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pancreatic adenocarcinoma chemotherapy

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https://www.readbyqxmd.com/read/28433254/does-adjuvant-therapy-improve-overall-survival-for-stage-ia-b-pancreatic-adenocarcinoma
#1
Katherine T Ostapoff, Emmanuel Gabriel, Kristopher Attwood, Boris W Kuvshinoff, Steven J Nurkin, Steven N Hochwald
BACKGROUND: Current guidelines recommend adjuvant chemotherapy for resected pancreatic adenocarcinoma (PDAC). However, no studies have addressed its survival benefit for stage I patients as they comprise <10% of PDAC. METHODS: Using the NCDB 2006-2012, resected PDAC patients with stage I disease who received adjuvant therapy (chemotherapy or chemoradiation) were analyzed. Factors associated with overall survival (OS) were identified. RESULTS: 3909 patients with resected stage IA or IB PDAC were identified...
April 19, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28428707/advanced-pancreatic-ductal-adenocarcinoma-complexities-of-treatment-and-emerging-therapeutic-options
#2
REVIEW
Chandra Diwakarla, Katherine Hannan, Nadine Hein, Desmond Yip
Pancreatic ductal adenocarcinoma is a devastating disease with a poor prognosis regardless of stage. To date the mainstay of therapy for advanced disease has been chemotherapy with little incremental improvements in outcome. Despite extensive research investigating new treatment options the current practices continue to utilise fluorouracil or gemcitabine containing combinations. The need for novel therapeutic approaches is mandated by the ongoing poor survival rates associated with this disease. One such approach may include manipulation of ribosome biogenesis and the nucleolar stress response, which has recently been applied to haematological malignancies such as lymphoma and prostate cancer with promising results...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28421348/the-basal-nutritional-state-of-pdac-patients-is-the-dominant-factor-for-completing-adjuvant-chemotherapy
#3
Daisaku Yamada, Hidetoshi Eguchi, Tadafumi Asaoka, Hideo Tomihara, Takehiro Noda, Hiroshi Wada, Koichi Kawamoto, Kunihito Gotoh, Yutaka Takeda, Masahiro Tanemura, Masaki Mori, Yuichiro Doki
PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is highly lethal, and several clinical trials have shown that adjuvant chemotherapy after curative resection can improve the prognosis of these patients. However, the adjuvant chemotherapy completion rate is less than satisfactory. If this rate could be increased then the overall prognosis of PDAC might be improved; however, reports addressing this problem are insufficient. To elucidate the factors, we retrospectively investigated PDAC patients...
April 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28421110/prognostic-evaluation-of-vimentin-expression-in-correlation-with-ki67-and-cd44-in-surgically-resected-pancreatic-ductal-adenocarcinoma
#4
Despoina Myoteri, Dionysios Dellaportas, Panagis M Lykoudis, Alexandros Apostolopoulos, Athanasios Marinis, Adamantia Zizi-Sermpetzoglou
Purpose. Radical surgical resection with adjuvant chemotherapy or chemo-radiotherapy is the most effective treatment for pancreatic ductal adenocarcinoma (PDAC). However, relatively few studies investigate the prognostic significance of biological markers in PDAC. This study aims to look into the expressions of vimentin, Ki67, and CD44 in PDAC surgical specimens and their potential prognostic implications in survival. Method. The study was designed as retrospective, and vimentin, Ki67, and CD44 expressions were evaluated by immunohistochemistry in 53 pancreatic ductal adenocarcinoma cases...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28420039/utilizing-salmonella-to-treat-solid-malignancies
#5
REVIEW
Nancy D Ebelt, Edwin R Manuel
Despite intensive research into novel treatment strategies for cancer, it remains the second most common cause of death in industrialized populations. Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive disease with dismal prognosis. Currently, surgical resection offers the best chance for extended survival, yet recurrence remains high and is associated with poor outcome. Systemic treatment has evolved from non-specific, cytotoxic chemotherapy to the use of cancer-targeting agents, profoundly changing treatment approaches in the metastatic and adjuvant settings...
