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https://www.readbyqxmd.com/read/28144084/should-every-patient-with-pancreatic-cancer-receive-perioperative-neoadjuvant-therapy
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28106283/therapeutic-potential-of-curcumin-in-treatment-of-pancreatic-cancer-current-status-and-future-perspectives
#8
Mina Hosseini, Seyed Mahdi Hassanian, Elham Mohamamdazade, Soodabeh ShahidSales, Mina Maftouh, Hasan Fayazbakhsh, Majid Khazaei, Amir Avan
Pancreatic cancer is among the leading cause of deaths due to cancer with extremely poor prognosis. Gemcitabine is being used in the treatment of patient with pancreatic ductal adenocarcinoma (PDAC), although, the response rate is bellow 12%. A recent phase III trial revealed that FOLFIRINOX could be an option for the treatment of metastatic PDAC patients, although it is associated with increased toxicity. Therefore, identification of novel agents that either improves gemcitabine activity, within novel combinatorial approaches, or with a better efficacy than gemcitabine is warranted...
January 20, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28078119/surgical-outcomes-of-post-chemoradiotherapy-unresectable-locally-advanced-rectal-cancers-improve-with-interim-chemotherapy-is-folfirinox-better-than-capox
#9
Vikas Ostwal, Reena Engineer, Anant Ramaswamy, Arvind Sahu, Saurabh Zanwar, Suprita Arya, Supriya Chopra, Munita Bal, Prachi Patil, Ashwin Desouza, Avanish Saklani
BACKGROUND: Role of chemotherapy in patients who continue to have unresectable disease after pre-operative chemo-radiotherapy (CRT) remains largely unaddressed. METHODS: Patients with LA rectal cancer from January 2013 to June 2015 were evaluated. Post-CRT, patients, who were deemed unresectable, were considered for further interim chemotherapy (i-CT). RESULTS: Seventy six patients (15%) with median age of 38.5 years received i-CT after CRT...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28062950/efficacy-and-safety-of-folfirinox-in-locally-advanced-pancreatic-cancer-a-single-center-experience
#10
G Lakatos, A Petranyi, A Szűcs, L Nehéz, L Harsanyi, P Hegyi, G Bodoky
The management of locally advanced pancreatic cancer (LAPC) is a major challenge. Although new drugs are available for the treatment of metastatic disease, the optimal treatment of non-metastatic cases remains controversial. The role of neoadjuvant therapy is still a question of debate in this setting. The aim of the study was to prospectively collect and analyse data on efficacy and safety of a modified FOLFIRINOX regimen in LAPC patients treated in a single institution. Another major objective was to assess the capability of FOLFIRINOX to render primary non-resectable cancer to resectable...
January 6, 2017: Pathology Oncology Research: POR
https://www.readbyqxmd.com/read/28056259/-progress-in-neoadjuvant-and-transformation-therapy-of-pancreatic-cancer
#11
D D Hu, M H Dai
Pancreatic adenocarcinoma is a malignant disease with considerable metastatic potential.While surgical resection can be potentially curative, tumor recurrence remains an important cause of treatment failure.Neoadjuvant chemotherapy can increase rate of resectability by decreasing tumor burden and decrease recurrence rate by clearing microscopic disease in lymph nodes and vessels.Currently, neoadjuvant therapy is recommended for patients with resectable who has signs of high risks or borderline resectable pancreatic adenocarcinoma...
January 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28040425/safety-and-efficacy-of-folfirinox-in-elderly-patients-with-metastatic-or-locally-advanced-pancreatic-adenocarcinoma-a-retrospective-analysis
#12
C Baldini, A Escande, O Bouché, F El Hajbi, J Volet, V Bourgeois, T Renaut Vantroys, A Ploquin, C Desauw, M Hebbar
BACKGROUND: FOLFIRINOX is a polychemotherapy regimen currently used to treat inoperable pancreatic cancer in patients with a good performance status (PS). FOLFIRINOX lengthens overall survival time (OS), but no specific data are available in elderly patients. METHODS: All cases of inoperable pancreatic adenocarcinoma in patients over 70 years old treated with FOLFIRINOX were retrospectively reviewed between 2008 and 2015 in five institutions in France. The primary objective was to evaluate the safety and efficacy of FOLFIRINOX in the elderly...
