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https://www.readbyqxmd.com/read/28804517/update-on-the-role-of-nanoliposomal-irinotecan-in-the-treatment-of-metastatic-pancreatic-cancer
#1
REVIEW
Fnu Asad Ur Rahman, Saeed Ali, Muhammad Wasif Saif
Median survival for patients with metastatic pancreatic cancer (MPC) treated with combination chemotherapeutic agents such as gemcitabine-based regimens and FOLFIRINOX is currently less than 12 months. This highlights the need for more efficacious first-line, as well as second-line therapies. Nanoliposomal irinotecan, in combination with 5-fluorouracil (5-FU)/folinic acid has recently been assessed as second-line therapy after initial gemcitabine-based therapy. It is the first, second-line treatment approved by the US Food and Drug Administration to treat patients with MPC based on results of the NAnoliPOsomaL Irinotecan (NAPOLI-1) study, which showed that this regimen significantly prolonged progression-free survival (3...
July 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28795609/comparison-of-treatment-patterns-and-economic-outcomes-among-metastatic-pancreatic-cancer-patients-initiated-on-nab-paclitaxel-gemcitabine-or-folfirinox
#2
Ali McBride, Machaon Bonafede, Qian Cai, Nicole Princic, Oth Tran, Corey Pelletier, Monika Parisi, Manish Patel
ABSRTACT Background: The economic burden of metastatic pancreatic cancer (mPC) is substantial while treatment options are limited. Little is known about the treatment patterns and healthcare costs among mPC patients who initiated first-line gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-P+G) and FOLFIRINOX. RESEARCH DESIGN AND METHODS: The MarketScan® claims databases were used to identify adults with ≥2 claims for pancreatic cancer, 1 claim for a secondary malignancy, completed ≥1 cycle of nab-P+G or FOLFIRINOX during 4/1/2013 and 3/31/2015, and had continuous plan enrollment for ≥6 months pre- and 3 months after the first-line treatment...
August 10, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28750659/alliance-for-clinical-trials-in-oncology-alliance-trial-a021501-preoperative-extended-chemotherapy-vs-chemotherapy-plus-hypofractionated-radiation-therapy-for-borderline-resectable-adenocarcinoma-of-the-head-of-the-pancreas
#3
Matthew H G Katz, Fang-Shu Ou, Joseph M Herman, Syed A Ahmad, Brian Wolpin, Robert Marsh, Spencer Behr, Qian Shi, Michael Chuong, Lawrence H Schwartz, Wendy Frankel, Eric Collisson, Eugene J Koay, JoLeen M Hubbard, James L Leenstra, Jeffrey Meyerhardt, Eileen O'Reilly
BACKGROUND: Borderline resectable pancreatic cancers infiltrate into adjacent vascular structures to an extent that makes an R0 resection unlikely when pancreatectomy is performed de novo. In a pilot study, Alliance for Clinical Trials in Oncology Trial A021101, the median survival of patients who received chemotherapy and radiation prior to anticipated pancreatectomy was 22 months, and 64% of operations achieved an R0 resection. However, the individual contributions of preoperative chemotherapy and radiation therapy to therapeutic outcome remain poorly defined...
July 27, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28736643/comparison-of-efficacy-and-toxicity-of-folfirinox-and-gemcitabine-with-nab-paclitaxel-in-unresectable-pancreatic-cancer
#4
Tetsuhito Muranaka, Masaki Kuwatani, Yoshito Komatsu, Kentaro Sawada, Hiroshi Nakatsumi, Yasuyuki Kawamoto, Satoshi Yuki, Yoshimasa Kubota, Kimitoshi Kubo, Shuhei Kawahata, Kazumichi Kawakubo, Hiroshi Kawakami, Naoya Sakamoto
BACKGROUND: Irinotecan, oxaliplatin and leucovorin-modulated fluorouracil (FOLFIRINOX) and the combination regimen of gemcitabine and nanoparticle albumin-bound paclitaxel (GnP) (nab-PTX) improve the prognosis of patients with metastatic pancreatic cancer. However, no study has compared the efficacy of the two regimens. We compared retrospectively the efficacy and safety of the two regimens in patients with unresectable pancreatic cancer. METHODS: Thirty-eight patients with unresectable locally advanced or metastatic pancreatic cancer received FOLFIRINOX or GnP as first-line chemotherapy between December 2013 and September 2015...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28736642/gemcitabine-nab-paclitaxel-as-second-line-therapy-following-folfirinox-in-metastatic-advanced-pancreatic-cancer-retrospective-analysis-of-response
