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https://www.readbyqxmd.com/read/29765563/targeted-therapies-in-the-management-of-locally-advanced-and-metastatic-pancreatic-cancer-a-systematic-review
#1
REVIEW
Anjali V Sheahan, Andrew V Biankin, Christopher R Parish, Levon M Khachigian
Pancreatic cancer has a dismal prognosis particularly in patients presenting with unresectable tumors. We performed a bibliometric analysis of clinical trials for pancreatic cancer conducted between 2014-2016 focusing on patients that presented with unresectable (locally advanced or metastatic) tumors. We discuss a range of studies that employed FOLFIRINOX, the gemcitabine + nab-paclitaxel combination and studies that used molecularly-targeted therapy. Major areas of focus have been dual targeting of EGFR and VEGFR, immunotherapy or a multimodal approach - combining chemotherapy with radiotherapy...
April 20, 2018: Oncotarget
https://www.readbyqxmd.com/read/29761331/folfirinox-versus-gemcitabine-nab-paclitaxel-for-neoadjuvant-treatment-of-resectable-and-borderline-resectable-pancreatic-head-adenocarcinoma
#2
Mashaal Dhir, Mazen S Zenati, Ahmad Hamad, Aatur D Singhi, Nathan Bahary, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
BACKGROUND: Both FOLFIRINOX and gemcitabine/nab-paclitaxel (G-nP) are used increasingly in the neoadjuvant treatment (NAT) of pancreatic ductal adenocarcinoma (PDA). This study aimed to compare neoadjuvant FOLFIRINOX and G-nP in the treatment of resectable (R) and borderline resectable (BR) head PDA. METHODS: A single-institution retrospective review of R and BR patients undergoing pancreaticoduodenectomy after NAT with FOLFIRINOX or G-nP was performed. Comparative analysis was performed using inverse-probability-weighted (IPW) estimators...
May 14, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29755782/folfirinox-treatment-leading-to-pathologic-complete-response-of-a-locally-advanced-pancreatic-cancer
#3
Andreas Minh Luu, Torsten Herzog, Philipp Hoehn, Anke Reinacher-Schick, Johanna Munding, Waldemar Uhl, Chris Braumann
Pancreatic cancer (PC) is a lethal disease with a poor prognosis. It is typically asymptomatic and therefore most often diagnosed at an advanced stage. A primary unresectable PC can become resectable in case of tumor regression turning palliative into neoadjuvant therapy. We present a 67-year old female patient who was diagnosed with a locally advanced adenocarcinoma of the pancreatic head. After receiving palliative intended chemotherapy with the FOLFIRINOX regimen, staging computed tomography revealed local resectability of the pancreatic head tumor...
April 2018: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29731985/association-between-homologous-recombination-repair-gene-mutations-and-response-to-oxaliplatin-in-pancreatic-cancer
#4
Tomohiro Kondo, Masashi Kanai, Tadayuki Kou, Tomohiro Sakuma, Hiroaki Mochizuki, Mayumi Kamada, Masahiko Nakatsui, Norimitsu Uza, Yuzo Kodama, Toshihiko Masui, Kyoichi Takaori, Shigemi Matsumoto, Hidehiko Miyake, Yasushi Okuno, Manabu Muto
Objectives: We aimed to examine the association between homologous recombination repair (HRR)-related gene mutations and efficacy of oxaliplatin-based chemotherapy in patients with pancreatic ductal adenocarcinoma (PDAC). Results: Non-synonymous mutations in HRR-related genes were found in 13 patients and only one patient had a family history of pancreatic cancer. Eight patients with HRR-related gene mutations (group A) and nine without HRR-related gene mutations (group B) received oxaliplatin-based chemotherapy...
April 13, 2018: Oncotarget
https://www.readbyqxmd.com/read/29721211/advanced-pancreatic-cancer-a-meta-analysis-of-clinical-trials-over-thirty-years
#5
Bradley R Hall, Andrew Cannon, Pranita Atri, Christopher S Wichman, Lynette M Smith, Apar K Ganti, Chandrakanth Are, Aaron R Sasson, Sushil Kumar, Surinder K Batra
Background: In contrast to other cancers, survival rates for pancreatic ductal adenocarcinoma (PDAC) patients have improved but minimally over the past thirty years. The aim of this study was to perform a meta-analysis of clinical trials published since 1986 to determine trends in median overall survival in primarily metastatic PDAC. Materials and methods: All Phase 2-4 clinical trials published during or after 1986 investigating first-line systemic chemotherapy in metastatic PDAC were included in the meta-analysis...
