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https://www.readbyqxmd.com/read/28422841/evaluation-of-gemcitabine-efficacy-after-the-folfirinox-regimen-in-patients-with-advanced-pancreatic-adenocarcinoma
#1
Marine Gilabert, Brice Chanez, Young Soo Rho, Marc Giovanini, Olivier Turrini, Gerald Batist, Petr Kavan, Jean Luc Raoul
To evaluate gemcitabine efficacy in advanced pancreatic cancer patients after the FOLFIRINOX regimen.Patients with locally-advanced or metastatic pancreatic adenocarcinoma from French and Canadian centers, who were treated with the first-line FOLFIRINOX regimen (FFX L1), followed by gemcitabine monotherapy as a second-line treatment (GEM L2), were retrospectively evaluated. Statistical analyses were performed on the demographic, toxicity, and response rate data. Overall survival (OS) and progression-free survival (PFS) were assessed using the Kaplan-Meier method...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421382/relationship-between-the-expression-of-o-6-methylguanine-dna-methyltransferase-mgmt-and-p53-and-the-clinical-response-in-metastatic-pancreatic-adenocarcinoma-treated-with-folfirinox
#2
Carole Vitellius, Caroline Eymerit-Morin, Dominique Luet, Lionel Fizanne, Fanny Foubert, Sandrine Bertrais, Marie-Christine Rousselet, François-Xavier Caroli-Bosc
BACKGROUND: To date, no predictive biomarker for the efficacy of FOLFIRINOX in metastatic pancreatic adenocarcinoma has been demonstrated. Deficiency in O(6)-methylguanine-DNA methyltransferase (MGMT) has been associated with a therapeutic response in endocrine tumors of the pancreas and the lack of expression of protein 53 (p53) could interfere with the action of MGMT. OBJECTIVE: The aim of our study was to assess the prevalence of MGMT and p53 in patients with metastatic pancreatic adenocarcinoma treated with FOLFIRINOX as a first-line treatment and to investigate their association with therapeutic response and survival...
April 18, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28408000/cost-effectiveness-analysis-of-systemic-therapies-in-advanced-pancreatic-cancer-in-the-canadian-health-care-system
#3
Doug Coyle, Yoo-Joung Ko, Kathryn Coyle, Ronak Saluja, Keya Shah, Kelly Lien, Henry Lam, Kelvin K W Chan
OBJECTIVES: To assess the cost-effectiveness of gemcitabine (G), G + 5-fluorouracil, G + capecitabine, G + cisplatin, G + oxaliplatin, G + erlotinib, G + nab-paclitaxel (GnP), and FOLFIRINOX in the treatment of advanced pancreatic cancer from a Canadian public health payer's perspective, using data from a recently published Bayesian network meta-analysis. METHODS: Analysis was conducted through a three-state Markov model and used data on the progression of disease with treatment from the gemcitabine arms of randomized controlled trials combined with estimates from the network meta-analysis for the newer regimens...
April 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28373919/complete-response-after-treatment-with-neoadjuvant-chemoradiation-with-prolonged-chemotherapy-for-locally-advanced-unresectable-adenocarcinoma-of-the-pancreas
#4
Tiffany A Pompa, William F Morano, Chetan Jeurkar, Hui Li, Suganthi Soundararajan, Jaganmohan Poli, Wilbur B Bowne, Michael Styler
Surgery is the only chance for cure in pancreatic ductal adenocarcinoma. In unresectable, locally advanced pancreatic cancer (LAPC), the National Comprehensive Cancer Network (NCCN) suggests chemotherapy and consideration for radiation in cases of unresectable LAPC. Here we present a rare case of unresectable LAPC with a complete histopathological response after chemoradiation followed by surgical resection. A 54-year-old female presented to our clinic in December 2013 with complaints of abdominal pain and 30-pound weight loss...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28344661/liposomal-irinotecan-in-gemcitabine-refractory-metastatic-pancreatic-cancer-efficacy-safety-and-place-in-therapy
#5
REVIEW
Emma Kipps, Kate Young, Naureen Starling
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. The majority of patients are diagnosed with locally advanced or metastatic disease with a prognosis of short months. Therapeutic options are limited and until recently, there was no standard second-line chemotherapy option. Liposomal constructs have been engineered to encapsulate chemotherapy thereby preventing premature metabolism, improving distribution and minimizing toxicity. Favourable preclinical data on liposomal irinotecan and early phase trials, led to a recently published phase III trial of liposomal irinotecan in combination with fluorouracil and folinic acid in patients with metastatic PDAC, who progressed after gemcitabine-based chemotherapy...
