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folfirinox for pancreatic cancer

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https://www.readbyqxmd.com/read/29903803/orthotopic-and-heterotopic-murine-models-of-pancreatic-cancer-and-their-different-responses-to-folfirinox-chemotherapy
#1
Derek J Erstad, Mozhdeh Sojoodi, Martin S Taylor, Sarani Ghoshal, Allen A Razavi, Katherine A Graham-O'Regan, Nabeel Bardeesy, Cristina R Ferrone, Michael Lanuti, Peter Caravan, Kenneth K Tanabe, Bryan C Fuchs
INTRODUCTION: Syngeneic, immunocompetent allograft tumor models recapitulate important aspects of the tumor microenvironment and have short tumor latency with predictable growth kinetics, making them useful for trialing novel therapeutics. We describe surgical techniques for orthotopic and heterotopic PDAC tumor implantation and characterize phenotypes based on implantation site. METHODS: Mice (n=8 per group) were implanted with 104 cells in the pancreas or flank...
June 14, 2018: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/29898269/metastatic-pancreatic-ductal-adenocarcinoma-diagnosis-and-treatment-with-a-view-to-the-future
#2
Adrian M J Pokorny, Venessa T Chin, Adnan M Nagrial, Desmond Yip, Lorraine A Chantrill
Metastatic pancreatic ductal adenocarcinoma (mPDAC) is a lethal disease with a poor 5-year survival. Systemic treatments can be used to control symptoms and prolong life. Cytotoxic chemotherapies are commonly administered, with combination treatments, such as fluorouracil, folinic acid, irinotecan and oxaliplatin (FOLFIRINOX) or nab-paclitaxel and gemcitabine showing the largest clinical benefits. Newer genomic classifications of PDAC may provide a rationale for targeted therapies or immunotherapies, although at present these remain largely experimental...
June 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29896283/from-first-line-to-sequential-treatment-in-the-management-of-metastatic-pancreatic-cancer
#3
REVIEW
Andrés Muñoz Martín, Manuel Hidalgo, Rafael Alvarez, Virginia Arrazubi, Joaquina Martínez-Galán, Mercedes Salgado, Teresa Macarulla, Alfredo Carrato
The current management of patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) is based on systemic chemotherapy. The results of the MPACT and PRODIGE clinical trials have demonstrated that the combination of nab-paclitaxel and gemcitabine (GEM) as well as FOLFIRINOX regimen result in improvement in overall survival when compared to GEM alone. Treatment guidelines now recommend either one of these two regimens as first line treatment for fit patients with mPDAC. Because no head-to-head comparison between the two regimens exists, the selection of one versus the other is based on clinical criteria...
2018: Journal of Cancer
https://www.readbyqxmd.com/read/29875415/the-benefits-of-modified-folfirinox-for-advanced-pancreatic-cancer-and-its-induced-adverse-events-a-systematic-review-and-meta-analysis
#4
Hongxuan Tong, Zhu Fan, Biyuan Liu, Tao Lu
FOLFIRINOX has been one of the first-line options for advanced pancreatic cancer, even though it induces significant adverse effects. Several institutions have begun using modified FOLFIRINOX to decrease its side effects and increase its tolerability. We systematically investigated the outcome from patients who initially received modified FOLFIRINOX as a chemotherapy regimen for advanced pancreatic cancer. We used the random-model generic inverse variance method to analyse the binary data with 95% confidence intervals (CIs)...