April 10, 2018: Oncotarget
https://www.readbyqxmd.com/read/29695574/biweekly-gemcitabine-nab-paclitaxel-as-first-line-treatment-for-advanced-pancreatic-cancer
#6
Stefania Kokkali, Elli-Sophia Tripodaki, Maria Drizou, Dimitra Stefanou, Elpida Magou, Dimosthenis Zylis, Matthaios Kapiris, Despoina Nasi, Chara Georganta, Alexandros Ardavanis
BACKGROUND/AIM: During recent years, a survival advantage was reported for first-line treatment of advanced pancreatic cancer with two new regimens, FOLFIRINOX and gemcitabine/nab-paclitaxel, over gemcitabine monotherapy. Gemcitabine/nab-paclitaxel administration on days 1, 8 and 15 of a 4-week cycle is associated with some practical disadvantages. We adopted a biweekly regimen with the same dose density. PATIENTS AND METHODS: Patients with Eastern Cooperative Oncology Group performance status 0-2 diagnosed with advanced histologically or cytologically confirmed pancreatic cancer and no prior treatment were included in the study...
May 2018: In Vivo
https://www.readbyqxmd.com/read/29683973/nationwide-multicenter-observational-study-of-folfirinox-chemotherapy-in-399-patients-with-unresectable-or-recurrent-pancreatic-cancer-in-japan
#7
Akiko Todaka, Nobumasa Mizuno, Masato Ozaka, Hideki Ueno, Satoshi Kobayashi, Kazuhiro Uesugi, Noritoshi Kobayashi, Hideyuki Hayashi, Kentaro Sudo, Naohiro Okano, Yosuke Horita, Keiko Kamei, Seigo Yukisawa, Shoji Nakamori, Yutaka Yachi, Toshiyuki Henmi, Marina Kobayashi, Narikazu Boku, Keita Mori, Akira Fukutomi
OBJECTIVES: FOLFIRINOX (oxaliplatin, irinotecan, 5-fluorouracil, and leucovorin) is the standard therapy worldwide for unresectable pancreatic cancer; however, clinical data for Japanese patients are limited. Therefore, the observational study of FOLFIRINOX for patients with pancreatic cancer was conducted. METHODS: The study included 399 patients with unresectable or recurrent pancreatic cancer, from 27 institutions in Japan, treated with FOLFIRINOX and surveyed until December 2015...
May 2018: Pancreas
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
#8
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/29651946/neoadjuvant-therapy-is-essential-for-resectable-pancreatic-cancer
#9
Jin-Zhi Xu, Wen-Quan Wang, Shi-Rong Zhang, Hua-Xiang Xu, Chun-Tao Wu, Zi-Hao Qi, He-Li Gao, Shuo Li, Quan-Xing Ni, Xian-Jun Yu, Liang Liu
BACKGROUND: Awareness of the benefits of neoadjuvant therapy is increasing, but its use as an initial therapeutic option for patients with resectable pancreatic cancer remains controversial, especially for those patients without high-risk prognostic features. Even for patients with high-risk features who are candidates to receive neoadjuvant therapy, no standard regimen exists. METHODS: In this review, we examined available data on neoadjuvant therapy in patients with resectable pancreatic cancer, including prospective studies, retrospective studies, and ongoing clinical trials, by searching PubMed/MEDLINE, ClinicalTrials...
April 12, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29651809/development-of-chemotherapy-and-significance-of-conversion-surgery-after-chemotherapy-in-unresectable-pancreatic-cancer
#10
REVIEW
Junji Furuse, Junji Shibahara, Masanori Sugiyama
While surgery currently remains the only potentially curative treatment available for pancreatic cancer, only 20% to 30% of patients have resectable disease at diagnosis. Recently, with the introduction of intensive chemotherapy regimens such as oxaliplatin, irinotecan, fluorouracil plus leucovorin (FOLFIRINOX) and gemcitabine plus nab-paclitaxel, for the treatment of unresectable pancreatic cancer, the antitumor activity and overall survival in patients with pancreatic cancer have dramatically improved. These advances in intensive chemotherapy have led to the possibility of conversion of unresectable disease to resectable disease, and it has been reported that more than 20% of pancreatic cancer patients with unresectable locally advanced disease at diagnosis undergo successful conversion surgery after FOLFIRINOX therapy...
