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pancreatic adenocarcinoma chemotherapy

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https://www.readbyqxmd.com/read/29679211/surgery-after-folfirinox-treatment-for-locally-advanced-and-borderline-resectable-pancreatic-cancer-increase-in-tumour-attenuation-on-ct-correlates-with-r0-resection
#1
Giovanni Marchegiani, Valentina Todaro, Enrico Boninsegna, Riccardo Negrelli, Binit Sureka, Debora Bonamini, Roberto Salvia, Riccardo Manfredi, Roberto Pozzi Mucelli, Claudio Bassi
OBJECTIVES: To assess factors associated with radical resection (R0) of pancreatic ductal adenocarcinoma (PDAC) after induction treatment with FOLFIRINOX. METHODS: Patients with either locally advanced (LA) and borderline resectable (BR) PDAC undergoing surgical exploration after FOLFIRINOX were retrospectively enrolled. Two pancreatic radiologists reviewed the CT blinded to the final outcome and assessed chemotherapy response and resectability. Patients were then divided into R0 resected (group A) and not resected/R1 resected (group B), which were compared...
April 20, 2018: European Radiology
https://www.readbyqxmd.com/read/29675111/a-survival-model-in-locally-advanced-and-metastatic-pancreatic-ductal-adenocarcinoma
#2
Yi Wang, Xiuying Xiao, Tianyi Wang, Lin Li, Yue Zhu, Haiyan Xu, Yuening Chu, Feng Jiao, Jiujie Cui, Liwei Wang
The prognostic role of serum LDH, CA19-9, CRP and ALB in PDAC patients are controversial. In contrast to single factor, there is much less information about the prognostic value of the combination of the four factors in locally advanced and metastatic PDAC patients. It's essential to set up a survival model with the combination of tumor metabolism, tumor biomarker, systemic inflammation and nutritional status to eliminate the prognostic inaccuracy in single biomarker. 94 advanced PDAC patients who received palliative chemotherapy from 2009 to 2017 were recruited for this study...
2018: Journal of Cancer
https://www.readbyqxmd.com/read/29674761/impact-of-body-mass-index-on-survival-of-pancreatic-cancer-patients-in-japan
#3
Tomohiro Okura, Masakuni Fujii, Junji Shiode, Yuri Ito, Toru Kojima, Junichiro Nasu, Takefumi Niguma, Masao Yoshioka, Tetsushige Mimura, Kazuhide Yamamoto
The impact of body mass index (BMI) on postoperative survival in Japanese patients with pancreatic cancer is unclear. We examined the relationship between preoperative BMI and the prognosis of Japanese patients who underwent surgery for pancreatic cancer to determine whether BMI affects these patients' prognosis. Of the patients who underwent pancreatectomy between January 2004 and August 2015 at our institution, 246 were pathologically diagnosed with pancreatic tubular adenocarcinoma; the cancer was located in the pancreatic head (n=161) and in the body and tail (n=85)...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29668413/pancreatic-adenocarcinoma-staging-in-the-era-of-preoperative-chemotherapy-and-radiation-therapy
#4
Marc Zins, Celso Matos, Christophe Cassinotto
Pancreatic ductal adenocarcinoma (PDA) remains among the most challenging malignancies to treat. At diagnosis, the tumor often already extends beyond the confines of the pancreas, spreading to an extent such that primary surgery with curative intent is very rarely feasible. Considerable momentum is now being given to a treatment strategy involving neoadjuvant chemotherapy or chemotherapy and radiation therapy in patients with nonmetastatic PDA. The main advantage of this strategy is better selection of patients likely to benefit from curative-intent surgery through the achievement of negative resection margins...