#5
Khanh T Nguyen, Aparna Kalyan, H Scott Beasley, Aatur D Singhi, Weijing Sun, Herbert J Zeh, Daniel Normolle, Nathan Bahary
BACKGROUND: Given the tolerability of nPG in first-line therapy, we desired to evaluate the response and toxicity profiles of second-line gemcitabine with nab-paclitaxel (nPG) following FOLFIRINOX. Methods: We retrospectively identified 30 patients who received first-line FOLFIRINOX for unresectable or metastatic pancreatic adenocarcinoma followed by second-line nPG. Response was evaluated by RECIST criteria and carbohydrate antigen 19-9 (CA19-9) change. RESULTS: Median age was 63 years with 77% percent having metastatic disease...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28736631/shifting-paradigm-of-developing-biologics-for-the-treatment-of-pancreatic-adenocarcinoma
#6
REVIEW
Ying Zeng, Agnieszka A Rucki, Xu Che, Lei Zheng
Pancreatic adenocarcinoma is still widely considered as a deadly disease even though there are substantial therapeutic developments in the past decade. Using combinational chemotherapy regimens, represented by gemcitabine plus nab-paclitaxel and FOLFIRINOX, was able to improve overall survival in patients with advanced disease to a limited extent. It has been a challenge to develop targeted therapies that are focused on the neoplasm cells of pancreatic adenocarcinoma. Recently, targeting the stroma and immune compartments of pancreatic adenocarcinoma has shown promising results...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28729048/modified-folfirinox-in-metastatic-pancreatic-cancer-a-prospective-study-in-chinese-population
#7
Xiang Li, Tao Ma, Qi Zhang, Yi-Gang Chen, Cheng-Xiang Guo, Yi-Nan Shen, Pei-Wei Sun, Guo-Gang Li, Shun-Liang Gao, Ri-Sheng Que, Jian-Ying Lou, Ri-Sheng Yu, Ying Yuan, Qi-Chun Wei, Shu-Mei Wei, Yun Zhang, Lei Zheng, Xue-Li Bai, Ting-Bo Liang
FOLFIRINOX chemotherapy has shown remarkable responses in patients with metastatic pancreatic cancer (MPC), and has significantly improved prognosis. However, FOLFIRINOX is currently not frequently applied in China because of its high incidence of adverse events, and there is no recognized optimization for this therapy in Chinese population. Modification of FOLFIRINOX may be better for its acceptance in China. In this study, we evaluated the efficacy and safety of modified-FOLFIRINOX in patients with MPC. A total of 62 MPC patients were treated with modified-FOLFIRINOX (no Fluorouracil bolus, 85% Oxaliplatin and 75% Irinotecan) between April 2014 and April 2017 in our institute...
July 17, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28725278/asco-2016-update-colorectal-liver-metastases
#8
REVIEW
Klaus Kaczirek
This short review summarizes the most relevant data on colorectal liver metastases (CLM) presented at the 2016 Annual Meeting of the American Society of Clinical Oncology (ASCO). For this update, congress abstracts were grouped into three clinically relevant scenarios: CLM that are deemed upfront resectable, borderline resectable, and primarily unresectable. According to a large registry study, small, upfront resectable, solitary CLM should be resected using a parenchymal sparing technique. A prospective noninterventional study suggested that chemotherapy plus the anti-VEGF (vascular endothelial growth factor) antibody bevacizumab is effective and well tolerated in patients with borderline resectable CLM...
2017: Memo
https://www.readbyqxmd.com/read/28723668/a-rare-case-of-esophageal-metastasis-from-pancreatic-ductal-adenocarcinoma-a-case-report-and-literature-review
#9
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...
