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https://www.readbyqxmd.com/read/29334562/is-a-pathological-complete-response-following-neoadjuvant-chemoradiation-associated-with-prolonged-survival-in-patients-with-pancreatic-cancer
#1
Jin He, Alex B Blair, Vincent P Groot, Ammar A Javed, Richard A Burkhart, Georgios Gemenetzis, Ralph H Hruban, Kevin M Waters, Justin Poling, Lei Zheng, Daniel Laheru, Joseph M Herman, Martin A Makary, Matthew J Weiss, John L Cameron, Christopher L Wolfgang
OBJECTIVES: To describe the survival outcome of patients with borderline resectable or locally advanced pancreatic ductal adenocarcinoma (BR/LA-PDAC) who have a pathologic complete response (pCR) following neoadjuvant chemoradiation. BACKGROUND: Patients with BR/LA-PDAC are often treated with neoadjuvant chemoradiation in an attempt to downstage the tumor. Uncommonly, a pCR may result. METHODS: A retrospective review of a prospectively maintained database was performed at a single institution...
January 12, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29300712/response-to-the-letter-to-the-editor-pancreatic-cancer-and-folfirinox-should-we-resect-all-responders-by-neoptolemos-and-colleagues
#2
Thilo Hackert, Christoph W Michalski, Markus W Büchler
No abstract text is available yet for this article.
February 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29300711/pancreatic-cancer-and-folfirinox-should-we-resect-all-responders
#3
John P Neoptolemos, Christopher M Halloran, Paula Ghaneh, Jorg Kleeff
No abstract text is available yet for this article.
February 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29300345/folfirinox-chemotherapy-in-metastatic-pancreatic-cancer-a-systematic-review-and-meta-analysis-of-retrospective-and-phase-ii-studies
#4
Stephane Thibodeau, Ioannis A Voutsadakis
The introduction of the FOLFIRINOX regimen within the last decade marked the first progress in the clinical field of metastatic pancreatic cancer which had not seen any improvements in treatment availability for several years. In a phase III randomized clinical trial, FOLFIRINOX showed superior efficacy compared to the previous standard treatment of gemcitabine monotherapy. Nevertheless, it is unknown whether the superior results observed in this single phase III clinical trial can be translated more broadly to clinical practice...
January 4, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29297902/-la-combinazione-di-gemcitabina-e-oxaliplatino-gemox-nel-trattamento-del-carcinoma-pancreatico-in-fase-avanzata-di-malattia-le-notizie-sulla-mia-morte-sono-state-esagerate
#5
Jacopo Giuliani, Andrea Bonetti
Riassunto. L'analisi è stata condotta al fine di valutare l'effetto sia sulla sopravvivenza globale (OS) sia sulla sopravvivenza libera da progressione di malattia (PFS) della chemioterapia di combinazione in prima linea per il carcinoma pancreatico in fase avanzata di malattia. La presente analisi è limitata agli studi randomizzati controllati (RCT) di fase III. Successivamente è stata applicata la European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) agli RCT di fase III analizzati per ricavare uno score relativo all'entità del beneficio clinico ottenuto per ciascun RCT...
December 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29288237/genomics-driven-precision-medicine-for-advanced-pancreatic-cancer-early-results-from-the-compass-trial
#6
Kyaw Lwin Aung, Sandra E Fischer, Robert E Denroche, Gun-Ho Jang, Anna Dodd, Sean Creighton, Bernadette Southwood, Sheng-Ben Liang, Dianne Chadwick, Amy Zhang, Grainne M O'Kane, Hamzeh Adel Amin Albaba, Shari Moura, Robert C Grant, Jessica K Miller, Faridah Mbabaali, Danielle Pasternack, Ilinca M Lungu, John M S Bartlett, Sangeet Ghai, Mathieu Lemire, Spring Holter, Ashton A Connor, Richard A Moffitt, Jen Jen Yeh, Lee Timms, Paul M Krzyzanowski, Neesha C Dhani, David W Hedley, Faiyaz Notta, Julie M Wilson, Malcolm J Moore, Steven Gallinger, Jennifer J Knox
PURPOSE: To perform real time whole genome sequencing (WGS) and RNA sequencing (RNASeq) of advanced pancreatic ductal adenocarcinoma (PDAC) to identify predictive mutational and transcriptional features for better treatment selection.  Experimental Design: Patients with advanced PDAC were prospectively recruited prior to first-line combination chemotherapy. Fresh tumor tissue was acquired by image guided percutaneous core biopsy for WGS and RNASeq. Laser capture microdissection was performed for all cases...
