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survival improvement in patients with pancreatic cancer

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https://www.readbyqxmd.com/read/28335509/novel-diagnostic-and-predictive-biomarkers-in-pancreatic-adenocarcinoma
#1
REVIEW
John C Chang, Madappa Kundranda
Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal disease for a multitude of reasons including very late diagnosis. This in part is due to the lack of understanding of the biological behavior of PDAC and the ineffective screening for this disease. Significant efforts have been dedicated to finding the appropriate serum and imaging biomarkers to help early detection and predict response to treatment of PDAC. Carbohydrate antigen 19-9 (CA 19-9) has been the most validated serum marker and has the highest positive predictive value as a stand-alone marker...
March 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28333072/detection-of-circulating-tumor-cells-using-negative-enrichment-immunofluorescence-and-an-in-situ-hybridization-system-in-pancreatic-cancer
#2
Yu Xu, Tai Qin, Jing Li, Xiuchao Wang, Chuntao Gao, Chao Xu, Jihui Hao, Jingcheng Liu, Song Gao, He Ren
Pancreatic cancer (PC) is the most lethal type of gastrointestinal cancer, and early detection and monitoring is an urgent problem. Circulating tumor cells (CTCs) are emerging as a non-invasive biomarker for tumor detection. However, the low sensitivity is a main problem in the traditional CellSearch System for detecting CTCs, especially in patients with PC. In this study, we used negative enrichment (NE), immunofluorescence and in situ hybridization (FISH) of chromosome 8 (NE-iFISH) to capture and identify CTCs in PC patients...
March 23, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28326457/minimally-invasive-surgical-approaches-for-pancreatic-adenocarcinoma-recent-trends
#3
REVIEW
Georgios D Lianos, Dimitrios K Christodoulou, Konstantinos H Katsanos, Christos Katsios, Georgios K Glantzounis
BACKGROUND: Pancreatic resection for cancer represents a real challenge for every surgeon. Recent improvements in laparoscopic experience, minimally invasive surgical techniques and instruments make now the minimally invasive approach a real "triumph." There is no doubt that minimally invasive surgery has replaced with great success conventional surgery in many fields, including surgical oncology. METHODS AND RESULTS: However, its progress in pancreatic resection for adenocarcinoma has been dramatically slow...
March 22, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28322154/mechanisms-and-drug-targets-for-pancreatic-cancer-chemoprevention
#4
Deepanshi Dhar, Komal Raina, Rajesh Agarwal
Pancreatic cancer management remains a major challenge to society. Poor prognosis results in dismal survival rates and quality of life for pancreatic cancer patients post chemo/radiation therapies. Although progress has been made in drug development for chemotherapeutics targeting pancreatic cancer, accompanying issues of resistance to these drugs renders the treatment futile. Emerging area of cancer chemoprevention is gaining importance with natural/dietary compounds serving as novel agents with strong anticancer properties; these are pleiotropic agents targeting multiple pathways with minimal toxicities in the surrounding normal tissue...
March 20, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28318082/histopathological-tumour-viability-after-neoadjuvant-chemotherapy-influences-survival-in-resected-pancreatic-cancer-analysis-of-early-outcome-data
#5
Phil Townend, Phil R de Reuver, Terence C Chua, Anubhav Mittal, Stephen J Clark, Nick Pavlakis, Anthony J Gill, Jaswinder S Samra
BACKGROUND: Neoadjuvant therapy is increasingly recognized as an effective strategy prior to pancreatoduodenectomy. We investigate the role of neoadjuvant chemotherapy (NAC) followed by surgery and the predictive role of viable residual tumour cells histopathologically on outcomes. METHODS: The study population comprised of 195 consecutive patients with pancreatic adenocarcinoma who were treated with either NAC or a surgery-first (SF) strategy. Histopathological viable tumour cells were examined in the NAC patients and clinicopathological factors were correlated with overall survival...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28316225/-the-clinical-impact-of-artery-first-approach-combined-with-vascular-resection-and-reconstruction-in-the-treatment-of-pancreatic-head-carcinoma
#6
J L Huang, W G Li, F Z Chen, Z J Su, F M Li, B Liu
Objective: To evaluate the application of artery first, combined vascular resection and reconstruction in the treatment of pancreatic head carcinoma. Methods: The clinical data of 13 patients with pancreatic head cancer were retrospectively analyzed from February 2014 to March 2016 in the Affiliated Hospital of Xiamen University. Preoperative computed tomography of high resolution layer or magnetic resonance imaging examination demonstrated pancreatic head carcinoma, as well as close adhesion, stenosis, compression or displacement of superior mesenteric vein or portal vein wall...
