACKGROUND: Pancreatic adenocarcinoma still has an excessively high mortality rate and resection is the only potentially curative treatment. The postoperative 5-year survival rate is approximately 20% and recurrence develops generally within 2 years. We report a case of a localized recurrent pancreatic adenocarcinoma in the remnant pancreas, 7 years after initial resection. CASE PRESENTATION: In 2008 an abdominal computed tomography scan showed a mass in the pancreas of a 70-year-old white woman, who presented with occlusive jaundice and abdominal pain in her right upper quadrant...
July 17, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28714519/circulating-regulatory-t-cell-subsets-predict-overall-survival-of-patients-with-unresectable-pancreatic-cancer
#4
Chen Liu, He Cheng, Guopei Luo, Yu Lu, Kaizhou Jin, Meng Guo, Quanxing Ni, Xianjun Yu
Most patients with pancreatic ductal adenocarcinoma (PDAC) have unresectable cancers with a dismal prognosis, in which cohort chemotherapy is the primary treatment. T cell immune adaption is critical for tumor immune escape and prognosis of this disease. The present study aimed to determine the correlation between peripheral T cell subset distribution in patients with unresectable PDAC and their response to chemotherapy. Two hundred and twelve patients with unresectable PDAC were included whose blood samples were collected for analysis of T cell subsets, including CD3+, CD4+, CD8+, CD8+CD28+ and CD4+CD25+CD127 T cells by flow cytometry before and after gemcitabine-based chemotherapy...
August 2017: International Journal of Oncology
https://www.readbyqxmd.com/read/28710540/home-based-exercise-during-preoperative-therapy-for-pancreatic-cancer
#5
An Ngo-Huang, Nathan H Parker, Xuemei Wang, Maria Q B Petzel, David Fogelman, Keri L Schadler, Eduardo Bruera, Jason B Fleming, Jeffrey E Lee, Matthew H G Katz
PURPOSE: Exercise concurrent with neoadjuvant chemotherapy and/or chemoradiation for pancreatic adenocarcinoma (PDAC) may mitigate the decline in function that may occur as a result of the disease or its treatment in the preoperative period. The primary objective of this single-arm prospective trial was to determine adherence to a home-based exercise program administered during preoperative therapy. METHODS: Twenty patients from a quaternary cancer center with potentially resectable PDAC were enrolled...
July 15, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28708929/stereotactic-body-radiotherapy-for-unresected-pancreatic-cancer-a-nationwide-review
#6
Susanna W L de Geus, Mariam F Eskander, Gyulnara G Kasumova, Sing Chau Ng, Tara S Kent, Joseph D Mancias, Mark P Callery, Anand Mahadevan, Jennifer F Tseng
BACKGROUND: The role of conventional radiotherapy in the management of pancreatic cancer has yet to be elucidated. Over the past decade, stereotactic body radiotherapy (SBRT) has emerged as a novel therapeutic option in pancreatic cancer care. This study evaluated the survival impact of SBRT on patients with unresected pancreatic cancer. METHODS: The National Cancer Data Base was queried for unresected patients who received chemotherapy for nonmetastatic pancreatic adenocarcinoma between 2004 and 2012...
July 14, 2017: Cancer
https://www.readbyqxmd.com/read/28708229/adjuvant-chemoradiotherapy-gemcitabine-based-in-pancreatic-adenocarcinoma-the-pisa-university-experience
#7
Aldo Sainato, Sabrina Montrone, Francesco Pasqualetti, Marianna Coppola, Nunzia L V Cernusco, Marco Panichi, Alessandra Gonnelli, Enrico Vasile, Riccardo Morganti, Alfredo Falcone, Ugo Boggi, Fabiola Paiar
INTRODUCTION: The role of adjuvant chemoradiotherapy in patients with pancreatic adenocarcinoma (PA) is controversial. In this study we aimed to assess the feasibility, disease-free survival (DFS) and overall survival (OS) of adjuvant chemoradiotherapy (gemcitabine based) in patients with resected PA and their correlation with prognostic factors. METHODS: 122 resected patients (stage ≥IIa) treated between February 1999 and December 2013 were analyzed. Two cycles of gemcitabine (1,000 mg/m2 on days 1, 8 and 15 every 28 days) were administered before concomitant radiotherapy (45 Gy/25 fractions) and chemotherapy (gemcitabine 300 mg/m2 weekly)...
