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https://www.readbyqxmd.com/read/27909037/safety-and-efficacy-of-stereotactic-body-radiation-therapy-combined-with-s-1-simultaneously-followed-by-sequential-s-1-as-an-initial-treatment-for-locally-advanced-pancreatic-cancer-silapanc-trial-study-design-and-rationale-of-a-phase-ii-clinical-trial
#1
Xiaofei Zhu, Xiaoping Ju, Fei Cao, Fang Fang, Shuiwang Qing, Yuxin Shen, Zhen Jia, Yangsen Cao, Huojun Zhang
INTRODUCTION: Upfront surgeries are not beneficial to most patients with pancreatic cancer. Therefore, more emphasis has been placed chemoradiotherapy in locally advanced pancreatic cancer recently. Gemcitabine-based regimens or FOLFIRINOX (a chemotherapy regimen including leucovorin, 5-FU, irinotecan, oxaliplatin) has been proven as a standard chemotherapy in pancreatic cancer. However, severe toxicities may prevent the completion of chemotherapy. S-1 has showed better objective response rates, similar overall survival rates and progression-free survival rates compared with gemcitabine, revealing that S-1 may be a potential candidate in treating pancreatic cancer, especially for patients refractory to gemcitabine...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27896637/seom-clinical-guideline-for-the-treatment-of-pancreatic-cancer-2016
#2
R Vera, E Dotor, J Feliu, E González, B Laquente, T Macarulla, E Martínez, J Maurel, M Salgado, J L Manzano
Pancreatic cancer remains an aggressive disease with a 5 year survival rate of 5%. Only 15% of patients with pancreatic cancer are eligible for radical surgery. Evidence suggests a benefit on survival with adjuvant chemotherapy (gemcitabine o fluourouracil) after R1/R0 resection. Adjuvant chemoradiotherapy is also a valid option in patients with positive margins. Borderline resectable pancreatic cancer is defined as the involvement of the mesenteric vasculature with a limited extension. These tumors are technically resectable, but with a high risk of positive margins...
November 28, 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27896518/analysis-of-predictors-of-resection-and-survival-in-locally-advanced-stage-iii-pancreatic-cancer-does-the-nature-of-chemotherapy-regimen-influence-outcomes
#3
Filip Bednar, Mazen S Zenati, Jennifer Steve, Sharon Winters, Lee M Ocuin, Nathan Bahary, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
BACKGROUND: Locally advanced unresectable pancreatic cancer (LAPC) historically portends a poor prognosis. FOLFIRINOX and gemcitabine/nab-paclitaxel have proven effective in the metastatic setting. We sought to evaluate the outcomes of these regimens compared with older regimens in LAPC. METHODS: A retrospective, single institutional review of all consecutive LAPC treated with "new" (FOLFIRINOX and/or gemcitabine/nab-paclitaxel) and "old" (gemcitabine or 5-FU) chemotherapy from 2010 to 2014 was performed...
November 28, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27896469/ct-evaluation-after-neoadjuvant-folfirinox-chemotherapy-for-borderline-and-locally-advanced-pancreatic-adenocarcinoma
#4
Mathilde Wagner, Celia Antunes, Daniel Pietrasz, Christophe Cassinotto, Magaly Zappa, Antonio Sa Cunha, Oliver Lucidarme, Jean-Baptiste Bachet
AIM: To assess anatomic changes on computed tomography (CT) after neoadjuvant FOLFIRINOX (5-fluorouracil/leucovorin/irinotecan/oxaliplatin) chemotherapy for secondary resected borderline resectable (BR) and locally advanced (LA) pancreatic adenocarcinoma and their accuracy to predict resectability and pathological response. METHODS: Thirty-six patients with secondary resected BR/LA pancreatic adenocarcinoma after neoadjuvant FOLFIRINOX chemotherapy (± chemoradiotherapy) were retrospectively included...