December 29, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29280707/successful-conservative-treatment-of-enterocutaneous-fistula-with-cyanoacrylate-surgical-sealant-case-report
#7
N Musa, F Aquilino, P Panzera, G Martines
AIM: Enterocutaneous (EC) fistula is an abnormal communication between the gastrointestinal tract and the skin. The majority of EC fistulas result from surgery. Only 15-25% of EC fistulas are spontaneous and they often result from underlying diseases such as Crohn's disease, radiation and chemotherapy. CASE REPORT: A 62-year old woman who, in 2012, underwent Pylorus-preserving cephalic pancreaticoduodenectomy (PPPD sec. Traverso-Longmire), due to an advanced pancreatic ductal adenocarcinoma (pT3N1M1)...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29246032/a-rare-case-of-esophageal-metastasis-from-pancreatic-ductal-adenocarcinoma-a-case-report-and-literature-review
#8
Lauren M Rosati, Megan N Kummerlowe, Justin Poling, Amy Hacker-Prietz, Amol K Narang, Eun J Shin, Dung T Le, Elliot K Fishman, Ralph H Hruban, Stephen C Yang, Matthew J Weiss, Joseph M Herman
Purpose: We report a very unique case of an esophageal metastasis from a pancreatic ductal adenocarcinoma (PDAC) primary. Methods: After obtaining consent from the patient, all relevant records of the case were obtained and retrospectively reviewed. Results: At presentation, the patient was diagnosed with synchronous pancreatic and esophageal cancer. He received six months of neoadjuvant therapy including FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and stereotactic body radiation therapy (SBRT) to the pancreatic tumor followed by a combined pancreaticoduodenectomy and Ivor Lewis esophagectomy...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29241394/neoadjuvant-therapy-offers-longer-survival-than-upfront-surgery-for-poorly-differentiated-and-higher-stage-pancreatic-cancer
#9
Anna Nurmi, Harri Mustonen, Helka Parviainen, Katriina Peltola, Caj Haglund, Hanna Seppänen
BACKGROUND: Neoadjuvant therapy for pancreatic cancer remains controversial. Our aim was to assess differences in survival, disease recurrence and histopathological tumor characteristics between patients treated with neoadjuvant therapy followed by subsequent surgery and patients undergoing upfront surgery. MATERIAL AND METHODS: Out of 399 consecutive pancreatic ductal adenocarcinoma (PDAC) patients operated at Helsinki University Hospital in 2000-2015, 75 borderline resectable patients were treated with neoadjuvant therapy...
December 15, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/29227344/predictors-of-resectability-and-survival-in-patients-with-borderline-and-locally-advanced-pancreatic-cancer-who-underwent-neoadjuvant-treatment-with-folfirinox
#10
Theodoros Michelakos, Ilaria Pergolini, Carlos Fernández-Del Castillo, Kim C Honselmann, Lei Cai, Vikram Deshpande, Jennifer Y Wo, David P Ryan, Jill N Allen, Lawrence S Blaszkowsky, Jeffrey W Clark, Janet E Murphy, Ryan D Nipp, Aparna Parikh, Motaz Qadan, Andrew L Warshaw, Theodore S Hong, Keith D Lillemoe, Cristina R Ferrone
OBJECTIVE: The aim of this study was to determine (1) whether preoperative factors can predict resectability of borderline resectable (BR) and locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant FOLFIRINOX, (2) which patients might benefit from adjuvant therapy, and (3) survival differences between resected BR/LA patients who received neoadjuvant FOLFIRINOX and upfront resected patients. BACKGROUND: Patients with BR/LA PDAC are often treated with FOLFIRINOX to obtain a margin-negative resection, yet selection of patients for resection remains challenging...