May 2018: Radiology
https://www.readbyqxmd.com/read/29665327/adjuvant-radiotherapy-and-chemotherapy-improve-survival-in-patients-with-pancreatic-adenocarcinoma-receiving-surgery-adjuvant-chemotherapy-alone-is-insufficient-in-the-era-of-intensity-modulation-radiation-therapy
#5
Mao-Chih Hsieh, Wei-Wen Chang, Hsin-Hsien Yu, Chang-Yun Lu, Chia-Lun Chang, Jyh-Ming Chow, Shee-Uan Chen, Yunfeng Cheng, Szu-Yuan Wu
In the era of intensity modulation radiation therapy (IMRT), no prospective randomized trial has evaluated the efficacy of adjuvant therapies such as adjuvant concurrent chemoradiotherapy (CCRT), adjuvant sequential chemotherapy and radiotherapy (CT-RT), and adjuvant CT alone in resectable pancreatic adenocarcinoma (PA). Through propensity score matching, we designed a nationwide, population-based, head-to-head cohort study to determine the effects of dissimilar adjuvant treatments on resectable PA. We minimized the confounding of various adjuvant treatment outcomes among the following resectable PA groups of patients from the Taiwan Cancer Registry database: group 1, adjuvant CCRT; group 2, adjuvant sequential CT-RT; and group 3, adjuvant CT alone...
April 17, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29663140/poorly-differentiated-ductal-adenocarcinoma-of-the-pancreas-with-rapid-progression-in-a-young-man
#6
Koji Tezuka, Tomoharu Ishiyama, Akiko Takeshita, Hidekazu Matsumoto, Akira Jingu, Jiro Kikuchi, Hideyuki Yamaya, Rintaro Ohe, Tetsuya Ishizawa
Pancreatic cancer in young adults is very rare. We report a case of young-onset poorly differentiated pancreatic ductal adenocarcinoma with rapid progression and poor prognosis in a 31-year-old Japanese man with no obvious family history of malignancy. Preoperative examinations revealed a mass lesion in the body of the pancreas, accompanied by a slightly dilated main pancreatic duct distal to the mass lesion. Pancreatic cancer with acute pancreatitis was suspected because of an elevation of serum pancreatic enzyme and tumor marker, along with imaging findings...
April 16, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29662656/stereotactic-body-radiation-therapy-for-palliative-management-of-pancreatic-adenocarcinoma-in-elderly-and-medically-inoperable-patients
#7
John F Ryan, Lauren M Rosati, Vincent P Groot, Dung T Le, Lei Zheng, Daniel A Laheru, Eun J Shin, Juan Jackson, Joseph Moore, Amol K Narang, Joseph M Herman
Stereotactic body radiation therapy (SBRT) represents a promising treatment option for patients with localized pancreatic ductal adenocarcinoma (PDAC) who cannot tolerate surgical therapy. We retrospectively reviewed the records of patients with localized PDAC treated with SBRT at our institution between 2010 and 2016 to identify patients deemed medically inoperable due to poor performance status, advanced age, and/or comorbid conditions. Overall survival (OS), progression-free survival (PFS), and local progression-free survival (LPFS) were estimated using Kaplan-Meier curves...