November 28, 2016: European Radiology
https://www.readbyqxmd.com/read/27895425/folfirinox-in-elderly-patients-with-pancreatic-or-colorectal-cancer-tolerance-and-efficacy
#5
Jean-Florian Guion-Dusserre, Aurélie Bertaut, François Ghiringhelli, Julie Vincent, Valérie Quipourt, Sophie Marilier, Zoé Tharin, Leila Bengrine-Lefevre
AIM: To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer. METHODS: This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin (85 mg/m(2) in over 120 min) followed by leucovorin (400 mg/m(2) in over 120 min), with the addition, after 30 min of irinotecan (180 mg/m(2) in over 90 min) then 5 fluorouracil (5FU) (400 mg/m(2) administred intravenous bolus), followed by 5FU (2400 mg/m(2) intraveinous infusion over 46 h) repeated every 2 wk...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27832445/pancreatic-cancer-and-liver-metastases-state-of-the-art
#6
REVIEW
Eugen Bellon, Florian Gebauer, Michael Tachezy, Jakob R Izbicki, Maximilian Bockhorn
Pancreatic cancer is still one of the most aggressive oncological diseases with a 5-year mortality rate below 10%. Surgery remains the only curative treatment; however, most patients present with late-stage disease deemed unresectable, either due to extensive local vascular involvement or the presence of distant metastasis. In the detection of hepatic metastases, the current standard is palliative chemotherapy with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) or nab-paclitaxel with gemcitabine...
September 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27811314/epigenetic-treatment-of-pancreatic-cancer-is-there-a-therapeutic-perspective-on-the-horizon
#7
REVIEW
Elisabeth Hessmann, Steven A Johnsen, Jens T Siveke, Volker Ellenrieder
Pancreatic ductal adenocarcinoma (PDAC) constitutes one of the most aggressive malignancies with a 5-year survival rate of <7%. Due to growing incidence, late diagnosis and insufficient treatment options, PDAC is predicted to soon become one of the leading causes of cancer-related death. Although intensified cytostatic combinations, particularly gemcitabine plus nab-paclitaxel and the folinic acid, fluorouracil, irinotecan, oxaliplatin (FOLFIRINOX) protocol, provide some improvement in efficacy and survival compared with gemcitabine alone, a breakthrough in the treatment of metastatic pancreatic cancer remains out of sight...
November 3, 2016: Gut
https://www.readbyqxmd.com/read/27765912/an-assessment-of-the-benefit-risk-balance-of-folfirinox-in-metastatic-pancreatic-adenocarcinoma
#8
Julien Péron, Pascal Roy, Thierry Conroy, Françoise Desseigne, Marc Ychou, Sophie Gourgou-Bourgade, Trevor Stanbury, Laurent Roche, Brice Ozenne, Marc Buyse
BACKGROUND: We sought to assess the benefit-risk balance of FOLFIRINOX versus gemcitabine in patients with metastatic pancreatic adenocarcinoma. METHODS: We used generalized pairwise comparisons. This statistical method permits the simultaneous analysis of several prioritized outcome measures. The first priority outcome was survival time (OS). Differences in OS that exceeded two months were considered clinically relevant. The second priority outcome was toxicity...
October 19, 2016: Oncotarget
https://www.readbyqxmd.com/read/27758723/-new-developments-in-the-treatment-of-pancreatic-cancer
#9
H A Marsman, M G Besselink
- The incidence of pancreatic cancer is increasing due to the ageing population among other things, while 5-year survival has improved in the past two decades from 3 to 7%.- In case of biliary obstruction due to pancreatic cancer, biliary drainage before surgery or ablative therapy using a covered metal stent instead of plastic reduces the rate of complications.- In patients with metastasized pancreatic cancer a combination of folinic acid, fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX) results in improved survival...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27740973/intraoperative-radiotherapy-in-the-era-of-intensive-neoadjuvant-chemotherapy-and-chemoradiotherapy-for-pancreatic-adenocarcinoma
#10
Florence K Keane, Jennifer Y Wo, Cristina R Ferrone, Jeffrey W Clark, Lawrence S Blaszkowsky, Jill N Allen, Eunice L Kwak, David P Ryan, Keith D Lillemoe, Carlos Fernandez-Del Castillo, Theodore S Hong
OBJECTIVES: Improved outcomes with FOLFIRINOX or gemcitabine with nab-paclitaxel in the treatment of metastatic pancreatic adenocarcinoma (PDAC) have prompted incorporation of these regimens into neoadjuvant treatment of locally advanced unresectable PDAC. Whereas some patients remain unresectable on surgical exploration, others are able to undergo resection after intensive neoadjuvant treatment. We evaluated outcomes and toxicity associated with use of intensive neoadjuvant treatment followed by intraoperative radiotherapy (IORT) in combination with resection or exploratory laparotomy...