March 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28315875/systematic-review-of-exocrine-pancreatic-insufficiency-after-gastrectomy-for-cancer
#7
Jennifer Straatman, Jim Wiegel, Nicole van der Wielen, E P Jansma, Miguel A Cuesta, Donald L van der Peet
BACKGROUND: Survival rates after a total gastrectomy with adequate lymphadenectomy are improving, leading to a shift in outcomes of interest from survival to postoperative outcomes and symptoms. In this systematic review, we investigate gastrointestinal symptoms that occur after a gastrectomy in relation to exocrine pancreatic insufficiency and the effect of pancreatic exocrine enzyme supplementation on these symptoms. METHODS: Online databases PubMed, Embase, and Cochrane Library were systematically searched in accordance with the PRISMA guidelines...
March 18, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28303435/systemic-combination-chemotherapy-in-elderly-pancreatic-cancer-a-review
#8
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/28301556/early-versus-delayed-initiation-of-adjuvant-treatment-for-pancreatic-cancer
#9
Hyoung Woo Kim, Jong-Chan Lee, Jongchan Lee, Jin Won Kim, Jaihwan Kim, Jin-Hyeok Hwang
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive tumor showing a tendency for early recurrence, even after curative resection. Although adjuvant treatment improves survival, it is unclear whether early adjuvant treatment initiation yields better outcomes in patients with PDAC. METHODS: We retrospectively enrolled 113 patients who underwent chemotherapy or chemoradiotherapy after curative resection of PDAC: Fifty-six and 57 patients were in the early and delayed groups, respectively based on the median time of treatment initiation (35 days [range, 20-83 days])...
2017: PloS One
https://www.readbyqxmd.com/read/28301350/a-phase-ii-study-of-ganetespib-as-second-line-or-third-line-therapy-for-metastatic-pancreatic-cancer
#10
Dana B Cardin, Ramya Thota, Laura W Goff, Jordan D Berlin, Clyde M Jones, Gregory D Ayers, Jennifer G Whisenant, Emily Chan
OBJECTIVES: Heat shock protein 90 regulates multiple signaling proteins involved in key pathways of pancreatic cancer pathogenesis. Ganetespib binds to heat shock protein 90 and interferes with its binding to client proteins thus leading to inactivation and degradation of the signaling proteins that promote cancer progression. This phase II study was designed to evaluate the efficacy of ganetespib in patients with refractory metastatic pancreatic cancer (rMPC). METHODS: Patients with rMPC received 175 mg/m ganetespib intravenously once weekly for 3 weeks in 4-week cycles...