March 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29650856/-a-case-of-performed-right-colectomy-with-pancreato-duodenectomy-for-transverse-colon-cancer-invased-to-duodenum
#8
Ryutaro Udo, Masanobu Enomoto, Kazushige Tsurui, Yuu Kuboyama, Hiroshi Kuwabara, Masatoshi Shigoka, Tetsuo Ishizaki, Kenji Katsumata, Hiyo Obikane, Akihiko Tsuchida
There is a clear consensus regarding the combined resection of organs with cancer invasion, patients with colon cancer. However, there are very few reports to our knowledge regarding the use of pancreato-duodenectomy(PD)for colon cancer patients with cancer invasion in the duodenum. We here report a colon cancer patient in whom we performed PD and right hemicolectomy, who showed favorable results with no recurrence. The patient was a 69-year-old woman. Her chief complaint was hypogastric pain. Her previous doctor performed colonoscopy and a colonoscopic biopsy, and detected a type 2 lesion, throughout the entire circumference of the transverse colon near the liver, and she was diagnosed with adenocarcinoma...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29629335/intraoperative-radiation-boost-to-the-surgical-resection-bed-following-pancreaticoduodenectomy-for-a-borderline-resectable-pancreatic-carcinoma-a-case-report
#9
Tarita O Thomas, William Small, Mark Fleming, Song Kang, Richard A Hoefer
Neoadjuvant therapy including chemotherapy alone or concurrent chemotherapy with external bream radiation is a standard treatment strategy for borderline resectable pancreatic adenocarcinoma and is also used routinely for primary operable cancers at some institutions (1). The use of intraoperative radiation therapy (IORT) has been limited largely because of the logistical issues in delivery of radiation during surgery (2). This is the first reported case of a borderline resectable pancreas cancer patient who underwent neoadjuvant chemo-radiation therapy followed by resection with the use of IORT using the mobile IntraBeam device to boost the resection bed and improve local control by dose escalation...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29625841/safety-and-efficacy-of-preoperative-or-postoperative-chemotherapy-for-resectable-pancreatic-adenocarcinoma-pact-15-a-randomised-open-label-phase-2-3-trial
#10
Michele Reni, Gianpaolo Balzano, Silvia Zanon, Alessandro Zerbi, Lorenza Rimassa, Renato Castoldi, Domenico Pinelli, Stefania Mosconi, Claudio Doglioni, Marta Chiaravalli, Chiara Pircher, Paolo Giorgio Arcidiacono, Valter Torri, Paola Maggiora, Domenica Ceraulo, Massimo Falconi, Luca Gianni
BACKGROUND: Pancreatic ductal adenocarcinoma are known to metastasise early and a rationale exists for the investigation of preoperative chemotherapy in patients with resectable disease. We aimed to assess the role of combination chemotherapy in this setting in the PACT-15 trial. METHODS: We did this randomised, open-label, phase 2-3 trial in ten hospitals in Italy. We report the phase 2 part here. Patients aged 18-75 years who were previously untreated for pancreatic ductal adenocarcinoma, with Karnofsky performance status of more than 60, and pathologically confirmed stage I-II resectable disease were enrolled...
April 3, 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29621664/chemotherapy-and-radiofrequency-induced-mild-hyperthermia-combined-treatment-of-orthotopic-pancreatic-ductal-adenocarcinoma-xenografts
#11
Martyna Krzykawska-Serda, Mahdi S Agha, Jason Chak-Shing Ho, Matthew J Ware, Justin J Law, Jared M Newton, Lam Nguyen, Steven A Curley, Stuart J Corr
Patients with pancreatic ductal adenocarcinomas (PDAC) have one of the poorest survival rates of all cancers. The main reason for this is related to the unique tumor stroma and poor vascularization of PDAC. As a consequence, chemotherapeutic drugs, such as nab-paclitaxel and gemcitabine, cannot efficiently penetrate into the tumor tissue. Non-invasive radiofrequency (RF) mild hyperthermia treatment was proposed as a synergistic therapy to enhance drug uptake into the tumor by increasing tumor vascular inflow and perfusion, thus, increasing the effect of chemotherapy...
April 2, 2018: Translational Oncology
https://www.readbyqxmd.com/read/29615310/meta-analysis-of-modified-folfirinox-regimens-for-patients-with-metastatic-pancreatic-cancer
#12
Pedro Luiz Serrano Usón Junior, Edna Terezinha Rother, Fernando Cotait Maluf, Diogo Diniz Gomes Bugano
BACKGROUND: We performed a meta-analysis of previous reports evaluating the effect of mFIO (modified FOLFIRINOX; leucovorin, 5-fluorouracil, irinotecan, oxaliplatin) regimens in advanced pancreatic cancer. MATERIALS AND METHODS: We performed a meta-analysis of reported studies in PubMed, Scopus, and Web of Science (1950-2016) in December 2016. The inclusion criteria were randomized trials, prospective or retrospective cohorts, patients with metastatic pancreatic adenocarcinoma, the use of mFIO or FOLFIRINOX (FIO) chemotherapy, and available information for ≥ 1 efficacy endpoint (response rate, progression-free survival, and/or overall survival)...