March 2017: Therapeutic Advances in Medical Oncology
https://www.readbyqxmd.com/read/28342938/the-impact-of-neoadjuvant-therapy-on-the-histopathological-features-of-pancreatic-ductal-adenocarcinoma-a-systematic-review-and-meta-analysis
#6
REVIEW
Stephan Schorn, Ihsan Ekin Demir, Carmen Mota Reyes, Cemil Saricaoglu, Nicole Samm, Rebekka Schirren, Elke Tieftrunk, Daniel Hartmann, Helmut Friess, Güralp Onur Ceyhan
BACKGROUND: Due to increased rates of curative tumor resections exceeding 60% after FOLFIRINOX-treatment, neoadjuvant therapy/NTx is increasingly recognized as an effective therapy option for downstaging borderline or locally advanced pancreatic ductal adenocarcinoma/PDAC. Yet, the effects of NTx on the common histopathological features of PDAC have not been systematically analysed. Therefore, the aim of the current study was to assess the impact of NTx on relevant histopathological features of PDAC...
March 14, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28324747/optimal-dose-reduction-of-folfirinox-for-preserving-tumour-response-in-advanced-pancreatic-cancer-using-cumulative-relative-dose-intensity
#7
Jong-Chan Lee, Jin Won Kim, Soyeon Ahn, Hyoung Woo Kim, Jongchan Lee, Young Hoon Kim, Kyu-Hyun Paik, Jaihwan Kim, Jin-Hyeok Hwang
BACKGROUND: FOLFIRINOX has increased efficacy but also toxicity. Despite various modified FOLFIRINOX regimens, how much reduction is acceptable remains unclear. This study aimed to find the optimal relative dose intensity (RDI, %) of FOLFIRINOX that preserves tumour responses in patients with advanced pancreatic cancer (PC). METHODS: We reviewed 201 patients with PC treated with first-line FOLFIRINOX during 2012-2015. We established a modified Hryniuk model (http://www...
March 16, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28304150/additional-chemotherapy-and-salvage-surgery-for-poor-response-to-chemoradiotherapy-in-rectal-cancers
#8
Reena Engineer, Vikas Ostwal, Supreeta Arya, Priyamvada Gupta, Supriya Chopra, Prachi Patil, Sudhir Jatal, Avanish Saklani
AIM: A proportion of locally advanced rectal cancer patients who receive neoadjuvant chemoradiotherapy (NACRT) are still unresectable. This study was undertaken to assess the outcomes of giving additional chemotherapy to rectal cancer patients with unresectable disease after NACRT. METHODS: Patients with poor response to NACRT where mesorectal fascia was still involved on MRI and R0 resection was doubtful, received additional four cycles of chemotherapy with either CAPOX or FOLFIRINOX regimen, and the response was reevaluated with MRI and reassessed for surgical resection...
March 17, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28303435/systemic-combination-chemotherapy-in-elderly-pancreatic-cancer-a-review
#9
REVIEW
Gwenalyn Garcia, Marcel Odaimi
PURPOSE: In recent years, significant progress in survival has been achieved using systemic combination chemotherapy in patients with pancreatic cancer. However, the elderly are largely underrepresented in clinical trials, and gains made from these may not necessarily apply to this important subgroup of patients. We review the currently available data regarding contemporary combination chemotherapy regimens, including FOLFIRINOX, gemcitabine plus nab-paclitaxel, nanoliposomal irinotecan plus 5-fluorouracil and leucovorin, and gemcitabine plus capecitabine, in elderly pancreatic cancer patients...
March 16, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28299752/therapeutic-implications-of-molecular-subtyping-for-pancreatic-cancer
#10
REVIEW
Michael J Pishvaian, Jonathan R Brody
The prognosis of metastatic pancreatic adenocarcinoma has recently begun to improve. In the last several years, first-line therapy with gemcitabine plus nab-paclitaxel or a regimen of fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) has boosted the median overall survival (OS) duration to 8.5 months and 11 months, respectively, in patients with metastatic pancreatic cancer, compared with a historic OS of only 6 months prior to 2011. Moreover, sequencing these two regimens improved median OS to an unprecedented 18 months...
