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folfirinox for pancreatic cancer

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https://www.readbyqxmd.com/read/28608558/efficacy-and-toxicity-of-different-chemotherapy-regimens-in-the-treatment-of-advanced-or-metastatic-pancreatic-cancer-a-network-meta-analysis
#1
Gui-Feng Liu, Gui-Jie Li, Hang Zhao
OBJECTIVE: A network meta-analysis was conducted to compare the efficacy and toxicity of different chemotherapy regimens in treating advanced or metastatic pancreatic cancer (PC). METHODS: PubMed, Cochrane Library and EMBASE databases from inception to June 2016 were searched. A combination of direct and indirect evidences was referred to for calculating the weighted mean difference (WMD) or the odds ratio (OR) and to establish surface under the cumulative ranking (SUCRA) curves, so as to evaluate the efficacy and toxicity of different chemotherapy regimens in treating advanced or metastatic PC...
June 13, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28599496/use-of-gemcitabine-as-a-second-line-treatment-following-chemotherapy-with-folfirinox-for-metastatic-pancreatic-adenocarcinoma
#2
Matthieu Sarabi, Laetitia Mais, Nadia Oussaid, Françoise Desseigne, Pierre Guibert, Christelle De La Fouchardiere
There is a lack of prospective data about second-line treatments for metastatic pancreatic ductal adenocarcinoma patients. This is partially due to recent changes in first-line chemotherapy treatments. Despite this dearth of information, 50.0% of the patients who experience failure with first-line folinic acid, 5-fluorouracil, irinotecan and oxaliplatin (folfirinox) treatment are eligible for additional chemotherapy. In this setting, gemcitabine is widely used without any standard recommendations available...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28588713/neoadjuvant-chemotherapy-in-borderline-resectable-pancreatic-cancer-a-case-report
#3
Maria Celeste Palmarocchi, Ruben Carlo Balzarotti Canger, Piercarlo Saletti
Pancreatic cancer is the fourth leading cause of cancer mortality and is associated with a poor overall survival even when diagnosed early and considered resectable. Complete surgical removal with negative histological margins is an independent predictor of survival and remains the only potential curative treatment. In borderline resectable pancreatic adenocarcinoma (BRPAC), preoperative systemic therapy may increase resectability and margin-negative resection rate. There is no current consensus on the optimal chemotherapy regimen for BRPAC...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28565894/contemporary-strategies-to-improve-the-outcome-in-locally-advanced-pancreatic-cancer
#4
Rick Schneider, Christoph Späth, Ulrich Nitsche, Mert Erkan, Jörg Kleeff
Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease with an overall 5-year survival rate of less than 7%. After many years of basic and clinical research efforts, pancreatic cancer patients presenting with locally advanced, unresectable tumors remain a therapeutic challenge. Despite the lack of high quality randomized controlled trials, perioperative/ neoadjuvant treatment strategies seem to be beneficial in these patients. At present the FOLFIRINOX regimen, which was established in the palliative setting, is increasingly recognized as the backbone of neoadjuvant therapy for locally advanced PDAC...
May 30, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28564637/efficacy-and-safety-of-neoadjuvant-folfirinox-for-borderline-resectable-pancreatic-adenocarcinoma-improved-efficacy-compared-with-gemcitabine-based-regimen
#5
Changhoon Yoo, Jihoon Kang, Kyu-Pyo Kim, Jae-Lyun Lee, Baek-Yeol Ryoo, Heung-Moon Chang, Sang Soo Lee, Do Hyun Park, Tae Jun Song, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Jin-Hong Park, Dae Wook Hwang, Ki Byung Song, Jae Hoon Lee, Song Cheol Kim
Borderline resectable pancreatic cancer (BRPC) is a potentially resectable disease but is associated with poorer survival compared to primary resectable disease. There has been no prospective trial that compare the efficacy of FOLFIRNOX and gemcitabine-based regimen for BRPC. Between February 2013 and December 2014, 18 patients with BRPC receiving FOLFIRINOX were reviewed retrospectively. For comparative analysis, data for all BRPC patients (n=18) in our previous phase 2 study of neoadjuvant fixed-dose rate-gemcitabine plus capecitabine were pooled...