December 24, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28030863/real-world-clinical-practice-of-intensified-chemotherapies-for-metastatic-pancreatic-cancer-results-from-a-pan-european-questionnaire-study
#13
Nha Le, Alessio Vinci, Marvin Schober, Sebastian Krug, Muhammad A Javed, Thomas Kohlmann, Malin Sund, Albrecht Neesse, Georg Beyer
INTRODUCTION: Recently, FOLFIRINOX and gemcitabine + nab-paclitaxel have been introduced as a novel intensified chemotherapy regimen for patients with metastasized pancreatic cancer. This study aims to analyze the real-world clinical practice with FOLFIRINOX and gemcitabine + nab-paclitaxel across Europe. METHODS: Invitations to participate in an anonymous web-based questionnaire were sent via e-mail to 5,420 doctors in 19 European countries through the network of national gastroenterological, oncological, surgical and pancreatic societies as well as the European Pancreatic Club...
2016: Digestion
https://www.readbyqxmd.com/read/28028360/dilemma-of-first-line-regimens-in-metastatic-pancreatic-adenocarcinoma
#14
REVIEW
Marwan Ghosn, Tony Ibrahim, Tarek Assi, Elie El Rassy, Hampig Raphael Kourie, Joseph Kattan
Pancreatic cancer is one of the deadliest cancers, ranking fourth among cancer-related deaths. Despite all the major molecular advances and treatment breakthroughs, mainly targeted therapies, the cornerstone treatment of metastatic pancreatic cancer (mPC) remains cytotoxic chemotherapy. In 2016, more than 40 years after the introduction of gemcitabine in the management of mPC, the best choice for first-line treatment has not yet been fully elucidated. Two main strategies have been adopted to enhance treatment efficacy...
December 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28011495/granulocyte-colony-stimulating-factor-producing-anaplastic-carcinoma-of-the-pancreas-case-report-and-review-of-the-literature
#15
Sarah Vinzens, Joel Zindel, Martin Zweifel, Tilman Rau, Beat Gloor, Annette Wochner
We report on the case of a 67-year-old man with granulocyte colony-stimulating factor (G-CSF) producing anaplastic carcinoma of the pancreas. Preoperative routine tests revealed an elevated white blood cell (WBC) count of 25.2 G/l, consisting almost exclusively of neutrophilic granulocytes (23.31 G/l) with a predominance of segmented neutrophils (78% of all neutrophilic granulocytes), and elevated levels of C-reactive protein at 87 mg/l. Upon surgery, local tumour infiltration was more extensive than expected from preoperative imaging...
2017: Anticancer Research
https://www.readbyqxmd.com/read/27919186/economic-evaluation-for-the-us-of-nab-paclitaxel-plus-gemcitabine-versus-folfirinox-versus-gemcitabine-in-the-treatment-of-metastatic-pancreas-cancer
#16
Mahdi Gharaibeh, Ali McBride, J Lyle Bootman, Hitendra Patel, Ivo Abraham
BACKGROUND: Nab-paclitaxel plus gemcitabine (NAB-P + GEM) and FOLFIRINOX have shown superior efficacy over gemcitabine (GEM) in the treatment of metastatic pancreatic ductal adenocarcinoma (mPDA). Although the incremental clinical benefits are modest, both treatments represent significant advances in the treatment of a high-mortality cancer. In this independent economic evaluation for the US, the aim was to estimate the comparative cost-utility and cost-effectiveness of these three regimens from the payer perspective...