March 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28291165/preoperative-treatment-with-folfirinox-and-successful-resection-for-a-patient-with-mixed-acinar-endocrine-carcinoma-of-the-pancreas
#11
Motokazu Sugimoto, O Joe Hines, David W Dawson, V Raman Muthusamy, Howard A Reber, Timothy R Donahue
No abstract text is available yet for this article.
April 2017: Pancreas
https://www.readbyqxmd.com/read/28286977/comparison-of-treatment-patterns-resource-utilization-and-cost-of-care-in-patients-with-metastatic-pancreatic-cancer-treated-with-first-line-nab-paclitaxel-plus-gemcitabine-or-folfirinox
#12
George P Kim, Monika F Parisi, Manish B Patel, Corey L Pelletier, Kathy W Belk
BACKGROUND: We compared real-world treatment patterns, resource utilization, and cost of care for patients with metastatic pancreatic cancer treated with first-line nab-paclitaxel + gemcitabine or FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, oxaliplatin). METHODS: This was a retrospective study of inpatient and hospital-based outpatient data in the United States. Primary endpoints included median time to treatment discontinuation (TTD) and total cost of care per patient per month...
May 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28256401/gemcitabine-as-second-line-chemotherapy-after-folfirinox-failure-in-advanced-pancreatic-adenocarcinoma-a-retrospective-study
#13
Juliette Viaud, Clémence Brac, Pascal Artru, Estelle Le Pabic, Bérengère Leconte, Anaïs Bodère, Marc Pracht, Samuel Le Sourd, Julien Edeline, Astrid Lièvre
BACKGROUND: Pancreatic adenocarcinoma (PA) is diagnosed in most cases at an advanced stage requiring chemotherapy. Folfirinox is the standard first-line treatment. After Folfirinox failure, gemcitabine alone is routinely used as second-line therapy without data supporting this attitude. AIM: Determine the response rate and outcome of patients with advanced PA treated with gemcitabine after Folfirinox failure. METHODS: We retrospectively analyzed all consecutive patients treated with gemcitabine after Folfirinox failure for a locally advanced or metastatic PA between 2009 and 2015...
February 14, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28144084/should-every-patient-with-pancreatic-cancer-receive-perioperative-neoadjuvant-therapy
#14
REVIEW
Ulrich Nitsche, Bo Kong, Alexander Balmert, Helmut Friess, Jörg Kleeff
Pancreatic ductal adenocarcinoma is a highly aggressive disease, and medical as well as surgical therapeutic options are limited. This article reviews stage dependent treatment options, with a special focus on the current controversy of perioperative treatment regimens in initially borderline resectable or locally advanced patients. Neoadjuvant treatment can potentially increase the rate of complete tumor resection and may be more effective than adjuvant systemic therapy. Further, in the case of disease progression during or after neoadjuvant therapy, patients can be spared extensive surgery...
October 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28139684/feasibility-of-alternating-induction-and-maintenance-chemotherapy-in-pancreatic-cancer
#15
Alexander Hann, Wolfram Bohle, Jan Egger, Wolfram Zoller
Chemotherapy regimens for pancreatic ductal adenocarcinoma (PDAC) have changed since the introduction of FOLFIRINOX. Due to toxicity, dosage and number of applied cycles are limited. In analogy to chemotherapy strategies in colon cancer we used a scheme of induction, maintenance and re-induction therapy in PDAC to alleviate such toxicities and increase the number of applied cycles. Here we report first experiences with this approach. Data of all patients who received FOLFIRINOX for metastatic or locally advanced PDAC in our center using induction chemotherapy followed by maintenance therapy from 2011 until November 2016 was collected and analyzed retrospectively...