October 12, 2016: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27724927/complete-pathological-response-following-neoadjuvant-folfirinox-in-borderline-resectable-pancreatic-cancer-a-case-report-and-review
#11
Mišo Gostimir, Sean Bennett, Terence Moyana, Harman Sekhon, Guillaume Martel
BACKGROUND: Pancreatic cancer is among the top 5 most common cancers worldwide, but is particularly devastating due to its insidious nature. Complete surgical resection remains the only potential curative treatment, although only 20 % of patients present with a resectable tumor. Patients may alternatively present with borderline resectable pancreatic cancer or locally advanced pancreatic cancer and can be offered treatment with neoadjuvant intent. The effectiveness of these treatments is unclear and there is a paucity of data to suggest one optimal treatment approach...
October 10, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27723905/improvement-in-advanced-pancreatic-cancer-survival-with-novel-chemotherapeutic-strategies-experience-of-a-community-based-hospital
#12
A Hann, W Bohle, J Egger, W G Zoller
Background: New chemotherapeutic strategies for locally advanced or metastatic pancreatic ductal adenocarcinoma (PDAC) have been shown to improve survival in randomized clinical trials. Little is known about the use of such chemotherapies and their benefit in community-based hospitals. This retrospective study analyzes the overall survival of these patients under "real life conditions" before and after the introduction of FOLFIRINOX in 2011. Methods: We retrospectively identified consecutive patients with PDAC who were treated at our hospital from 2011 to June 2014 (2011+ cohort) and 2004 to 2010 (historical cohort)...
October 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27718779/eosinophilia-as-the-presenting-sign-in-pancreatic-cancer-an-extremely-rare-occurrence
#13
Uroosa Ibrahim, Divya Asti, Amina Saqib, Bindu Madhavi Mudduluru, Sadaf Ayaz, Marcel Odaimi
A case of pancreatic adenocarcinoma diagnosed following work up for eosinophilia is reported. A 68-year-old female was referred to our Hematology clinic for an absolute eosinophil count of 1869 per microliter. No allergic signs or symptoms were reported. Laboratory studies for parasitic infestations autoimmune disease and collagen vascular disease were negative. Computed tomography of the abdomen revealed a mass in the neck of the pancreas with fine needle aspiration biopsy consistent with adenocarcinoma. The patient received one cycle of modified FOLFIRINOX with complete resolution of the eosinophilia...
October 8, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27714651/comparison-of-folfirinox-chemotherapy-with-other-regimens-in-patients-with-biliary-tract-cancers-a-retrospective-study
#14
Tulay Kus, Gokmen Aktas, Mehmet Emin Kalender, Alper Sevinc, Celaletdin Camci
PURPOSE: The aim of this retrospective study was to compare the different treatment options of patients with advanced biliary tract carcinoma (BTC) who were treated with platinum-gemcitabine (CG) or platinum-5-fluorouracil (CF) or 5-Fluorouracil-oxaliplatin-irinotecan (FOLFIRINOX) chemotherapy. METHODS: We included the patients with advanced BTC who were registered at the Department of Oncology in Gaziantep University between January 2008 and January 2016. The following data were analyzed: disease control rate (DCR), progression free survival (PFS) of first and second-line of chemotherapy, and overall survival (OS)...
October 6, 2016: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/27698926/folfirinox-in-locally-advanced-and-metastatic-pancreatic-cancer-a-single-centre-cohort-study
#15
S J Rombouts, T H Mungroop, M N Heilmann, H W van Laarhoven, O R Busch, I Q Molenaar, M G Besselink, J W Wilmink
Introduction: FOLFIRINOX is emerging as new standard of care for fit patients with locally advanced pancreatic cancer (LAPC) and metastatic pancreatic cancer (MPC). However, some of the physicians are reluctant to use FOLFIRINOX due to high toxicity rates reported in earlier studies. We reviewed our experience with FOLFIRINOX in LAPC and MPC, focussing on dose adjustments, toxicity and efficacy. Methods: We reviewed all patients with LAPC or MPC treated with FOLFIRINOX in our institution between April 2011 and December 2015...