June 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28705006/best-practices-for-the-treatment-of-metastatic-pancreatic-adenocarcinoma-the-therapeutic-landscape-in-2017
#10
Pelin Cinar, Andrew H Ko
The vast majority of patients diagnosed with pancreatic adenocarcinoma have inoperable, most commonly metastatic, disease at the time of initial presentation, at which point systemic therapy becomes the mainstay of treatment. Although survival rates remain very poor in this clinical setting, patients currently have a greater number of therapeutic options available to them than ever before, and consequently individuals are more frequently able to be sequenced through multiple lines of treatment. In this review, we will provide an overview of the current treatment landscape for metastatic pancreatic cancer in 2017, focusing on best practices and the various factors that should be considered in selecting the most appropriate regimen for a given individual...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28685089/comparing-the-cost-effectiveness-of-folfirinox-nab-paclitaxel-plus-gemcitabine-gemcitabine-and-s-1-for-the-treatment-of-metastatic-pancreatic-cancer
#11
Machiko Kurimoto, Michio Kimura, Eiseki Usami, Mina Iwai, Tatsuya Hirose, Shiori Kawachi, Tomoaki Yoshimura
The recommended chemotherapy regimens for pancreatic cancer include the combination of 5-fluorouracil/leucovorin, oxaliplatin and irinotecan (FOLFIRINOX), nab-paclitaxel (nab-PTX) plus gemcitabine (GEM), GEM alone and tegafur/gimeracil/oteracil potassium (S-1) alone. Although the cost-effectiveness of metastatic pancreatic cancer chemotherapies has been extensively investigated, to the best of our knowledge, no study has specifically compared the cost-effectiveness among FOLFIRINOX, nab-PTX + GEM, GEM and S-1 regimens to date...
July 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28681936/toxicity-of-chemotherapy-regimens-in-advanced-and-metastatic-pancreatic-cancer-therapy-a-network-meta-analysis
#12
Xiao-Fang Wang, Wen-Feng Huang, Jian Nie, Yong Zhou, Ding-Wu Tan, Ji-Hao Jiang
This network meta-analysis is adopted in order to compare the toxicity of different chemotherapy regimens in the treatment of advanced/metastatic pancreatic cancer (PC). Randomized controlled trials (RCTs) about different chemotherapy regimens for advanced/metastatic PC were included in this network meta-analysis using Cochrane Library and PubMed electronic databases. The network meta-analysis was performed to combine direct and indirect evidence in order to calculate the odd ratios (OR) and draw a surface under the cumulative ranking (SUCRA) curve...
July 6, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28679984/a-case-of-a-patient-with-granulocyte-colony-stimulating-factor-producing-pancreatic-cancer-who-responded-to-nab-paclitaxel-plus-gemcitabine
#13
Kunio Kataoka, Koichi Achiwa, Yoshiyuki Minami, Motokazu Fujita, Takehito Naitoh, Masahiro Yamada, Hideko Yamamoto, Hiroshi Matsubara, Fumihiro Urano
A 67-year-old male patient presented with an irregular mass involving the pancreatic body and tail with multiple liver/lymph node metastases. A biopsy indicated the presence of a poorly differentiated adenocarcinoma. Fever and increased white blood cell count, C-reactive protein levels, and granulocyte-colony stimulating factor (G-CSF) levels led to the diagnose of G-CSF-producing pancreatic cancer. The patient did not respond to FOLFIRINOX therapy (leucovorin, fluorouracil, irinotecan, and oxaliplatin), but nab-paclitaxel plus gemcitabine treatment was effective, resulting in tumor shrinkage and reduced G-CSF levels...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28631776/-panoramica-sui-risultati-degli-studi-pre-clinici-sugli-effetti-dell-epigallocatechina-gallato-la-pi%C3%A3-abbondante-catechina-presente-nel-t%C3%A3-verde-nel-trattamento-del-cancro-al-pancreas
#14
Sabrina Bimonte, Marco Cascella, Maddalena Leongito, Raffaele Palaia, Domenico Caliendo, Francesco Izzo, Arturo Cuomo
Riassunto. Il tumore del pancreas è una delle principali cause di mortalità e morbilità in tutto il mondo. Nonostante la resezione chirurgica rimanga il trattamento elettivo per questa malattia, solo una minoranza dei pazienti è candidata a intervento chirurgico, in quanto la diagnosi è molto spesso tardiva. Recentemente, nuovi schemi di chemioterapia con la combinazione di diversi farmaci, come il FOLFIRINOX (5-FU, leucovorina, irinotecan, and oxaliplatino), hanno mostrato di migliorare la sopravvivenza libera da progressione di malattia...
June 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28612202/management-of-unresectable-locally-advanced-pancreatic-adenocarcinoma
#15
REVIEW
M Salgado, S Arévalo, O Hernando, A Martínez, R Yaya, M Hidalgo
The diagnosis of unresectable locally advanced pancreatic adenocarcinoma (LAPC) requires confirmation, through imaging tests, of the unfeasibility of achieving a complete surgical resection, in the absence of metastatic spread. The increase in overall survival (OS), together with an appropriate symptom management is the therapeutic target in LAPC, maintaining an acceptable quality of life and, if possible, increasing the time until the appearance of metastasis. Chemoradiation (CRT) improves OS compared to best support treatment or radiotherapy (RT) but with greater toxicity...