May 2018: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29616439/nab-paclitaxel-plus-gemcitabine-versus-folfirinox-as-the-first-line-chemotherapy-for-patients-with-metastatic-pancreatic-cancer-retrospective-analysis
#11
Jihoon Kang, Inhwan Hwang, Changhoon Yoo, Kyu-Pyo Kim, Jae Ho Jeong, Heung-Moon Chang, Sang Soo Lee, Do Hyun Park, Tae Jun Song, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Seung-Mo Hong, Sang Hyun Shin, Dae Wook Hwang, Ki Byung Song, Jae Hoon Lee, Song Cheol Kim, Baek-Yeol Ryoo
Purpose nab-paclitaxel plus gemcitabine (AG) and FOLFIRINOX have been established as standard first-line treatment in metastatic pancreatic cancer (mPC). We performed retrospective analysis comparing the efficacies of AG and FOLFIRINOX in daily practice setting. Materials and Methods We analyzed 308 patients who presented initially as mPC and received AG (n = 149) or FOLFIRINOX (n = 159) as first-line treatment between 2013 and 2016. Primary endpoints were progression-free survival (PFS) and overall survival (OS)...
April 3, 2018: Investigational New Drugs
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/29614063/comparisons-of-efficacy-safety-and-cost-of-chemotherapy-regimens-folfox4-and-folfirinox-in-rectal-cancer-a-randomized-multicenter-study
#13
Fei Qi, Zhaozheng Zheng, Qiang Yan, Jian Liu, Yan Chen, Guiyang Zhang
BACKGROUND The currently available chemotherapeutic regimens do not use a specifically designed drug delivery system. The objective of this study was to compare outcome measures, adverse effects, and cost of FOLFOX4 and FOLFIRINOX treatments in rectal cancer patients. MATERIAL AND METHODS We enrolled patients who, after surgery, did not undergo chemotherapy or radiotherapy (Control group); were administered 200 mg/m² folinic acid, 400 mg/m² fluorouracil, and 85 mg/m² oxaliplatin (FFO group); or were administered 400 mg/m² folinic acid, 400 mg/m² fluorouracil, 180 mg/m² irinotecan, and 85 mg/m2 oxaliplatin (FFIO group)...
April 3, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29603014/impact-of-formulation-on-the-iontophoretic-delivery-of-the-folfirinox-regimen-for-the-treatment-of-pancreatic-cancer
#14
James D Byrne, Mohammad R N Jajja, Adrian T O'Neill, Allison N Schorzman, Amanda W Keeler, J Christopher Luft, William C Zamboni, Joseph M DeSimone, Jen Jen Yeh
PURPOSE: Effective treatment of patients with locally advanced pancreatic cancer is a significant unmet clinical need. One major hurdle that exists is inadequate drug delivery due to the desmoplastic stroma and poor vascularization that is characteristic of pancreatic cancer. The local iontophoretic delivery of chemotherapies provides a novel way of improving treatment. With the growing practice of highly toxic combination therapies in the treatment of pancreatic cancer, the use of iontophoresis for local delivery can potentiate the anti-cancer effects of these therapies while sparing unwanted toxicity...
March 30, 2018: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/29600384/paclitaxel-as-albumin-bound-nanoparticles-with-gemcitabine-for-untreated-metastatic-pancreatic-cancer-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#15
REVIEW
Angela Stainthorpe, Janette Greenhalgh, Adrian Bagust, Marty Richardson, Angela Boland, Sophie Beale, Rui Duarte, Eleanor Kotas, Lindsay Banks, Daniel Palmer
As part of the single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited Celgene Ltd to submit clinical and cost-effectiveness evidence for paclitaxel as albumin-bound nanoparticles (Nab-Pac) in combination with gemcitabine (Nab-Pac + Gem) for patients with untreated metastatic pancreatic cancer. The STA was a review of NICE's 2015 guidance (TA360) in which Nab-Pac + Gem was not recommended for patients with untreated metastatic pancreatic cancer...