March 15, 2017: American Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28299752/therapeutic-implications-of-molecular-subtyping-for-pancreatic-cancer
#11
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/28282277/role-of-stereotactic-body-radiotherapy-in-the-treatment-of-elderly-and-poor-performance-status-patients-with-pancreatic-cancer
#12
Lauren M Rosati, Joseph M Herman
Literature on the management of nonmetastatic pancreatic ductal adenocarcinoma in patients who are elderly or have poor performance status is sparse. The median survival of this unique cohort of patients is < 6 months, and most patients are only offered single-agent gemcitabine or supportive care. Recently, adding nanoparticle albumin-bound paclitaxel to gemcitabine was shown to improve survival of patients with metastatic disease with Eastern Cooperative Group performance status of 2. Although standard chemoradiotherapy provides long-term locoregional control in locally advanced pancreatic cancer, it is difficult for this group of patients to tolerate 6 weeks of therapy...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28273369/is-estrogen-exposure-a-protective-factor-for-pancreatic-neuroendocrine-tumors-in-female-multiple-endocrine-neoplasia-syndrome-type-1-patients
#13
Wei Qiu, Ioannis Christakis, Ashley A Stewart, Danica M Vodopivec, Angelica Silva-Figueroa, Huiqin Chen, Terri L Woodard, Daniel M Halperin, Jeffrey E Lee, James C Yao, Nancy D Perrier
OBJECTIVE: Pancreatic neuroendocrine tumors (PNETs) are the most common cause of death in multiple endocrine neoplasia type 1 (MEN1) patients. Women have been shown to have improved survival, which may suggest a possible protective effect of female sex hormones. The aim of this study was to evaluate the relationship between estrogen exposure and PNET tumorigenesis, tumor growth, and survival in female MEN1 patients with these tumors. DESIGN: We performed a retrospective chart review of the existing MEN1 database in our institution...
March 8, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28267380/abscopal-effect-of-metastatic-pancreatic-cancer-after-local-radiotherapy-and-granulocyte-macrophage-colony-stimulating-factor-therapy
#14
Fang Shi, Xin Wang, Feifei Teng, Li Kong, Jinming Yu
The role of immunotherapy in combination with traditional treatment regime in improving the survival of cancer patients has attracted more and more attention. Especially the abscopal effect that describes the phenomenon of localized radiotherapy leading to regression of distant unirradiated tumors and the role of enhanced radiotherapy-induced immunogenic cell death and activation of immune system have become a focus of the studies. Granulocyte-macrophage colony-stimulating factor (GM-CSF) is known a powerful stimulator of the generation, migration and activation of antigen presenting cells such as dendritic cells (DC) and macrophages...
March 7, 2017: Cancer Biology & Therapy
https://www.readbyqxmd.com/read/28265583/clinical-outcomes-of-specific-immunotherapy-in-advanced-pancreatic-cancer-a-systematic-review-and-meta-analysis
#15
REVIEW
Jiang Chen, Guo Xiao-Zhong, Xing-Shun Qi
Specific immunotherapies, including vaccines with autologous tumor cells and tumor antigen-specific monoclonal antibodies, are important treatments for PC patients. To evaluate the clinical outcomes of PC-specific immunotherapy, we performed a systematic review and meta-analysis of the relevant published clinical trials. The effects of specific immunotherapy were compared with those of nonspecific immunotherapy and the meta-analysis was executed with results regarding the overall survival (OS), immune responses data, and serum cancer markers data...
2017: Journal of Immunology Research
https://www.readbyqxmd.com/read/28259610/vandetanib-plus-gemcitabine-versus-placebo-plus-gemcitabine-in-locally-advanced-or-metastatic-pancreatic-carcinoma-vip-a-prospective-randomised-double-blind-multicentre-phase-2-trial
#16
Gary Middleton, Daniel H Palmer, William Greenhalf, Paula Ghaneh, Richard Jackson, Trevor Cox, Anthony Evans, Victoria E Shaw, Jonathan Wadsley, Juan W Valle, David Propper, Harpreet Wasan, Stephen Falk, David Cunningham, Fareeda Coxon, Paul Ross, Srinivasan Madhusudan, Nick Wadd, Pippa Corrie, Tamas Hickish, Eithne Costello, Fiona Campbell, Charlotte Rawcliffe, John P Neoptolemos
BACKGROUND: Erlotinib is an EGFR tyrosine kinase inhibitor that has shown a significant but only marginally improved median overall survival when combined with gemcitabine in patients with locally advanced and metastatic pancreatic cancer. Vandetanib is a novel tyrosine kinase inhibitor of VEGFR2, RET, and EGFR, all of which are in involved in the pathogenesis of pancreatic cancer. We investigated the clinical efficacy of vandetanib when used in combination with gemcitabine in patients with advanced pancreatic cancer...