April 18, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28414297/tumor-penetrating-peptide-enhances-transcytosis-of-silicasome-based-chemotherapy-for-pancreatic-cancer
#6
Xiangsheng Liu, Paulina Lin, Ian Perrett, Joshua Lin, Yu-Pei Liao, Chong Hyun Chang, Jinhong Jiang, Nanping Wu, Timothy Donahue, Zev Wainberg, Andre E Nel, Huan Meng
Pancreatic ductal adenocarcinoma (PDAC) is almost uniformly fatal; however, some improvement in overall survival has been achieved with the introduction of nanocarriers that deliver irinotecan or paclitaxel. Although it is generally assumed that nanocarriers rely principally on abnormal leaky vasculature for tumor access, a transcytosis transport pathway that is regulated by neuropilin-1 (NRP-1) has recently been reported. NRP-1-mediated transport can be triggered by the cyclic tumor-penetrating peptide iRGD...
April 17, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28413673/survival-of-patients-with-pancreatic-cancer-treated-with-varied-modalities-a-single-centre-study
#7
Michael Blaszak, Maher El-Masri, Khalid Hirmiz, John Mathews, Abeer Omar, Tarek Elfiki, Rasna Gupta, Caroline Hamm, Sindu Kanjeekal, Amin Kay, Swati Kulkarni, Akmal Ghafoor
The present retrospective chart review examined the overall survival (OS) of patients with pancreatic ductal adenocarcinoma based on the disease stage in a sample of 296 patients with pancreatic cancer. Secondary outcome measurements included OS in chemotherapy vs. supportive treatment groups among metastatic patients, OS based on response to chemotherapy among metastatic patients, and OS and disease free survival (DFS) in surgically resected disease with vs. without adjuvant therapy. Data were analyzed using Kaplan-Meier and multivariate cox-regression analyses based on a 95% confidence interval (CI) or an α-value of 0...
April 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28407704/delayed-epidural-mucin-collection-after-surgery-for-spinal-metastatic-pancreatic-adenocarcinoma
#8
Dong Ha Kim, Dong Hwan Kim, Hwan Soo Kim, Kyoung Hyup Nam, Byung Kwan Choi, In Ho Han
A rare case of delayed large epidural mucin collection causing neurologic deficit after surgery for metastatic pancreatic cancer is reported. A 65-year-old man presented with intractable upper-thoracic back pain radiating to the chest and gait disturbance. He had a history of subtotal pancreatectomy due to intraductal papillary mucinous neoplasm (IPMN) of the pancreas and concurrent chemotherapy. Eight months after pancreatectomy, multiple thoracic spinal metastasis was diagnosed with routine up positron emission tomography-computed tomography...
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28407327/oncolytic-viral-therapy-for-pancreatic-cancer
#9
REVIEW
Ahmad Rahal, Benjamin Musher
Outcomes of pancreatic adenocarcinoma (PDA) remain dismal despite extensive clinical investigation. Combination chemotherapy provides modest improvements in survival above best supportive care, and immunotherapy has thus far not proven effective. Nevertheless, growing insight into antitumor immunity and the tumor microenvironment has inspired the discovery of novel agents targeting PDA. Oncolytic viruses represent an emerging class of immunotherapeutic agents that have undergone extensive preclinical investigation and warrant further investigation in well-designed clinical trials...
April 13, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28407261/nationwide-trends-and-outcomes-associated-with-neoadjuvant-therapy-in-pancreatic-cancer-an-analysis-of-18%C3%A2-243-patients
#10
Linda M Youngwirth, Daniel P Nussbaum, Samantha Thomas, Mohamed A Adam, Dan G Blazer, Sanziana A Roman, Julie A Sosa
BACKGROUND: Neoadjuvant therapy has theoretical benefits for pancreatic cancer; however, its association with perioperative outcomes remains controversial. This study sought to evaluate variation in use of neoadjuvant therapy and outcomes following pancreatic resection. METHODS: The National Cancer Data Base (1998-2011) was queried for patients with Stage I or II pancreatic adenocarcinoma who underwent pancreaticoduodenectomy. Subjects were classified by use of neoadjuvant chemotherapy and/or radiation therapy...