March 14, 2018: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29614005/role-of-gene-therapy-in-pancreatic-cancer-a-review
#13
REVIEW
Mizuho Sato-Dahlman, Keith Wirth, Masato Yamamoto
Mortality from pancreatic ductal adenocarcinoma (PDAC) has remained essentially unchanged for decades and its relative contribution to overall cancer death is projected to only increase in the coming years. Current treatment for PDAC includes aggressive chemotherapy and surgical resection in a limited number of patients, with median survival of optimal treatment rather dismal. Recent advances in gene therapies offer novel opportunities for treatment, even in those with locally advanced disease. In this review, we summarize emerging techniques to the design and administration of virotherapy, synthetic vectors, and gene-editing technology...
April 3, 2018: Cancers
https://www.readbyqxmd.com/read/29599906/dynamic-changes-during-the-treatment-of-pancreatic-cancer
#14
Robert A Wolff, Andrea Wang-Gillam, Hector Alvarez, Hervé Tiriac, Dannielle Engle, Shurong Hou, Abigail F Groff, Anthony San Lucas, Vincent Bernard, Kelvin Allenson, Jonathan Castillo, Dong Kim, Feven Mulu, Jonathan Huang, Bret Stephens, Ignacio I Wistuba, Matthew Katz, Gauri Varadhachary, YoungKyu Park, James Hicks, Arul Chinnaiyan, Louis Scampavia, Timothy Spicer, Chiara Gerhardinger, Anirban Maitra, David Tuveson, John Rinn, Gregory Lizee, Cassian Yee, Arnold J Levine
This manuscript follows a single patient with pancreatic adenocarcinoma for a five year period, detailing the clinical record, pathology, the dynamic evolution of molecular and cellular alterations as well as the responses to treatments with chemotherapies, targeted therapies and immunotherapies. DNA and RNA samples from biopsies and blood identified a dynamic set of changes in allelic imbalances and copy number variations in response to therapies. Organoid cultures established from biopsies over time were employed for extensive drug testing to determine if this approach was feasible for treatments...
March 13, 2018: Oncotarget
https://www.readbyqxmd.com/read/29596894/pancreatic-neuroendocrine-carcinomas-reveal-a-closer-relationship-to-ductal-adenocarcinomas-than-to-neuroendocrine-tumors-g3
#15
Björn Konukiewitz, Moritz Jesinghaus, Katja Steiger, Anna Melissa Schlitter, Atsuko Kasajima, Bence Sipos, Giuseppe Zamboni, Wilko Weichert, Nicole Pfarr, Günter Klöppel
Pancreatic neuroendocrine carcinoma is a rare aggressive tumor commonly harboring TP53 and RB1 alterations and lacking neuroendocrine related genetic changes such as mutations in MEN1 and ATRX/DAXX. Little is known about its genetic profile with regard to that of pancreatic ductal adenocarcinoma. We therefore conducted a detailed genetic study in 12 pancreatic neuroendocrine carcinomas of large cell (n=9) and small cell type (n=3) using massive parallel sequencing applying a 409 gene panel on an Ion Torrent system...
March 26, 2018: Human Pathology
https://www.readbyqxmd.com/read/29593916/primary-pancreatic-burkitt-s-lymphoma-a-case-report-and-review-of-the-literature
#16
Venkata Rajesh Konjeti, Gerald M Hefferman, Sravanthi Paluri, Prerna Ganjoo
Primary pancreatic lymphoma (PPL) is of very rare occurrence as an extra nodal site of Non-Hodgkin's lymphoma (NHL). It represents less than 1% of NHL. Out of which Burkitt lymphoma of pancreas is of a rare presentation. It usually occurs in children and presenting in adults is uncommon. The prevalence of pancreatic Burkitt lymphoma is not known as the incidence is significantly low. Clinical features of PPL are predominantly nonspecific and can become difficult with associated inflammation of pancreas. Differentiation of lymphoma to adenocarcinoma is important as chemotherapy is the main stay of treatment in lymphoma...