June 6, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29868007/pancreatic-ductal-adenocarcinoma-a-strong-imbalance-of-good-and-bad-immunological-cops-in-the-tumor-microenvironment
#5
REVIEW
Etienne D Foucher, Clément Ghigo, Salem Chouaib, Jérôme Galon, Juan Iovanna, Daniel Olive
Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal cancers with very few available treatments. For many decades, gemcitabine was the only treatment for patients with PDAC. A recent attempt to improve patient survival by combining this chemotherapy with FOLFIRINOX and nab-paclitaxel failed and instead resulted in increased toxicity. Novel therapies are urgently required to improve PDAC patient survival. New treatments in other cancers such as melanoma, non-small-cell lung cancer, and renal cancer have emerged, based on immunotherapy targeting the immune checkpoints cytotoxic T-lymphocyte-associated antigen 4 or programmed death 1 ligand...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29867436/treatment-of-leptomeningeal-carcinomatosis-in-a-patient-with-metastatic-pancreatic-cancer-a-case-report-and-review-of-the-literature
#6
William Rainey Johnson, Brett J Theeler, David Van Echo, Patrick Young, Mary Kwok
Pancreatic cancer is the fourth leading cause of cancer-related death with a median survival of 3-11 months when metastatic. We present a patient with metastatic pancreatic cancer and an exceptional response to initial systemic chemotherapy with FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin). Despite evidence of disease control on body imaging, he developed symptomatic leptomeningeal disease and brain metastases 29 months into treatment. He received aggressive treatment with capecitabine and irinotecan, intrathecal topotecan, and eventually bevacizumab...
May 2018: Case Reports in Oncology
https://www.readbyqxmd.com/read/29866170/attenuated-folfirinox-in-the-salvage-treatment-of-gemcitabine-refractory-advanced-pancreatic-cancer-a-phase-ii-study
#7
Jung Hoon Kim, Sang-Cheol Lee, Sung Yong Oh, Seo-Young Song, Namsu Lee, Eun Mi Nam, Soonil Lee, In Gyu Hwang, Hyo Rak Lee, Kyu Taek Lee, Sang-Byung Bae, Han Jo Kim, Joung Soon Jang, Do Hyoung Lim, Hyun Woo Lee, Seok Yun Kang, Jung Hun Kang
BACKGROUND: Combination therapy with oxaliplatin, irinotecan, fluorouracil, and leucovorin (FOLFIRINOX) chemotherapy drastically improves survival of advanced pancreatic cancer patients. However, the efficacy of FOLFIRINOX as a second-line treatment after gemcitabine failure has not been tested prospectively. We investigated the feasibility and safety of attenuated FOLFIRINOX in patients with gemcitabine-refractory advanced pancreatic cancer. METHODS: A multicenter phase II prospective open-label, single-arm study was conducted at 14 hospitals...
June 4, 2018: Cancer communications
https://www.readbyqxmd.com/read/29846765/gemcitabine-plus-nab-paclitaxel-vs-folfirinox-for-patients-with-advanced-pancreatic-cancer
#8
Junko Tahara, Kyoko Shimizu, Nao Otsuka, Junichi Akao, Yukiko Takayama, Katsutoshi Tokushige
PURPOSE: New chemotherapies have become available for the treatment of advanced pancreatic cancer and have led to changes in its standard treatments. Since pancreatic cancer is becoming more common as a result of population aging, there is a need for diversification of chemotherapy. METHODS: Between March 2014 and April 2017, FOLFIRINOX (FFX) or gemcitabine plus nab-paclitaxel (G-nab) was used as first-line therapy to treat 27 patients with locally advanced and metastatic pancreatic cancer at our hospital...
May 30, 2018: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/29808697/-a-development-and-overview-of-the-use-of-chemotherapy-and-the-role-of-radiotherapy-and-surgery-in-patients-with-newly-diagnosed-pancreatic-tumor-and-cancer-in-the-current-5-year-center-practice
#9
S Vokurka, M Votavová, J Kulhánková, H Korunková, O Fiala, K Štěrbová, T Svoboda, R Vojtíšek, V M Matějka, J Fínek
BACKGROUND: Chemotherapy (CHT), surgery and radiotherapy (RT) are essential modalities in the treatment of pancreatic malignancies. Their use in practice may be influenced by a number of factors. PATIENTS AND METHODS: Retrospective analysis of CHT, surgery and RT indications and CHT results in patients reported with pancreatic tumor in Pilsen in 2012-2016. RESULTS: A total of 348 patients with median age 68 (19-89) years with newly diagnosed pancreatic tumor, resp...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/29800971/total-neoadjuvant-therapy-with-folfirinox-followed-by-individualized-chemoradiotherapy-for-borderline-resectable-pancreatic-adenocarcinoma-a-phase-2-clinical-trial
#10
Janet E Murphy, Jennifer Y Wo, David P Ryan, Wenqing Jiang, Beow Y Yeap, Lorraine C Drapek, Lawrence S Blaszkowsky, Eunice L Kwak, Jill N Allen, Jeffrey W Clark, Jason E Faris, Andrew X Zhu, Lipika Goyal, Keith D Lillemoe, Thomas F DeLaney, Carlos Fernández-Del Castillo, Cristina R Ferrone, Theodore S Hong
Importance: Patients with borderline-resectable pancreatic ductal adenocarcinoma have historically poor outcomes with surgery followed by adjuvant chemotherapy. Evaluation of a total neoadjuvant approach with highly active therapy is warranted. Objective: To evaluate the margin-negative (R0) resection rate in borderline-resectable pancreatic ductal adenocarcinoma after neoadjuvant FOLFIRINOX (fluorouracil, irinotecan, and oxaliplatin) therapy and individualized chemoradiotherapy...