March 29, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29596120/survival-in-locally-advanced-pancreatic-cancer-after-neoadjuvant-therapy-and-surgical-resection
#16
Georgios Gemenetzis, Vincent P Groot, Alex B Blair, Daniel A Laheru, Lei Zheng, Amol K Narang, Elliot K Fishman, Ralph H Hruban, Jun Yu, Richard A Burkhart, John L Cameron, Matthew J Weiss, Christopher L Wolfgang, Jin He
OBJECTIVE: The aim of the study was to identify the survival of patients with locally advanced pancreatic cancer (LAPC) and assess the effect of surgical resection after neoadjuvant therapy on patient outcomes. BACKGROUND: An increasing number of LAPC patients who respond favorably to neoadjuvant therapy undergo surgical resection. The impact of surgery on patient survival is largely unknown. MATERIALS AND METHODS: All LAPC patients who presented to the institutional pancreatic multidisciplinary clinic (PMDC) from January 2013 to September 2017 were included in the study...
March 28, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29562843/irinotecan-associated-dysarthria-a-single-institution-case-series-with-management-implications-in-patients-with-gastrointestinal-malignancies
#17
David B Zhen, Rachel L McDevitt, Mark M Zalupski, Vaibhav Sahai
Irinotecan (Camptosar© , CPT-11), a topoisomerase I inhibitor, is a commonly used cytotoxic chemotherapeutic in the treatment of multiple malignancies, particularly of gastrointestinal origin. Dysarthria secondary to irinotecan has been described as a rare side effect in a few case reports with limited data to recommend appropriate management. We describe herein a large single institution experience of patients with gastrointestinal malignancies who experienced dysarthria while being treated with irinotecan-based chemotherapy regimens (FOLFIRINOX or FOLFIRI+/-bevacizumab)...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29560127/neoadjuvant-photodynamic-therapy-augments-immediate-and-prolonged-oxaliplatin-efficacy-in-metastatic-pancreatic-cancer-organoids
#18
Mans Broekgaarden, Imran Rizvi, Anne-Laure Bulin, Ljubica Petrovic, Ruth Goldschmidt, Iqbal Massodi, Jonathan P Celli, Tayyaba Hasan
Effective treatment of advanced metastatic disease remains the primary challenge in the management of inoperable pancreatic cancer. Current therapies such as oxaliplatin (OxPt)-based chemotherapy regimens (FOLFIRINOX) provide modest short-term survival improvements, yet with significant toxicity. Photodynamic therapy (PDT), a light-activated cancer therapy, demonstrated clinical promise for pancreatic cancer treatment and enhances conventional chemotherapies with non-overlapping toxicities. This study investigates the capacity of neoadjuvant PDT using a clinically-approved photosensitizer, benzoporphyrin derivative (BPD, verteporfin), to enhance OxPt efficacy in metastatic pancreatic cancer...
February 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29557103/chemotherapy-and-radiotherapy-for-advanced-pancreatic-cancer
#19
REVIEW
Venessa Chin, Adnan Nagrial, Katrin Sjoquist, Chelsie A O'Connor, Lorraine Chantrill, Andrew V Biankin, Rob Jpm Scholten, Desmond Yip
BACKGROUND: Pancreatic cancer (PC) is a highly lethal disease with few effective treatment options. Over the past few decades, many anti-cancer therapies have been tested in the locally advanced and metastatic setting, with mixed results. This review attempts to synthesise all the randomised data available to help better inform patient and clinician decision-making when dealing with this difficult disease. OBJECTIVES: To assess the effect of chemotherapy, radiotherapy or both for first-line treatment of advanced pancreatic cancer...
March 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29556385/phase-i-study-of-third-line-palliative-chemotherapy-with-low-dose-paclitaxel-for-pancreatic-cancer
#20
Hidehiro Tajima, Mitsuyoshi Okazaki, Takahisa Yamaguchi, Yoshinao Ohbatake, Koichi Okamoto, Shinichi Nakanuma, Shiro Terai, Seisho Sakai, Jun Kinoshita, Isamu Makino, Keishi Nakamura, Hironori Hayashi, Katsunobu Oyama, Masafumi Inokuchi, Tomoharu Miyashita, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, Tetsuo Ohta
The prognosis of patients with unresectable or recurrent pancreatic cancers is very poor. Prior to development of nab-paclitaxel (PTX) plus gemcitabine (GEM) therapy and FOLFIRINOX therapy, there was no recommended third-line chemotherapy after 5-fluorouracil (5-FU) and GEM-based regimens. The present study conducted a Phase I clinical trial of weekly low-dose PTX as a third-line palliative chemotherapy for patients with pancreatic cancer. PTX was administered on days 1, 8, 15, and 22 of each cycle, repeated twice as follows: Level 1, 40 mg/m2 (n=6); Level 2, 50 mg/m2 (n=4)...
April 2018: Molecular and Clinical Oncology
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