June 13, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28608558/efficacy-and-toxicity-of-different-chemotherapy-regimens-in-the-treatment-of-advanced-or-metastatic-pancreatic-cancer-a-network-meta-analysis
#16
Gui-Feng Liu, Gui-Jie Li, Hang Zhao
Objective A network meta-analysis was conducted to compare the efficacy and toxicity of different chemotherapy regimens in treating advanced or metastatic pancreatic cancer (PC). PubMed, Cochrane Library and EMBASE databases from inception to June 2016 were searched. A combination of direct and indirect evidences was referred to for calculating the weighted mean difference (WMD) or the odds ratio (OR) and to establish surface under the cumulative ranking (SUCRA) curves, so as to evaluate the efficacy and toxicity of different chemotherapy regimens in treating advanced or metastatic PC...
June 13, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28599496/use-of-gemcitabine-as-a-second-line-treatment-following-chemotherapy-with-folfirinox-for-metastatic-pancreatic-adenocarcinoma
#17
Matthieu Sarabi, Laetitia Mais, Nadia Oussaid, Françoise Desseigne, Pierre Guibert, Christelle De La Fouchardiere
There is a lack of prospective data about second-line treatments for metastatic pancreatic ductal adenocarcinoma patients. This is partially due to recent changes in first-line chemotherapy treatments. Despite this dearth of information, 50.0% of the patients who experience failure with first-line folinic acid, 5-fluorouracil, irinotecan and oxaliplatin (folfirinox) treatment are eligible for additional chemotherapy. In this setting, gemcitabine is widely used without any standard recommendations available...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28594714/tailored-treatment-strategy-for-locally-advanced-rectal-carcinoma-based-on-the-tumor-response-to-induction-chemotherapy-preliminary-results-of-the-french-phase-ii-multicenter-greccar4-trial
#18
Philippe Rouanet, Eric Rullier, Bernard Lelong, Philippe Maingon, Jean-Jacques Tuech, Denis Pezet, Florence Castan, Stéphanie Nougaret
BACKGROUND: Preoperative radiochemotherapy and total mesorectal excision are the standard-of-care for locally advanced rectal carcinoma, but some patients could be over- or undertreated. OBJECTIVE: This study aimed to assess the feasibility of radiochemotherapy tailored based on the tumor response to induction chemotherapy (FOLFIRINOX) to obtain a minimum R0 resection rate of 90% in the 4 arms of the study. DESIGN: This study is a multicenter randomized trial (NCT01333709)...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28588779/pancreatic-acinar-cell-carcinoma-presenting-with-panniculitis-successfully-treated-with-folfirinox-a-case-report
#19
Tomoyasu Yoshihiro, Kenta Nio, Kenji Tsuchihashi, Hiroshi Ariyama, Kenichi Kohashi, Nobuhiro Tsuruta, Fumiyasu Hanamura, Kyoko Inadomi, Mamoru Ito, Kosuke Sagara, Yuta Okumura, Michitaka Nakano, Shuji Arita, Hitoshi Kusaba, Yoshinao Oda, Koichi Akashi, Eishi Baba
Pancreatic acinar cell carcinoma (PACC) is a rare tumor of the exocrine pancreas, representing only 1% of all pancreatic malignancies. A 50-year-old man presented with edema of the thumb joints bilaterally, followed by an appearance of masses in the bilateral lower extremities and fever (38°C). The masses were diagnosed as panniculitis by skin biopsy, and multiple intraperitoneal masses were incidentally detected on pelvic magnetic resonance imaging performed to investigate the leg abnormalities. The patient was referred to the Kyushu University Hospital for further investigation, and fluorodeoxyglucose-positron emission tomography/computed tomography (CT) revealed high-uptake tumors in the pancreatic tail, in the periphery of the liver, and in the pelvis...
June 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28588713/neoadjuvant-chemotherapy-in-borderline-resectable-pancreatic-cancer-a-case-report
#20
Maria Celeste Palmarocchi, Ruben Carlo Balzarotti Canger, Piercarlo Saletti
Pancreatic cancer is the fourth leading cause of cancer mortality and is associated with a poor overall survival even when diagnosed early and considered resectable. Complete surgical removal with negative histological margins is an independent predictor of survival and remains the only potential curative treatment. In borderline resectable pancreatic adenocarcinoma (BRPAC), preoperative systemic therapy may increase resectability and margin-negative resection rate. There is no current consensus on the optimal chemotherapy regimen for BRPAC...
June 2017: Oncology Letters
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