May 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28560601/induction-chemotherapy-followed-by-resection-or-irreversible-electroporation-in-locally-advanced-pancreatic-cancer-impala-a-prospective-cohort-study
#6
Jantien A Vogel, Steffi J Rombouts, Thijs de Rooij, Otto M van Delden, Marcel G Dijkgraaf, Thomas M van Gulik, Jeanin E van Hooft, Hanneke W van Laarhoven, Robert C Martin, Annuska Schoorlemmer, Johanna W Wilmink, Krijn P van Lienden, Olivier R Busch, Marc G Besselink
BACKGROUND: Following induction chemotherapy, both resection or irreversible electroporation (IRE) may further improve survival in patients with locally advanced pancreatic cancer (LAPC). However, prospective studies combining these strategies are currently lacking, and available studies only report on subgroups that completed treatment. This study aimed to determine the applicability and outcomes of resection and IRE in patients with nonprogressive LAPC after induction chemotherapy. METHODS: This was a prospective, single-center cohort study in consecutive patients with LAPC (September 2013 to March 2015)...
May 30, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28516291/downstaging-in-stage-iv-pancreatic-cancer-a-new-population-eligible-for-surgery
#7
Isabella Frigerio, Paolo Regi, Alessandro Giardino, Filippo Scopelliti, Roberto Girelli, Claudio Bassi, Stefano Gobbo, Paolo Tinazzi Martini, Paola Capelli, Mirko D'Onofrio, Giuseppe Malleo, Laura Maggino, Elena Viviani, Giovanni Butturini
BACKGROUND: Recent papers consider surgery as an option for synchronous liver oligometastatic patients [metastatic pancreatic ductal adenocarcinoma (mPDAC)]. In this study, we present our series of resected mPDACs after neoadjuvant chemotherapy (nCT). PATIENTS AND METHODS: All patients resected after downstaging of mPDAC were included in this study. Downstaging criteria were disappearance of liver metastasis and a decrease in cancer antigen (CA) 19-9. The type and duration of nCT, last nCT surgery interval, histology, morbidity, and mortality were recorded, and overall survival (OS) and disease-free survival (DFS) were analyzed...
May 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28495639/safety-and-tolerability-of-the-first-in-class-agent-cpi-613-in-combination-with-modified-folfirinox-in-patients-with-metastatic-pancreatic-cancer-a-single-centre-open-label-dose-escalation-phase-1-trial
#8
Angela Alistar, Bonny B Morris, Rodwige Desnoyer, Heidi D Klepin, Keyanoosh Hosseinzadeh, Clancy Clark, Amy Cameron, John Leyendecker, Ralph D'Agostino, Umit Topaloglu, Lakmal W Boteju, Asela R Boteju, Rob Shorr, Zuzana Zachar, Paul M Bingham, Tamjeed Ahmed, Sandrine Crane, Riddhishkumar Shah, John J Migliano, Timothy S Pardee, Lance Miller, Gregory Hawkins, Guangxu Jin, Wei Zhang, Boris Pasche
BACKGROUND: Pancreatic cancer statistics are dismal, with a 5-year survival of less than 10%, and more than 50% of patients presenting with metastatic disease. Metabolic reprogramming is an emerging hallmark of pancreatic adenocarcinoma. CPI-613 is a novel anticancer agent that selectively targets the altered form of mitochondrial energy metabolism in tumour cells, causing changes in mitochondrial enzyme activities and redox status that lead to apoptosis, necrosis, and autophagy of tumour cells...
May 8, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28489753/effect-of-folfirinox-as-second-line-chemotherapy-for-metastatic-pancreatic-cancer-after-gemcitabine-based-chemotherapy-failure
#9
Noritoshi Kobayashi, Takeshi Shimamura, Motohiko Tokuhisa, Ayumu Goto, Itaru Endo, Yasushi Ichikawa
BACKGROUND: This study aimed to determine the maximum tolerated dose (MTD), dose-limiting toxicity, and efficacy of second-line chemotherapy with FOLFIRINOX after gemcitabine (GEM)-based chemotherapy failure in metastatic pancreatic cancer (MPC). METHODS: We studied 18 histopathologically proven MPC patients. The schedule was 85 mg/m oxaliplatin, irinotecan, and 400 mg/m leucovorin, followed by 400 mg/m 5-fluorouracil (5-FU) as a bolus on day 1 and 2400 mg/m 5-FU as a 46-hour continuous infusion biweekly...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28486290/-radiological-and-surgical-implications-of-neoadjuvant-treatment-with-folfirinox-for-locally-advanced-and-borderline-resectable-pancreatic-cancer
#10
Satyajit Ashok Godhi, Kunal Parasar, Sundeep Saluja, Pramod Mishra
No abstract text is available yet for this article.