2016: Journal of Cancer
https://www.readbyqxmd.com/read/27637757/economic-evaluations-of-first-line-chemotherapy-regimens-for-pancreatic-cancer-a-critical-review
#16
Mahdi Gharaibeh, J Lyle Bootman, Ali McBride, Jennifer Martin, Ivo Abraham
Effect sizes of efficacy of first-line treatments for (metastatic) pancreas cancer are constrained, underscoring the need for evaluations of the efficacy-to-cost relationship. We critically review economic evaluations of first-line chemotherapy regimens for pancreatic cancer since the 1997 introduction of gemcitabine. We searched PubMed/MEDLINE and EMBASE (1997-2015), and the websites of health technology assessment agencies. Two authors independently reviewed economic studies for eligibility in this review; evaluated peer-reviewed, journal-published studies in terms of the Drummond Checklist; and critiqued the technical and scientific merit of all studies...
September 14, 2016: PharmacoEconomics
https://www.readbyqxmd.com/read/27634903/early-tumor-shrinkage-as-a-predictor-of-favorable-outcomes-in-patients-with-advanced-pancreatic-cancer-treated-with-folfirinox
#17
Yasuhiro Kaga, Yu Sunakawa, Yutaro Kubota, Teppei Tagawa, Taikan Yamamoto, Toshikazu Ikusue, Yu Uto, Kouichirou Miyashita, Hirokazu Toshima, Kouji Kobayashi, Atsushi Hisamatsu, Wataru Ichikawa, Takashi Sekikawa, Ken Shimada, Yasutsuna Sasaki
There are several reports on the correlation between early tumor shrinkage (ETS) or depth of response (DpR) and survival in chemotherapies for colorectal cancer; however, few studies have investigated it in pancreatic cancer. We therefore investigated whether the ETS will predict outcomes in 59 patients with advanced pancreatic cancer treated with FOLFIRINOX therapy. The association of ETS with progression-free survival (PFS) and overall survival (OS) was evaluated but also we addressed to the correlation between outcomes and DpR...
September 13, 2016: Oncotarget
https://www.readbyqxmd.com/read/27621332/current-and-evolving-therapies-for-metastatic-pancreatic-cancer-are-we-stuck-with-cytotoxic-chemotherapy
#18
REVIEW
Gauri R Varadhachary, Robert A Wolff
At present, front-line therapy for metastatic pancreatic ductal adenocarcinoma is combination chemotherapy, most commonly FOLFIRINOX (fluorouracil, irinotecan, and oxaliplatin) or gemcitabine and nanoparticle albumin-bound paclitaxel. Despite a better understanding of the genomic landscape and the importance of the tumor microenvironment, we have not made a seismic shift in the overall survival for this disease. Given our growing understanding of the biology of pancreatic ductal adenocarcinoma, the question remains whether novel, noncytotoxic agents will augment or even replace conventional chemotherapy...
September 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27610011/folfirinox-and-translational-studies-towards-personalized-therapy-in-pancreatic-cancer
#19
REVIEW
Chiara Caparello, Laura L Meijer, Ingrid Garajova, Alfredo Falcone, Tessa Y Le Large, Niccola Funel, Geert Kazemier, Godefridus J Peters, Enrico Vasile, Elisa Giovannetti
Pancreatic cancer is an extremely aggressive disease; although progress has been made in the last few years, the prognosis of these patients remains dismal. FOLFIRINOX is now considered a standard treatment in first-line setting, since it demonstrated an improved overall and progression-free survival vs gemcitabine alone. However, the enthusiasm over the benefit of this three-drug regimen is tempered by the associated increased toxicity profile, and many efforts have been made to improve the feasibility of this schedule...
August 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27604886/primary-tumor-resection-following-favorable-response-to-systemic-chemotherapy-in-stage-iv-pancreatic-adenocarcinoma-with-synchronous-metastases-a-bi-institutional-analysis
#20
G Paul Wright, Katherine E Poruk, Mazen S Zenati, Jennifer Steve, Nathan Bahary, Melissa E Hogg, Amer H Zuriekat, Christopher L Wolfgang, Herbert J Zeh, Matthew J Weiss
INTRODUCTION: Patients with metastatic pancreatic adenocarcinoma have traditionally been offered palliative chemotherapy alone, and the role of surgery in these patients remains unknown. METHODS: A bi-institutional retrospective review was performed for patients with metastatic pancreatic adenocarcinoma who underwent resection of the primary tumor from 2008 to 2013. The primary outcome measured was postoperative overall survival. Secondary outcomes included postoperative disease-free survival and overall survival from the time of diagnosis...
September 7, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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