July 11, 2017: Tumori
https://www.readbyqxmd.com/read/28705004/multimodality-management-of-borderline-resectable-pancreatic-adenocarcinoma
#8
Laura R Prakash, Matthew H G Katz
Patients with borderline resectable pancreatic adenocarcinoma have primary tumors within the pancreas that involve the mesenteric vasculature to a limited degree. Their tumors are nonetheless at high-risk for a microscopically positive surgical resection margin and/or early treatment failure when pancreatectomy is performed de novo. The optimal treatment strategy for these patients has not been established; however, relatively favorable outcomes can be achieved with systemic chemotherapy and radiation therapy (RT) prior to intended resection...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28705003/adjuvant-and-neoadjuvant-therapy-for-resectable-pancreatic-adenocarcinoma
#9
Davendra P S Sohal
Resectable pancreatic adenocarcinoma presents the opportunity for cure of this highly lethal disease by allowing complete surgical removal. However, cure rates remain low. Adjuvant therapy following surgical resection is the standard of care. Most data support the use of gemcitabine or 5-fluorouracil in the adjuvant setting, and emerging data indicate gemcitabine plus capecitabine may improve outcomes. Use of adjuvant radiation remains controversial. Ongoing clinical studies will help better define the role of multi-agent regimens as well as radiation in the adjuvant setting...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28703890/targeted-therapies-in-pancreatic-cancer-promises-and-failures
#10
Matineh Barati Bagherabad, Fahimeh Afzaljavan, Soodabeh ShahidSales, Seyed Mahdi Hassanian, Amir Avan
Pancreatic ductal adenocarcinoma (PDAC) is an incidence rate nearly equal to its mortality rate. The poor prognosis of the disease can be explained by the absence of effective biomarkers for screening and early detection, together with the aggressive behavior and resistance to the currently available chemotherapy. The therapeutic failure can also be attributed to the inter-/intra- tumor genetic heterogeneity and the abundance of tumor stroma that occupies the majority of the tumor mass. Gemcitabine is used in the treatment of PDAC, however, the response rate is less than 12%...
July 13, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28702772/a-phase-ii-trial-of-erlotinib-monotherapy-in-advanced-pancreatic-cancer-as-a-first-or-second-line-agent
#11
Christos Fountzilas, Ravi Chhatrala, Nikhil Khushalani, Wei Tan, Charles LeVea, Alan Hutson, Chris Tucker, Wen Wee Ma, Graham Warren, Patrick Boland, Renuka Iyer
INTRODUCTION: Pancreatic adenocarcinoma carries a grim prognosis. In 2007, gemcitabine with erlotinib emerged as an appropriate treatment option for patients with advanced inoperable or metastatic disease (APC). In this phase II trial we sought to evaluate the efficacy of erlotinib monotherapy in patients with APC who had disease refractory to or ineligibility for gemcitabine-based therapy. METHODS: Eligible patients who had received 0 or 1 non-EGFR inhibitor containing gemcitabine-based chemotherapy for APC were recruited prospectively and treated with erlotinib 150 mg orally daily until unacceptable toxicity or disease progression...