May 3, 2018: JAMA Oncology
https://www.readbyqxmd.com/read/29798952/nontrial-real-world-outcomes-in-unresectable-locally-advanced-pancreatic-cancer-chemotherapy-and-chemoradiation-is-the-standard-while-surgery-is-uncommon
#11
Anant Ramaswamy, Sunny Jandyal, Vikas Ostwal, Reena Engineer, Shirley Lewis, Subhadeep Bose, Nikhil Pande, Shailesh V Shrikhande
BACKGROUND: Outcomes and survival of truly unresectable locally advanced pancreatic cancers (LAPC) is often reported along with borderline resectable pancreatic cancers especially from a real world cohort. METHODS: The audit of LAPC patients, diagnosed based on the NCCN criteria between February 2013 and January 2016 was used to identify patients starting and continuing treatment in our institution. Practice patterns, outcomes and prognostic factors for overall survival were evaluated...
July 2017: Indian Journal of Cancer
https://www.readbyqxmd.com/read/29791286/metastatic-pancreatic-cancer-asco-clinical-practice-guideline-update
#12
Davendra P S Sohal, Erin B Kennedy, Alok Khorana, Mehmet S Copur, Christopher H Crane, Ignacio Garrido-Laguna, Smitha Krishnamurthi, Cassadie Moravek, Eileen M O'Reilly, Philip A Philip, Ramesh K Ramanathan, Joseph T Ruggiero, Manish A Shah, Susan Urba, Hope E Uronis, Michelle W Lau, Daniel Laheru
Purpose In 2016, ASCO published a guideline to assist in clinical decision making in metastatic pancreatic cancer for initial assessment after diagnosis, first- and second-line treatment options, palliative and supportive care, and follow-up. The purpose of this update is to incorporate new evidence related to second-line therapy for patients who have experienced disease progression or intolerable toxicity during first-line therapy. Methods ASCO convened an Expert Panel to conduct a systematic review of the literature on second-line therapy published between June 2015 and January 2018...
May 23, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29765563/targeted-therapies-in-the-management-of-locally-advanced-and-metastatic-pancreatic-cancer-a-systematic-review
#13
REVIEW
Anjali V Sheahan, Andrew V Biankin, Christopher R Parish, Levon M Khachigian
Pancreatic cancer has a dismal prognosis particularly in patients presenting with unresectable tumors. We performed a bibliometric analysis of clinical trials for pancreatic cancer conducted between 2014-2016 focusing on patients that presented with unresectable (locally advanced or metastatic) tumors. We discuss a range of studies that employed FOLFIRINOX, the gemcitabine + nab-paclitaxel combination and studies that used molecularly-targeted therapy. Major areas of focus have been dual targeting of EGFR and VEGFR, immunotherapy or a multimodal approach - combining chemotherapy with radiotherapy...