December 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29221990/molecular-and-cellular-mechanisms-of-chemoresistance-in-pancreatic-cancer
#11
REVIEW
Aleksandra Adamska, Omar Elaskalani, Aikaterini Emmanouilidi, Minkyoung Kim, Norbaini Binti Abdol Razak, Pat Metharom, Marco Falasca
Pancreatic Ductal Adenocarcinoma (PDAC) is one of the most chemoresistant cancers, and current therapies targeting cancer-associated molecular pathways have not given satisfactory results, owing in part to rapid upregulation of alternative compensatory pathways. Most of the available treatments are palliative, focussing on improving the quality of life. At present, available options are surgery, embolization, radiation, chemotherapy, immunotherapy and use of other more targeted drugs. In this review, we describe the cellular and molecular effects of current chemotherapy drugs such as gemcitabine, FOLFIRINOX (5-fluorouracil [5-FU], oxaliplatin, irinotecan, and leucovorin) and ABRAXANE (nab-Paclitaxel), which have shown a survival benefit, although modest, for pancreatic cancer patients...
November 22, 2017: Advances in Biological Regulation
https://www.readbyqxmd.com/read/29207968/palliative-chemotherapy-for-pancreatic-adenocarcinoma-a-retrospective-cohort-analysis-of-efficacy-and-toxicity-of-the-folfirinox-regimen-focusing-on-the-older-patient
#12
Anne Katrin Berger, Georg Martin Haag, Martin Ehmann, Anne Byl, Dirk Jäger, Christoph Springfeld
BACKGROUND: Pancreatic cancer occurs more frequently in older patients, but these are underrepresented in the phase III clinical studies that established the current treatment standards. This leads to uncertainty regarding the treatment of older patients with potentially toxic but active regimens like FOLFIRINOX. METHODS: We conducted a retrospective analysis of patients treated according to the FOLFIRINOX protocol at our institution between 2010 and 2014 with a focus on older patients...
December 6, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29196437/targeting-both-tumour-associated-cxcr2-neutrophils-and-ccr2-macrophages-disrupts-myeloid-recruitment-and-improves-chemotherapeutic-responses-in-pancreatic-ductal-adenocarcinoma
#13
Timothy M Nywening, Brian A Belt, Darren R Cullinan, Roheena Z Panni, Booyeon J Han, Dominic E Sanford, Ryan C Jacobs, Jian Ye, Ankit A Patel, William E Gillanders, Ryan C Fields, David G DeNardo, William G Hawkins, Peter Goedegebuure, David C Linehan
OBJECTIVE: Chemokine pathways are co-opted by pancreatic adenocarcinoma (PDAC) to facilitate myeloid cell recruitment from the bone marrow to establish an immunosuppressive tumour microenvironment (TME). Targeting tumour-associated CXCR2+neutrophils (TAN) or tumour-associated CCR2+ macrophages (TAM) alone improves antitumour immunity in preclinical models. However, a compensatory influx of an alternative myeloid subset may result in a persistent immunosuppressive TME and promote therapeutic resistance...
December 1, 2017: Gut
https://www.readbyqxmd.com/read/29189332/clinical-management-metastatic-disease
#14
Andrew H Ko
Most patients with pancreatic cancer either present with or eventually develop metastatic disease during the course of their illness. For such individuals, systemic therapy, namely, cytotoxic therapy, represents the mainstay of treatment and is administered with noncurative intent. Of the various chemotherapy options now available for treating metastatic pancreatic cancer, 2 combination regimens, FOLFIRINOX (infusional 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and the doublet of gemcitabine and albumin-bound paclitaxel, have emerged as frontline standards of care, based on phase III studies demonstrating a significant survival benefit compared with single-agent gemcitabine...
November 2017: Cancer Journal
https://www.readbyqxmd.com/read/29162142/-heatpac-a-phase-ii-randomized-study-of-concurrent-thermochemoradiotherapy-versus-chemoradiotherapy-alone-in-locally-advanced-pancreatic-cancer
#15
Niloy Ranjan Datta, Bernhard Pestalozzi, Pierre-Alain Clavien, Alexander Siebenhüner, Emsad Puric, Shaka Khan, Christoph Mamot, Oliver Riesterer, Jürg Knuchel, Cäcilia Sophie Reiner, Stephan Bodis
BACKGROUND: Pancreatic cancer has a dismal prognosis with 5-year overall survival rate of around 5%. Although surgery is still the best option in operable cases, majority of the patients who present in locally advanced stages are deemed inoperable. Novel approaches are therefore needed for the management of around 80% of these inoperable locally advanced pancreatic cancers (LAPC). Hyperthermia (39-43 °C) is a potent radiosensitizer and further enhances the action of gemcitabine, also a known radiosensitizer...