June 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28476943/patterns-of-chemotherapy-use-in-a-u-s-based-cohort-of-patients-with-metastatic-pancreatic-cancer
#11
Thomas A Abrams, Gary Meyer, Jeffrey A Meyerhardt, Brian M Wolpin, Deborah Schrag, Charles S Fuchs
PURPOSE: Few population studies have examined patterns of systemic therapy administration in metastatic pancreatic cancer (MPC) or the predictors associated with specific treatment choices. PATIENTS AND METHODS: We assessed 4,011 consecutive MPC patients who received chemotherapy between January 2005 and December 2015 at academic, private, and community-based oncology practices subscribing to a U.S.-wide chemotherapy order entry system capturing disease, patient, provider, and treatment data...
May 5, 2017: Oncologist
https://www.readbyqxmd.com/read/28462862/high-prevalence-of-incidental-and-symptomatic-venous-thromboembolic-events-in-patients-with-advanced-pancreatic-cancer-under-palliative-chemotherapy-a-retrospective-cohort-study
#12
Anne Katrin Berger, Hans Martin Singh, Wiebke Werft, Alexander Muckenhuber, Martin R Sprick, Andreas Trumpp, Wilko Weichert, Dirk Jäger, Christoph Springfeld
OBJECTIVES: Pancreatic cancer patients are at high risk for venous thromboembolic events (VTEs), and chemotherapy is a known additional risk factor. In this context, there is a controversial discussion whether prophylactic anticoagulation should be offered to all outpatients receiving chemotherapy. METHODS: In this retrospective study, we analyzed incidental and symptomatic VTEs in 150 pancreatic cancer patients receiving either gemcitabine-based chemotherapy or chemotherapy according to the FOLFIRINOX protocol...
April 22, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28461766/comparative-effectiveness-and-resource-utilization-of-nab-paclitaxel-plus-gemcitabine-vs-folfirinox-or-gemcitabine-for-the-first-line-treatment-of-metastatic-pancreatic-adenocarcinoma-in-a-us-community-setting
#13
Fadi Braiteh, Manish B Patel, Monika Parisi, Quanhong Ni, Siyeon Park, Claudio Faria
INTRODUCTION: Despite a clinically relevant, statistically significant survival benefit with nab-paclitaxel plus gemcitabine and FOLFIRINOX vs single-agent gemcitabine for metastatic pancreatic cancer (mPC), little is known regarding their real-world effectiveness. We analyzed patients with mPC using a nationally representative electronic medical records database to address this unmet need. METHODS: This retrospective analysis of the Navigating Cancer database compared outcomes among patients who received first-line nab-paclitaxel plus gemcitabine, FOLFIRINOX, or gemcitabine for mPC...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28459988/what-treatment-in-2017-for-inoperable-pancreatic-cancers
#14
J Taieb, A-L Pointet, J L Van Laethem, B Laquente, S Pernot, F Lordick, M Reni
Pancreatic adenocarcinoma (PA) is a frequent and severe disease, either diagnosed as metastatic pancreatic adenocarcinoma (MPA) or as locally advanced pancreatic carcinoma (LAPC). Though no improvement in patients outcome have been made between 1996 and 2011, since 5 years new treatment options have become available to treat our patients. New standard first line regimens, such as FOLFIRINOX and gemcitabine combined with nab-paclitaxel, have improved overall survivals and second line treatments have been tested and validated...
April 27, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28422841/evaluation-of-gemcitabine-efficacy-after-the-folfirinox-regimen-in-patients-with-advanced-pancreatic-adenocarcinoma
#15
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/28408000/cost-effectiveness-analysis-of-systemic-therapies-in-advanced-pancreatic-cancer-in-the-canadian-health-care-system
#16
COMPARATIVE STUDY
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
#17
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
#18
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/28324747/optimal-dose-reduction-of-folfirinox-for-preserving-tumour-response-in-advanced-pancreatic-cancer-using-cumulative-relative-dose-intensity
#19
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/28303435/systemic-combination-chemotherapy-in-elderly-pancreatic-cancer-a-review
#20
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
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