July 12, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28700995/extended-pancreatectomy-does-it-have-a-role-in-the-contemporary-management-of-pancreatic-adenocarcinoma
#12
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
https://www.readbyqxmd.com/read/28700784/association-of-clinical-factors-with-a-major-pathologic-response-following-preoperative-therapy-for-pancreatic-ductal-adenocarcinoma
#13
Jordan M Cloyd, Huamin Wang, Michael E Egger, Ching-Wei D Tzeng, Laura R Prakash, Anirban Maitra, Gauri R Varadhachary, Rachna Shroff, Milind Javle, David Fogelman, Robert A Wolff, Michael J Overman, Eugene J Koay, Prajnan Das, Joseph M Herman, Michael P Kim, Jean-Nicolas Vauthey, Thomas A Aloia, Jason B Fleming, Jeffrey E Lee, Matthew H G Katz
Importance: We previously demonstrated that a major pathologic response to preoperative therapy, defined histopathologically by the presence of less than 5% viable cancer cells in the surgical specimen, is an important prognostic factor for patients with pancreatic ductal adenocarcinoma. However, to our knowledge, the patients most likely to experience a significant response to therapy are undefined. Objective: To identify clinical factors associated with major pathologic response in a large cohort of patients who underwent preoperative therapy and pancreatectomy for pancreatic ductal adenocarcinoma...
July 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28697176/hmga1-expression-levels-are-elevated-in-pancreatic-intraepithelial-neoplasia-cells-in-the-ptf1a-cre-lsl-krasg12d-transgenic-mouse-model-of-pancreatic-cancer
#14
Michelle J Veite-Schmahl, William C Joesten, Michael A Kennedy
BACKGROUND: Pancreatic cancer is currently the third leading cause of cancer deaths in the United States and it is predicted to become the second by the year 2030. High-mobility group A1 protein (HMGA1) is an oncogenic transcription factor, localised and active in cell nuclei, that is linked to tumour progression in many human cancers, including pancreatic cancer. Overexpression of HMGA1 renders cancer cells resistant to chemotherapy. Although the Ptf1a-Cre; LSL-KrasG12D transgenic mouse is perhaps the most widely utilised animal model for human pancreatic cancer, expression levels of HMGA1 in pancreata from this mouse model have not been characterised...
July 11, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28697131/patterns-of-care-for-locally-advanced-pancreatic-adenocarcinoma-using-the-national-cancer-database
#15
Arya Amini, Bernard L Jones, Priscilla Stumpf, Stephen Leong, Christopher H Lieu, Colin Weekes, S Lindsey Davis, Wells A Messersmith, William T Purcell, Debashis Ghosh, Tracey Schefter, Karyn A Goodman
OBJECTIVES: The role of radiotherapy (RT) in locally advanced pancreatic cancer (LAPC) is uncertain. This study examines patterns of care and survival outcomes of LAPC undergoing chemotherapy alone versus chemotherapy plus RT (C + RT). METHODS: The National Cancer Database was queried for nonmetastatic LAPC patients who received chemotherapy alone or C + RT. RESULTS: Of the 13,695 patients included, 5306 underwent chemotherapy alone and 4971, C + RT...
August 2017: Pancreas
https://www.readbyqxmd.com/read/28693250/bcl-2-bcl-xl-inhibitor-abt-737-sensitizes-pancreatic-ductal-adenocarcinoma-to-paclitaxel-induced-cell-death
#16
Shuya Kasai, Takuya Sasaki, Ayano Watanabe, Masao Nishiya, Shinji Yasuhira, Masahiko Shibazaki, Chihaya Maesawa
Pancreatic ductal adenocarcinoma (PDA) is an aggressive malignant disease that is resistant to various chemotherapeutic agents and commonly relapses. Efficient elimination of metastasized PDA is critical for a positive post-surgical treatment outcome. The present study analyzed the effect of the B-cell lymphoma-2 (Bcl-2)/B-cell lymphoma extra-large (Bcl-xL) inhibitor, ABT-737, on paclitaxel-induced PDA cell death. A total of 8 PDA cell lines were subjected to immunoblotting to compare the expression of Bcl-2/Bcl-xL and other factors associated with taxane resistance, including myeloid cell leukemia 1 and βIII-tubulin (TUBB3)...