April 13, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28404939/d-tocotrienol-a-natural-form-of-vitamin-e-inhibits-pancreatic-cancer-stem-like-cells-and-prevents-pancreatic-cancer-metastasis
#11
Kazim Husain, Barbara A Centeno, Domenico Coppola, Jose Trevino, Said M Sebti, Mokenge P Malafa
The growth, metastasis, and chemotherapy resistance of pancreatic ductal adenocarcinoma (PDAC) is characterized by the activation and growth of tumor-initiating cells in distant organs that have stem-like properties. Thus, inhibiting growth of these cells may prevent PDAC growth and metastases. We have demonstrated that δ-tocotrienol, a natural form of vitamin E (VEDT), is bioactive against cancer, delays progression, and prevents metastases in transgenic mouse models of PDAC. In this report, we provide the first evidence that VEDT selectively inhibits PDAC stem-like cells...
February 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28398845/potentially-curable-pancreatic-cancer-american-society-of-clinical-oncology-clinical-practice-guideline-update
#12
Alok A Khorana, Pamela B Mangu, Jordan Berlin, Anitra Engebretson, Theodore S Hong, Anirban Maitra, Supriya G Mohile, Matthew Mumber, Richard Schulick, Marc Shapiro, Susan Urba, Herbert J Zeh, Matthew H G Katz
Purpose To update the Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline published on May 31, 2016. The October 2016 update focuses solely on new evidence that pertains to clinical question 4 of the guideline: What is the appropriate adjuvant regimen for patients with pancreatic cancer who have undergone an R0 or R1 resection of their primary tumor? Methods The recently published results of a randomized phase III study prompted an update of this guideline...
April 11, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28397697/nab-paclitaxel-plus-either-gemcitabine-or-simplified-leucovorin-and-fluorouracil-as-first-line-therapy-for-metastatic-pancreatic-adenocarcinoma-afugem-gercor-a-non-comparative-multicentre-open-label-randomised-phase-2-trial
#13
Jean-Baptiste Bachet, Pascal Hammel, Jérôme Desramé, Aurélia Meurisse, Benoist Chibaudel, Thierry André, Philippe Debourdeau, Jérome Dauba, Thierry Lecomte, Jean-François Seitz, Christophe Tournigand, Thomas Aparicio, Véronique Guerin Meyer, Julien Taieb, Julien Volet, Amandine Monier, Franck Bonnetain, Christophe Louvet
BACKGROUND: Nab-paclitaxel plus gemcitabine has become a standard treatment regimen in patients with metastatic pancreatic adenocarcinoma; however, retrospective data suggest that gemcitabine might be inefficient in 50-60% of patients and thus not an optimum regimen in combination with nab-paclitaxel. We did a phase 2 trial to assess the activity and safety of a new regimen of nab-paclitaxel plus simplified leucovorin and fluorouracil. METHODS: We did a non-comparative, multicentre, open-label, randomised phase 2 trial in 15 hospitals and institutions in France...
May 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28393575/using-circulating-cell-free-dna-to-monitor-personalized-cancer-therapy
#14
Michael Oellerich, Ekkehard Schütz, Julia Beck, Philipp Kanzow, Piers N Plowman, Glen J Weiss, Philip D Walson
High-quality genomic analysis is critical for personalized pharmacotherapy in patients with cancer. Tumor-specific genomic alterations can be identified in cell-free DNA (cfDNA) from patient blood samples and can complement biopsies for real-time molecular monitoring of treatment, detection of recurrence, and tracking resistance. cfDNA can be especially useful when tumor tissue is unavailable or insufficient for testing. For blood-based genomic profiling, next-generation sequencing (NGS) and droplet digital PCR (ddPCR) have been successfully applied...
April 10, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28392554/significance-of-baseline-and-change-in-neutrophil-to-lymphocyte-ratio-in-predicting-prognosis-a-retrospective-analysis-in-advanced-pancreatic-ductal-adenocarcinoma
#15
Yang Chen, Huan Yan, YanRong Wang, Yan Shi, GuangHai Dai
The neutrophil-lymphocyte ratio (NLR) has been reported to be associated with prognosis in several cancers. The objective of our study was to evaluate the prognostic role of baseline NLR and change in NLR (ΔNLR) in advanced pancreatic cancer underwent chemotherapy. Between January 2010 and June 2015, 132 patients underwent chemotherapy were eligible for assessment. Based on our patients' data, the cut-off value of NLR was 2.78 according to receiver operating characteristic curve. We observed that a high level of baseline NLR (NLR > 2...
