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https://www.readbyqxmd.com/read/29162142/-heatpac-a-phase-ii-randomized-study-of-concurrent-thermochemoradiotherapy-versus-chemoradiotherapy-alone-in-locally-advanced-pancreatic-cancer
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/29069039/neoadjuvant-modified-folfirinox-followed-by-surgical-resection-of-both-the-primary-and-metastatic-tumors-of-a-pancreatic-hepatoid-carcinoma-with-synchronous-liver-metastasis-a-case-report
#7
Tao Ma, Xueli Bai, Guogang Li, Shumei Wei, Tingbo Liang
RATIONALE: Pancreatic hepatoid carcinoma (PHC) is a rare form of pancreatic malignancy mimicking hepatocellular carcinoma (HCC) in morphology, immunohistochemistry, and behavior. PHC usually has an aggressive clinical course and poor prognosis. Effective treatment strategies are lacking due to poor understanding and extreme rarity of such kind of malignancy. PATIENT CONCERNS:: we present the case of a 75-year-old man with tumors in the liver and the tail of pancreas that were detected in a routine health check-up...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29052123/successful-chemotherapy-with-modified-folfirinox-for-pancreatic-acinar-cell-carcinoma
#8
Minami Hashimoto, Takuto Hikichi, Tomohiro Suzuki, Mayumi Tai, Osamu Ichii, Nobuo Matsuhashi, Eisaku Kita, Shintaro Takahashi, Yoshinori Okubo, Hando Hakozaki, Yutaka Ejiri, Hiromasa Ohira
Abdominal ultrasonography revealed a pancreatic mass in a 67-year-old man with diabetes mellitus. Endoscopic ultrasound-guided fine needle aspiration led to the histological diagnosis of acinar cell carcinoma. The clinical stage was determined to be IVb based on findings of multiple metastatic lesions in the liver and lymph nodes, as well as splenic vein infiltration. Because the patient was not a surgical candidate, he underwent chemotherapy with modified FOLFIRINOX. In the absence of any severe adverse events, 12 courses of chemotherapy were delivered, resulting in marked shrinkage of both the primary and metastatic lesions...
October 19, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29033758/resection-of-locally-advanced-pancreatic-neoplasms-after-neoadjuvant-chemotherapy-with-nab-paclitaxel-and-gemcitabine-following-folfirinox-failure
#9
Sarah Hahn, Ahmet Ayav, Anthony Lopez
The incidence of pancreatic cancer has dramatically increased over the past years, but the prognosis has not improved. Between 30 and 40% of tumors are considered locally advanced, essentially due to vascular involvement. In recent years, new chemotherapy protocols with high response rates have been developed. FOLFIRINOX seems to be an interesting option in this situation, but hematologic toxicity could be an obstacle to its prescription. Nab-paclitaxel and gemcitabine offer significant response rates with a reasonable safety profile...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28989542/cross-over-comparison-and-new-chemotherapy-regimens-in-metastatic-pancreatic-cancer
#10
REVIEW
Markus Kieler, Matthias Unseld, Daniela Bianconi, Gerald W Prager
Despite decades of research, pancreatic ductal adenocarcinoma (PDAC) is still one of the most lethal malignant diseases with a devastating 5‑year overall survival of only 4-5%. Indeed, long-term survival was not affected by the introduction of new systemic cytotoxic chemotherapies which remain the key cornerstone in the treatment of metastatic PDAC. In the first-line setting, FOLFIRINOX based upon the results of the PRODIGE/ACCORD trial and gemcitabine with albumin-bound paclitaxel (GNP) based upon the MPACT trial have both been approved as therapeutic options for patients with no significant comorbidities and good performance status...