2018: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/29590448/18f-fluorodeoxyglucose-positron-emission-tomography-to-indicate-conversion-surgery-in-patients-with-initially-unresectable-locally-advanced-pancreatic-cancer
#17
Keiichi Okano, Hironobu Suto, Minoru Oshima, Yasuhisa Ando, Mina Nagao, Hideki Kamada, Hideki Kobara, Tsutomu Masaki, Hiroyuki Okuyama, Yoshihiro Okita, Akihito Tsuji, Yasuyuki Suzuki
Objective: Advances in chemotherapy and chemoradiotherapy have enabled conversion of initially unresectable locally advanced (UR-LA) pancreatic adenocarcinoma (PDAC) to a resectable disease. However, definitive criteria for conversion surgery have not been established. We evaluated the potential of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to indicate conversion surgery in patients with primary UR-LA PDAC. Methods: Twenty consecutive patients with UR-LA PDAC underwent chemoradiation or chemotherapy followed by assessment with FDG-PET...
March 26, 2018: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29589221/long-term-survival-with-repeat-resection-for-lung-oligometastasis-from-pancreatic-ductal-adenocarcinoma-a-case-report
#18
Ryota Matsuki, Masanori Sugiyama, Hidefumi Takei, Haruhiko Kondo, Masachika Fujiwara, Junji Shibahara, Junji Furuse
BACKGROUND: Long-term survival after resection of metastases from pancreatic ductal adenocarcinoma is rare. CASE PRESENTATION: A 54-year-old man underwent pancreaticoduodenectomy (PD) for pancreatic ductal adenocarcinoma (PDAC) with UICC staging pT3N1M0 followed by adjuvant chemotherapy with gemcitabine (GEM). Three years after radical resection of the primary tumor, a tiny nodule was found in the lower lobe of the left lung. Despite treatment with GEM, it increased gradually, but no other metastases were found...
March 27, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29582218/current-concepts-in-the-treatment-of-resectable-pancreatic-cancer
#19
REVIEW
Marc T Roth, Jordan D Berlin
PURPOSE OF REVIEW: The diagnosis of pancreatic cancer carries with it a high mortality rate. Despite advances in the field, this has remained relatively unchanged over the last few decades. Current options for the treatment of resectable pancreatic ductal adenocarcinoma will be reviewed here in conjunction with the historical data that support them. We will focus on updates in treatment guidelines and ongoing clinical trials of interest. RECENT FINDINGS: For localized disease, standard of care includes resection followed by adjuvant chemotherapy ± chemoradiation...
March 26, 2018: Current Oncology Reports
https://www.readbyqxmd.com/read/29581564/prognostic-impact-of-early-nutritional-support-in-patients-affected-by-locally-advanced-and-metastatic-pancreatic-ductal-adenocarcinoma-undergoing-chemotherapy
#20
Ilaria Trestini, Luisa Carbognin, Isabella Sperduti, Clelia Bonaiuto, Alessandra Auriemma, Davide Melisi, Lisa Salvatore, Emilio Bria, Giampaolo Tortora
BACKGROUND/OBJECTIVES: The aim of this analysis was to determine the risk of malnutrition and the prognostic value of nutritional intervention in patients affected by pancreatic ductal adenocarcinoma (PDAC) undergoing chemotherapy. SUBJECTS/METHODS: Clinical-pathological and nutritional data were correlated with overall survival (OS) using a Cox model. Nutritional status was determined by Malnutrition Universal Screening Tool (MUST), body mass index, weight loss in the past 6 months, presence of nutrition-related symptoms, and current energy intake...
March 26, 2018: European Journal of Clinical Nutrition
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