November 21, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/29162047/treatment-recommendations-within-the-leeway-of-clinical-guidelines-a-qualitative-interview-study-on-oncologists-clinical-deliberation
#16
I Otte, S Salloch, A Reinacher-Schick, J Vollmann
BACKGROUND: Recommending the optimal treatment for an individual patient requires a well-balanced consideration of various medical, social and ethical factors. The interplay of these factors, interpretation of the patient's situation and understanding of the existing clinical guidelines can lead to divergent therapy recommendations, depending on the attending physician. Gaining a better understanding of the individual process of medical decision-making and the differences occurring will support the delivery of optimal individualized care within the clinical setting...
November 21, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29143916/a-real-world-comparison-of-folfirinox-gemcitabine-plus-nab-paclitaxel-and-gemcitabine-in-advanced-pancreatic-cancers
#17
Ying Wang, Pierre Camateros, Winson Y Cheung
PURPOSE: FOLFIRINOX (FFN), nab-paclitaxel plus gemcitabine (GN), and gemcitabine are three systemic therapies that provide clinically meaningful benefit to patients with unresectable pancreatic cancer (UPC). There are no clinical trials that directly compare the efficacy of all three regimens. In this study, we aim to examine and compare the real-world effectiveness of these treatments. METHODS: Patients diagnosed with UPC who initiated palliative chemotherapy from August 2014 to January 2016 at any one of six cancer centers in British Columbia were identified from the provincial pharmacy...
November 16, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/29137884/uptake-and-effectiveness-of-folfirinox-for-advanced-pancreatic-cancer-a-population-based-study
#18
S Karim, J Zhang-Salomans, J J Biagi, T Asmis, C M Booth
AIMS: Although FOLFIRINOX is a standard treatment option for advanced pancreas cancer, there are few data describing utilisation and effectiveness in routine clinical practice. Here we report practice patterns and outcomes in the general population of Ontario, Canada. MATERIALS AND METHODS: Using the Ontario Cancer Registry and New Drug Funding Program, we identified all patients with pancreas cancer treated with palliative intent gemcitabine or FOLFIRINOX in Ontario during 2006-2014...
November 11, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/29101303/pancreatic-ductal-adenocarcinoma-subtyping-using-the-biomarkers-hepatocyte-nuclear-factor-1a-and-cytokeratin-81-correlates-with-outcome-and-treatment-response
#19
Alexander Muckenhuber, Anne Katrin Berger, Anna Melissa Schlitter, Katja Steiger, Björn Konukiewitz, Andreas Trumpp, Roland Eils, Jens Werner, Helmut Friess, Irene Esposito, Günter Klöppel, Guralp O Ceyhan, Moritz Jesinghaus, Carsten Denkert, Marcus Bahra, Albrecht Stenzinger, Martin R Sprick, Dirk Jäger, Christoph Springfeld, Wilko Weichert
PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is associated with a dismal prognosis and poor therapeutic response to current chemotherapy regimens in unselected patient populations. Recently, it has been shown that PDAC may be stratified into functionally and therapeutically relevant molecular subgroups and that some of these subtypes can be recapitulated by immunohistochemistry for KRT81 (QM/squamous/basal like) and HNF1A (non-QM, overlap with exocrine/ADEX subtype). EXPERIMENTAL DESIGN: We validated the different outcome of the HNF1A / KRT81 PDAC subtypes in two independent cohorts of surgically treated patients and examined the treatment response to chemotherapy in a third cohort of unresectable patients...
November 3, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29094028/survival-outcome-and-prognostic-factors-of-neoadjuvant-treatment-followed-by-resection-for-borderline-resectable-pancreatic-cancer
#20
Hyeong Seok Kim, Jin-Young Jang, Youngmin Han, Kyoung Bun Lee, Ijin Joo, Doo-Ho Lee, Jae Ri Kim, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim
Purpose: Neoadjuvant treatment may provide improved survival outcomes for patients with borderline resectable pancreatic cancer (BRPC). The purpose of this study is to evaluate the clinical outcomes of neoadjuvant treatment and to identify prognostic factors. Methods: Forty patients who met the National Comprehensive Cancer Network definition of BRPC and received neoadjuvant treatment followed by surgery between 2007 and 2015 were evaluated. Prospectively collected clinicopathological outcomes were analyzed retrospectively...
October 2017: Annals of Surgical Treatment and Research
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