2017: Memo
https://www.readbyqxmd.com/read/28982109/retrospective-analysis-of-ca19-9-decrease-in-patients-with-metastatic-pancreatic-carcinoma-treated-with-folfirinox-or-gemcitabine-in-a-randomized-phase-iii-study-accord11-prodige4
#11
Marie Robert, Marta Jarlier, Sophie Gourgou, Françoise Desseigne, Marc Ychou, Olivier Bouché, Beata Juzyna, Thierry Conroy, Jaafar Bennouna
OBJECTIVES: Carbohydrate antigen 19-9 (CA19-9) is a sensitive and specific serum marker in pancreatic cancer. Our retrospective analysis aims to evaluate CA19-9 decrease in patients with metastatic pancreatic cancer treated in ACCORD11/PRODIGE4 (FOLFIRINOX vs. gemcitabine). METHODS: A total of 342 patients were treated. CA19-9 was measured at 8 weeks (±2) in 160 patients from a total of 282 with abnormal CA19-9 values at baseline (gemcitabine arm, n = 75; FOLFIRINOX arm, n = 85)...
October 6, 2017: Oncology
https://www.readbyqxmd.com/read/28968257/clinical-characteristics-of-patients-experiencing-pathologic-complete-response-following-neoadjuvant-therapy-for-borderline-resectable-locally-advanced-pancreatic-adenocarcinoma
#12
Neda Hashemi-Sadraei, Olumide B Gbolahan, Hai Salfity, Bert O'Neil, Michael G House, Safi Shahda
OBJECTIVES: The purpose of this study is to describe clinical characteristics and outcomes of patients with borderline resectable pancreatic cancer (BRPC) or locally advanced pancreatic cancer (LAPC) who achieved pathologic complete response (pCR) following neoadjuvant therapy. MATERIALS AND METHODS: A single institution clinical database for patients with pancreatic ductal adenocarcinoma was queried. Between 2008 and 2014 patients were identified with BRPC and LAPC, who underwent surgical resection after receiving neoadjuvant treatment...
September 29, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28931010/response-to-folfirinox-by-gender-in-patients-with-metastatic-pancreatic-cancer-results-from-the-prodige-4-accord-11-randomized-trial
#13
RANDOMIZED CONTROLLED TRIAL
Aurélien Lambert, Marta Jarlier, Sophie Gourgou Bourgade, Thierry Conroy
BACKGROUND: Hohla et al. suggested that female gender could positively predict response to FOLFIRINOX in patients with advanced pancreatic cancer. In this study, we explored the response to the FOLFIRINOX regimen by gender within the trial PRODIGE4/ACCORD 11. PATIENTS AND METHODS: Data were described by gender, both in FOLFIRINOX group and in the intention-to-treat population of the trial. The relative effect of gender (females in comparison to males) on overall survival (OS) and progression-free survival was estimated by using a Cox proportional hazard model and was presented with the Hazard Ratio and their 95% confidence interval...
2017: PloS One
https://www.readbyqxmd.com/read/28926090/efficacy-of-different-chemotherapy-regimens-in-treatment-of-advanced-or-metastatic-pancreatic-cancer-a-network-meta-analysis
#14
Shu-Hua Zhang, Gui-Feng Liu, Xue-Feng Li, Lin Liu, Shao-Nan Yu
We performed a network meta-analysis (NMA) to compare the short- and long-term efficacy of Gemcitabine, Gemcitabine + S-1 (tegafur), Gemcitabine + nab-paclitaxel, Gemcitabine + Capecitabine, Gemcitabine + Cisplatin, FOLFIRINOX (oxaliplatin + irinotecan + fluorouracil + leucovorin), Gemcitabine + oxaliplatin, Gemcitabine + irinotecan, Gemcitabine + Exatecan, Gemcitabine + pemetrexed, Gemcitabine + 5-FU and S-1 in treating advanced or metastatic pancreatic cancer (PC)...
September 19, 2017: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/28895032/resection-of-locally-advanced-pancreatic-cancer-without-regression-of-arterial-encasement-after-modern-era-neoadjuvant-therapy
#15
Michael D Kluger, M Farzan Rashid, Vilma L Rosario, Beth A Schrope, Jonathan A Steinman, Elizabeth M Hecht, John A Chabot
INTRODUCTION: Modern-era systemic therapy for locally advanced pancreatic adenocarcinoma (LAPC) offers improved survival relative to historical regimens but not necessarily improved radiographic downstaging to allow more patients to undergo resection. The aim of this study was to evaluate the survival, progression, and pathologic outcomes after resection of LAPC that did not regress from > 180 degrees arterial encasement after neoadjuvant therapy. METHODS: Sixty-one LAPC patients were brought to the operating room after neoadjuvant therapy for NCCN-defined unresectable pancreatic cancer between 2012 and 2017...