July 2017: Oncology Letters
https://www.readbyqxmd.com/read/28692661/the-extracellular-matrix-and-focal-adhesion-kinase-signaling-regulate-cancer-stem-cell-function-in-pancreatic-ductal-adenocarcinoma
#17
Asma Begum, Theodore Ewachiw, Clinton Jung, Ally Huang, K Jessica Norberg, Luigi Marchionni, Ross McMillan, Vesselin Penchev, N V Rajeshkumar, Anirban Maitra, Laura Wood, Chenguang Wang, Christopher Wolfgang, Ana DeJesus-Acosta, Daniel Laheru, Irina M Shapiro, Mahesh Padval, Jonathan A Pachter, David T Weaver, Zeshaan A Rasheed, William Matsui
Cancer stem cells (CSCs) play an important role in the clonogenic growth and metastasis of pancreatic ductal adenocarcinoma (PDAC). A hallmark of PDAC is the desmoplastic reaction, but the impact of the tumor microenvironment (TME) on CSCs is unknown. In order to better understand the mechanisms, we examined the impact of extracellular matrix (ECM) proteins on PDAC CSCs. We quantified the effect of ECM proteins, β1-integrin, and focal adhesion kinase (FAK) on clonogenic PDAC growth and migration in vitro and tumor initiation, growth, and metastasis in vivo in nude mice using shRNA and overexpression constructs as well as small molecule FAK inhibitors...
2017: PloS One
https://www.readbyqxmd.com/read/28688722/retrospective-cohort-analysis-of-neoadjuvant-treatment-and-survival-in-resectable-and-borderline-resectable-pancreatic-ductal-adenocarcinoma-in-a-high-volume-referral-centre
#18
M Itchins, J Arena, C B Nahm, J Rabindran, S Kim, E Gibbs, S Bergamin, T C Chua, A J Gill, R Maher, C Diakos, M Wong, A Mittal, G Hruby, A Kneebone, N Pavlakis, J Samra, S Clarke
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease. Neoadjuvant therapy (NA) with chemotherapy (NAC) and radiotherapy (RT) prior to surgery provides promise. In the absence of prospective data, well annotated clinical data from high-volume units may provide pilot data for randomised trials. METHODS: Medical records from a tertiary hospital in Sydney, Australia, were analysed to identify all patients with resectable or borderline resectable PDAC...
June 28, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28687963/sparc-gene-variants-predict-clinical-outcome-in-locally-advanced-and-metastatic-pancreatic-cancer-patients
#19
Cristina Arqueros, Juliana Salazar, M J Arranz, Ana Sebio, Josefina Mora, Ivana Sullivan, María Tobeña, Marta Martín-Richard, Agustí Barnadas, Montserrat Baiget, David Páez
Secreted protein acidic and rich in cysteine (SPARC) is a glycoprotein of the extracellular matrix whose expression can be altered in malignant pancreatic cells and in the adjacent stromal fibroblasts. We evaluated the possible role of SPARC gene variants as prognostic markers for locally advanced and metastatic pancreatic cancer. We analyzed eight tagging single-nucleotide polymorphisms (TagSNPs) in the SPARC gene in 74 patients with pancreatic ductal adenocarcinoma treated with chemotherapy alone or combined with radiotherapy...
August 2017: Medical Oncology
https://www.readbyqxmd.com/read/28687431/resectable-invasive-ipmn-versus-sporadic-pancreatic-adenocarcinoma-of-the-head-of-the-pancreas-should-these-two-different-diseases-receive-the-same-treatment-a-matched-comparison-study-of-the-french-surgical-association-afc
#20
P Duconseil, J Périnel, A Autret, M Adham, A Sauvanet, L Chiche, J-Y Mabrut, J-J Tuech, C Mariette, N Régenet, J-M Fabre, P Bachellier, J-R Delpéro, F Paye, O Turrini
PURPOSE: To compare survival and impact of adjuvant chemotherapy in patients who underwent pancreaticoduodenectomy (PD) for invasive intraductal papillary mucinous neoplasm (IIPMN) and sporadic pancreatic ductal adenocarcinoma (PDAC). METHODS: From 2005 to 2012, 240 patients underwent pancreatectomy for IIPMN and 1327 for PDAC. Exclusion criteria included neoadjuvant treatment, pancreatic resection other than PD, vascular resection, carcinoma in situ, or <11 examined lymph nodes...
June 29, 2017: European Journal of Surgical Oncology
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