January 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28133357/-a-case-of-unresectable-advanced-rectal-cancer-with-a-pancreatic-tumor-that-was-successfully-treated-with-folfirinox
#16
Nobushige Yabe, Shinji Murai, Hiroki Ozawa, Takahiro Yokose, Ippei Oto, Takahisa Yoshikawa, Kenjiro Kitasato, Hirotomo Shimizu, Kenji Kojima, Hirotoshi Hasegawa, Yuko Kitagawa
A 72-year-old man was admitted to our hospital department in September 2014 because of a positive fecal occult blood test.Colonoscopy showed a type 2 tumor in half of the AV 15 cm rectosigmoid colon.Histology of the biopsy indicated a moderately differentiated adenocarcinoma, and the RAS gene test found wild type.On CT examination, there were multiple liver lung metastases and a 30mm diameter tumor with pancreatic duct extension to the pancreatic body.A PET-CT examination had a high SUVmax at the same site...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133194/-pancreatic-cancer-with-liver-metastasis-treated-with-radical-surgery-after-chemotherapy
#17
Yoshiteru Katsura, Yutaka Takeda, Yoshiaki Ohmura, Takuya Sakamoto, Junichi Inatome, Atsushi Naito, Kohei Murakami, Yoshinori Kagawa, Atsushi Takeno, Chiyomi Egawa, Takeshi Kato, Shigeyuki Tamura
Pancreatic ductal carcinoma is a highly aggressive cancer, and chemotherapy is the standard therapy for pancreatic adenocarcinoma. We report curative resection for a case of pancreatic cancer with liver metastasis after chemotherapy. A 67-yearold woman presented with vomiting and weight loss, and was admitted to our hospital for an evaluation of pancreatic lesions. Computed tomography revealed a hypoattenuating tumor in the head of the pancreas. We would usually perform pancreatoduodenectomy based on a diagnosis of cStage III ...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133096/-primary-prophylactic-administration-of-pegfilgrastim-in-folfirinox-therapy-for-locally-advanced-pancreatic-carcinoma
#18
Riki Ninomiya, Akiko Nakazawa, Youichi Miyata, Tetsuya Mitsui, Masahiko Komagome, Akira Maki, Fumiaki Ozawa, Yoshifumi Beck
FOLFIRINOX therapy has a high response rate for pancreatic carcinoma, but has serious adverse effects. FOLFIRINOX therapy was administered to 11 patients with locally advanced pancreatic carcinoma at our hospital. We investigated the usefulness of primary prophylactic administration of pegfilgrastim(PegG). In the group receiving PegG, as well as with onset of neutropenia and thrombocytopenia, febrile neutropenia was reduced. Rates of anorexia and fatigue were also lower than in those who did not receive PegG...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133089/-strategy-for-unresectable-pancreatic-cancer-with-stenosis-of-the-duodenum-a-case-report
#19
Masahiko Komagome, Riki Ninomiya, Akiko Nakazawa, Tetsuya Mitsui, Akira Maki, Fumiaki Ozawa, Yoshifumi Beck
Unresectable(UR)pancreatic cancer often causes duodenal obstruction. Case 1: A 58-year-old man was diagnosed with UR pancreatic cancer with obstruction of the 3rd duodenal portion. A duodenum 2nd portion jejunum bypass was performed, and FOLFIRINOX was introduced and continued over 6 months. Case 2: A 74-year-old man was diagnosed with UR pancreatic cancer with obstruction of the duodenum near the Treitz ligament. A duodenum 3rd portion jejunum bypass was performed, and gemcitabine plus nab-paclitaxel was introduced...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28125374/the-value-of-survival-gains-in-pancreatic-cancer-from-novel-treatment-regimens
#20
Joanna P MacEwan, Wes Yin, Satyin Kaura, Zeba M Khan
BACKGROUND: Metastatic pancreatic cancer (mPC) is associated with low survival, with less than 10% of patients surviving 5 years. Recent therapies improve survival outcomes where few alternative therapies exist, but few economic analyses measure the value of survival gains attributable to new therapies. OBJECTIVE: To estimate the value of survival gains in advanced or mPC attributable to the introduction of novel treatment regimens. METHODS: Multivariate Cox proportional hazards models were used to estimate real-world survival gains associated with the introduction of gemcitabine (GEM) for patients diagnosed with stage IV or unstaged mPC in the Surveillance, Epidemiology, and End Results Program cancer registries...
February 2017: Journal of Managed Care & Specialty Pharmacy
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