September 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28890819/the-role-of-induction-chemotherapy-chemoradiotherapy-in-localised-pancreatic-cancer-initial-experience-in-scotland
#16
Derek Grose, David McIntosh, Nigel Jamieson, Ross Carter, Euan Dickson, David Chang, Husam Marashi, Christina Wilson, Mohammed Alfayez, Ashleigh Kerr, Roisin O'Donoghue, Lea Haskins, Fraser Duthie, Colin J McKay, Janet Graham
BACKGROUND: Despite being relatively rare pancreatic cancer is one of the highest causes of death. Even within the potentially resectable group outcomes are poor. We present our initial experiences utilising a neoadjuvant approach to localised pancreatic cancer, evaluating survival, response rates and tolerability. METHODS: This was a retrospective analysis of a prospectively maintained database. Patients from 2012 to 2015 referred to a busy regional Hepato-Pancreatic Biliary (HPB) MDT were included...
August 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28888554/how-to-treat-pancreatic-adenocarcinoma-in-elderly-how-far-can-we-go-in-2017
#17
REVIEW
Marine Gilabert, Jean Luc Raoul, Frederique Rousseau
Pancreatic adenocarcinoma is one of the most fatal cancers that frequently affects older patients. Limited data suggest that older patients are as likely to benefit from surgery, radiation, and chemotherapy as younger patients. The only potentially curative approach for pancreatic cancer is surgery but this is only performed in less than 20% of patients considered resectable. With improvements in surgical techniques, older patients without major comorbidities show a course of disease after resection similar to that of younger patients...
November 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28884286/combination-of-irinotecan-oxaliplatin-and-5-fluorouracil-as-a-rechallenge-regimen-for-heavily-pretreated-metastatic-colorectal-cancer-patients
#18
Gustavo Dos Santos Fernandes, Maria Ignez Braghiroli, Michelle Artioli, Ana Carolina Carvalho Rocha Paterlini, Marcela Crosara Teixeira, Brenda Pires Gumz, Daniel da Motta Girardi, Oddone F M Braghiroli, Frederico Perego Costa, Paulo M Hoff
PURPOSE: Our objective was to evaluate the benefit of re-exposing patients with refractory metastatic colorectal cancer (mCRC) to a combination of oxaliplatin, irinotecan and 5-fluorouracil treatment. METHODS: We retrospectively analysed patients with mCRC who received a combination of oxaliplatin, irinotecan and fluorouracil as a rechallenge regimen after progressing on the same drugs. Both FOLFOXIRI and FOLFIRINOX were used. Toxicity was evaluated for each treatment cycle, and survival analysis was performed using the Kaplan-Meier method...
September 8, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28869888/pancreatic-ductal-adenocarcinoma-state-of-the-art-2017-and-new-therapeutic-strategies
#19
REVIEW
Marta Chiaravalli, Michele Reni, Eileen M O'Reilly
Pancreatic ductal adenocarcinoma (PDAC) is a fatal malignancy with an overall 5-year survival of 8% for all stages combined. The majority of patients present with stage IV disease at diagnosis and these patients have an overall 5-year survival of 3%. Currently, the standard of care for metastatic pancreas adenocarcinoma is combination cytotoxic therapy, namely FOLFIRINOX or gemcitabine plus nab-paclitaxel for good performance status patients. Given the challenges and the rising incidence of PDAC expected to become the second leading cause of cancer-related death by 2030, there is a major unmet need to develop more effective therapies...
November 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28868015/chronic-oxaliplatin-based-chemotherapy-in-a-primary-ampullary-adenocarcinoma-patient-without-significant-peripheral-neuropathy-case-report-and-literature-review
#20
Nedal Bukhari, Eric Winquist
Peripheral neuropathy is the most common dose-limiting toxicity associated with oxaliplatin. We report on a 61-year-old female patient with advanced primary ampullary adenocarcinoma who received 35 cycles of FOLFIRINOX (5-fluorouracil, irinotecan, and oxaliplatin) chemotherapy. The patient has tolerated this treatment without developing significant peripheral neuropathy.
May 2017: Case Reports in Oncology
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