April 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28383673/overall-survival-prediction-and-usefulness-of-second-line-chemotherapy-in-advanced-pancreatic-adenocarcinoma
#16
Angélique Vienot, Guillaume Beinse, Christophe Louvet, Louis de Mestier, Aurélia Meurisse, Francine Fein, Bruno Heyd, Denis Cleau, Christelle d'Engremont, Anne-Claire Dupont-Gossart, Zaher Lakkis, Christophe Tournigand, Olivier Bouché, Benoît Rousseau, Cindy Neuzillet, Franck Bonnetain, Christophe Borg, Dewi Vernerey
Background: In advanced pancreatic ductal adenocarcinoma (aPDAC), there is no consensual strategy for second-line chemotherapy (L2). Better discrimination of overall survival (OS) may help clinical decision-making. We aimed to predict OS from the beginning of L2 and to assess the benefit from chemotherapy among the identified risk groups. Methods: Analyses were derived from all consecutive aPDAC patients treated at Besancon University Hospital, Besancon, France, between January 2003 and December 2013 (n = 462)...
April 4, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28378854/omega-3-therapeutic-supplementation-in-a-patient-with-metastatic-adenocarcinoma-of-the-pancreas-with-muscle-mass-depletion
#17
R Ramalho, P Ramalho, N Couto, P Pereira
Pancreatic adenocarcinoma has an extremely poor prognosis. With the best available treatments, the median overall survival duration is still less than 1 year. Most patients develop anorexia and major muscle mass loss that interfere with chemotherapy tolerance and survival. In this paper, we present a case in which these problems were a major concern. A multidisciplinary approach with chemotherapy and close nutritional support permitted better control of the disease and longer survival. We also review the literature on nutritional interventions that show an improvement in quality of life and survival in these patients...
April 5, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28373919/complete-response-after-treatment-with-neoadjuvant-chemoradiation-with-prolonged-chemotherapy-for-locally-advanced-unresectable-adenocarcinoma-of-the-pancreas
#18
Tiffany A Pompa, William F Morano, Chetan Jeurkar, Hui Li, Suganthi Soundararajan, Jaganmohan Poli, Wilbur B Bowne, Michael Styler
Surgery is the only chance for cure in pancreatic ductal adenocarcinoma. In unresectable, locally advanced pancreatic cancer (LAPC), the National Comprehensive Cancer Network (NCCN) suggests chemotherapy and consideration for radiation in cases of unresectable LAPC. Here we present a rare case of unresectable LAPC with a complete histopathological response after chemoradiation followed by surgical resection. A 54-year-old female presented to our clinic in December 2013 with complaints of abdominal pain and 30-pound weight loss...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28373365/current-and-emerging-therapies-in-metastatic-pancreatic-cancer
#19
EDITORIAL
Gulam Abbas Manji, Kenneth P Olive, Yvonne M Saenger, Paul Oberstein
Targeted therapies and immunotherapy have changed the face of multiple solid malignancies, including metastatic melanoma and lung cancer, but no such therapies exist for pancreatic ductal adenocarcinoma (PDAC) despite the knowledge of key mutations and an increasing understanding of the tumor microenvironment. Until now, most clinical studies have not been biomarker driven in this highly immunosuppressive and heterogeneous cancer. Ongoing basic and translational studies are better classifying the disease in hopes of identifying critical pathways that distinguish the unique PDAC subtypes, which will lead to personalized therapies...
April 1, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28373361/pancreatic-cancer-a-riddle-wrapped-in-a-mystery-inside-an-enigma
#20
EDITORIAL
Erkut Borazanci, Chi V Dang, Robert W Robey, Susan E Bates, John A Chabot, Daniel D Von Hoff
Pancreatic ductal adenocarcinoma (PDAC) is one of the most difficult-to-treat cancers. With an increasing incidence and inability to make major progress, it represents the very definition of unmet medical need. Progress has been made in understanding the basic biology-systematic genomic sequencing has led to the recognition that PDAC is not typically a heavily mutated tumor, although there are exceptions. The most consistently mutated genes are KRAS, CDKN2A, TP53, and SMAD4/DPC4 Study of familial PDAC has led to the recognition that a variety of defects in DNA repair genes can be associated with the emergence of pancreatic cancer...
April 1, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
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