March 1, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28256961/gemcitabine-mono-therapy-versus-gemcitabine-plus-targeted-therapy-in-advanced-pancreatic-cancer-a-meta-analysis-of-randomized-phase-iii-trials
#17
Alessandro Ottaiano, Monica Capozzi, Chiara De Divitiis, Alfonso De Stefano, Gerardo Botti, Antonio Avallone, Salvatore Tafuto
BACKGROUND: Prognosis of advanced pancreatic cancer is dismal and the novel targeted therapies, albeit successfully used to treat many advanced tumors, have shown modest results. We performed a meta-analysis in order to quantify the effect size on survival of adding targeted therapy to single agent gemcitabine. METHODS: Randomized phase III trials comparing gemcitabine mono-therapy versus gemcitabine plus a targeted agent in first-line treatment of advanced pancreatic cancer designed on survival as primary outcome were selected...
March 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28253833/emerging-antibodies-for-the-treatment-of-pancreatic-cancer
#18
Kalliopi Andrikou, Chiara Peterle, Stefania Pipitone, Massimiliano Salati, Stefano Cascinu
Pancreatic ductal adenocarcinoma cancer (PDAC) is the fourth leading cause of cancer death worldwide. Recently, two chemotherapy regimens have proven to improve median overall survival in comparison with gemcitabine. Based on better understanding of tumor molecular biology and of the role of tumor microenvironment, monoclonal antibodies (mAbs) could be an interesting and new type of targeted treatment of PDAC. Areas covered: Preclinical and clinical trials have evaluated the efficacy of several mAbs in pancreatic cancer treatment...
March 2017: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/28251282/multicenter-randomized-open-label-phase-ii-study-comparing-s-1-alternate-day-oral-therapy-with-the-standard-daily-regimen-as-a-first-line-treatment-in-patients-with-unresectable-advanced-pancreatic-cancer
#19
Hiroki Yamaue, Atsushi Shimizu, Yasuhiro Hagiwara, Masayuki Sho, Hiroaki Yanagimoto, Shoji Nakamori, Hideki Ueno, Hiroshi Ishii, Masayuki Kitano, Kazuya Sugimori, Hiroyuki Maguchi, Shinichi Ohkawa, Hiroshi Imaoka, Daisuke Hashimoto, Kazuki Ueda, Hiroko Nebiki, Tatsuya Nagakawa, Hiroyuki Isayama, Isao Yokota, Yasuo Ohashi, Tetsuhiko Shirasaka
PURPOSE: Non-inferiority for overall survival (OS) following alternate-day treatment with the oral anticancer drug S-1 compared with standard daily treatment was assessed in Japanese patients with unresectable advanced pancreatic cancer in a multicenter, randomized, phase II study. This trial was registered at the UMIN Clinical Trials Registry (no. 000008604). METHODS: Chemotherapy-naïve patients with locally advanced or metastatic pancreatic cancer were randomly assigned 2:1 to treatment with alternate-day (twice daily on alternate days from days 1 through 42 of a 42-day cycle) or daily (twice daily on days 1 through 28 of a 42-day cycle) treatment with S-1...
March 1, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28249796/biological-determinants-of-radioresistance-and-their-remediation-in-pancreatic-cancer
#20
REVIEW
Parthasarathy Seshacharyulu, Michael J Baine, Joshua J Souchek, Melanie Menning, Sukhwinder Kaur, Ying Yan, Michel M Ouellette, Maneesh Jain, Chi Lin, Surinder K Batra
Despite recent advances in radiotherapy, a majority of patients diagnosed with pancreatic cancer (PC) do not achieve objective responses due to the existence of intrinsic and acquired radioresistance. Identification of molecular mechanisms that compromise the efficacy of radiation therapy and targeting these pathways is paramount for improving radiation response in PC patients. In this review, we have summarized molecular mechanisms associated with the radio-resistant phenotype of PC. Briefly, we discuss the reversible and irreversible biological consequences of radiotherapy, such as DNA damage and DNA repair, mechanisms of cancer cell survival and radiation-induced apoptosis following radiotherapy...
February 27, 2017: Biochimica et Biophysica Acta
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