December 21, 2016: Journal of Medical Economics
https://www.readbyqxmd.com/read/27909037/safety-and-efficacy-of-stereotactic-body-radiation-therapy-combined-with-s-1-simultaneously-followed-by-sequential-s-1-as-an-initial-treatment-for-locally-advanced-pancreatic-cancer-silapanc-trial-study-design-and-rationale-of-a-phase-ii-clinical-trial
#17
Xiaofei Zhu, Xiaoping Ju, Fei Cao, Fang Fang, Shuiwang Qing, Yuxin Shen, Zhen Jia, Yangsen Cao, Huojun Zhang
INTRODUCTION: Upfront surgeries are not beneficial to most patients with pancreatic cancer. Therefore, more emphasis has been placed chemoradiotherapy in locally advanced pancreatic cancer recently. Gemcitabine-based regimens or FOLFIRINOX (a chemotherapy regimen including leucovorin, 5-FU, irinotecan, oxaliplatin) has been proven as a standard chemotherapy in pancreatic cancer. However, severe toxicities may prevent the completion of chemotherapy. S-1 has showed better objective response rates, similar overall survival rates and progression-free survival rates compared with gemcitabine, revealing that S-1 may be a potential candidate in treating pancreatic cancer, especially for patients refractory to gemcitabine...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27896637/seom-clinical-guideline-for-the-treatment-of-pancreatic-cancer-2016
#18
R Vera, E Dotor, J Feliu, E González, B Laquente, T Macarulla, E Martínez, J Maurel, M Salgado, J L Manzano
Pancreatic cancer remains an aggressive disease with a 5 year survival rate of 5%. Only 15% of patients with pancreatic cancer are eligible for radical surgery. Evidence suggests a benefit on survival with adjuvant chemotherapy (gemcitabine o fluourouracil) after R1/R0 resection. Adjuvant chemoradiotherapy is also a valid option in patients with positive margins. Borderline resectable pancreatic cancer is defined as the involvement of the mesenteric vasculature with a limited extension. These tumors are technically resectable, but with a high risk of positive margins...
December 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27896518/analysis-of-predictors-of-resection-and-survival-in-locally-advanced-stage-iii-pancreatic-cancer-does-the-nature-of-chemotherapy-regimen-influence-outcomes
#19
Filip Bednar, Mazen S Zenati, Jennifer Steve, Sharon Winters, Lee M Ocuin, Nathan Bahary, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
BACKGROUND: Locally advanced unresectable pancreatic cancer (LAPC) historically portends a poor prognosis. FOLFIRINOX and gemcitabine/nab-paclitaxel have proven effective in the metastatic setting. We sought to evaluate the outcomes of these regimens compared with older regimens in LAPC. METHODS: A retrospective, single institutional review of all consecutive LAPC treated with "new" (FOLFIRINOX and/or gemcitabine/nab-paclitaxel) and "old" (gemcitabine or 5-FU) chemotherapy from 2010 to 2014 was performed...
November 28, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27896469/ct-evaluation-after-neoadjuvant-folfirinox-chemotherapy-for-borderline-and-locally-advanced-pancreatic-adenocarcinoma
#20
Mathilde Wagner, Celia Antunes, Daniel Pietrasz, Christophe Cassinotto, Magaly Zappa, Antonio Sa Cunha, Oliver Lucidarme, Jean-Baptiste Bachet
AIM: To assess anatomic changes on computed tomography (CT) after neoadjuvant FOLFIRINOX (5-fluorouracil/leucovorin/irinotecan/oxaliplatin) chemotherapy for secondary resected borderline resectable (BR) and locally advanced (LA) pancreatic adenocarcinoma and their accuracy to predict resectability and pathological response. METHODS: Thirty-six patients with secondary resected BR/LA pancreatic adenocarcinoma after neoadjuvant FOLFIRINOX chemotherapy (± chemoradiotherapy) were retrospectively included...
November 28, 2016: European Radiology
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