April 20, 2018: Oncotarget
https://www.readbyqxmd.com/read/29731985/association-between-homologous-recombination-repair-gene-mutations-and-response-to-oxaliplatin-in-pancreatic-cancer
#14
Tomohiro Kondo, Masashi Kanai, Tadayuki Kou, Tomohiro Sakuma, Hiroaki Mochizuki, Mayumi Kamada, Masahiko Nakatsui, Norimitsu Uza, Yuzo Kodama, Toshihiko Masui, Kyoichi Takaori, Shigemi Matsumoto, Hidehiko Miyake, Yasushi Okuno, Manabu Muto
Objectives: We aimed to examine the association between homologous recombination repair (HRR)-related gene mutations and efficacy of oxaliplatin-based chemotherapy in patients with pancreatic ductal adenocarcinoma (PDAC). Results: Non-synonymous mutations in HRR-related genes were found in 13 patients and only one patient had a family history of pancreatic cancer. Eight patients with HRR-related gene mutations (group A) and nine without HRR-related gene mutations (group B) received oxaliplatin-based chemotherapy...
April 13, 2018: Oncotarget
https://www.readbyqxmd.com/read/29721211/advanced-pancreatic-cancer-a-meta-analysis-of-clinical-trials-over-thirty-years
#15
Bradley R Hall, Andrew Cannon, Pranita Atri, Christopher S Wichman, Lynette M Smith, Apar K Ganti, Chandrakanth Are, Aaron R Sasson, Sushil Kumar, Surinder K Batra
Background: In contrast to other cancers, survival rates for pancreatic ductal adenocarcinoma (PDAC) patients have improved but minimally over the past thirty years. The aim of this study was to perform a meta-analysis of clinical trials published since 1986 to determine trends in median overall survival in primarily metastatic PDAC. Materials and methods: All Phase 2-4 clinical trials published during or after 1986 investigating first-line systemic chemotherapy in metastatic PDAC were included in the meta-analysis...
April 10, 2018: Oncotarget
https://www.readbyqxmd.com/read/29695574/biweekly-gemcitabine-nab-paclitaxel-as-first-line-treatment-for-advanced-pancreatic-cancer
#16
Stefania Kokkali, Elli-Sophia Tripodaki, Maria Drizou, Dimitra Stefanou, Elpida Magou, Dimosthenis Zylis, Matthaios Kapiris, Despoina Nasi, Chara Georganta, Alexandros Ardavanis
BACKGROUND/AIM: During recent years, a survival advantage was reported for first-line treatment of advanced pancreatic cancer with two new regimens, FOLFIRINOX and gemcitabine/nab-paclitaxel, over gemcitabine monotherapy. Gemcitabine/nab-paclitaxel administration on days 1, 8 and 15 of a 4-week cycle is associated with some practical disadvantages. We adopted a biweekly regimen with the same dose density. PATIENTS AND METHODS: Patients with Eastern Cooperative Oncology Group performance status 0-2 diagnosed with advanced histologically or cytologically confirmed pancreatic cancer and no prior treatment were included in the study...
May 2018: In Vivo
https://www.readbyqxmd.com/read/29683973/nationwide-multicenter-observational-study-of-folfirinox-chemotherapy-in-399-patients-with-unresectable-or-recurrent-pancreatic-cancer-in-japan
#17
Akiko Todaka, Nobumasa Mizuno, Masato Ozaka, Hideki Ueno, Satoshi Kobayashi, Kazuhiro Uesugi, Noritoshi Kobayashi, Hideyuki Hayashi, Kentaro Sudo, Naohiro Okano, Yosuke Horita, Keiko Kamei, Seigo Yukisawa, Shoji Nakamori, Yutaka Yachi, Toshiyuki Henmi, Marina Kobayashi, Narikazu Boku, Keita Mori, Akira Fukutomi
OBJECTIVES: FOLFIRINOX (oxaliplatin, irinotecan, 5-fluorouracil, and leucovorin) is the standard therapy worldwide for unresectable pancreatic cancer; however, clinical data for Japanese patients are limited. Therefore, the observational study of FOLFIRINOX for patients with pancreatic cancer was conducted. METHODS: The study included 399 patients with unresectable or recurrent pancreatic cancer, from 27 institutions in Japan, treated with FOLFIRINOX and surveyed until December 2015...
May 2018: Pancreas
https://www.readbyqxmd.com/read/29679211/surgery-after-folfirinox-treatment-for-locally-advanced-and-borderline-resectable-pancreatic-cancer-increase-in-tumour-attenuation-on-ct-correlates-with-r0-resection
#18
Giovanni Marchegiani, Valentina Todaro, Enrico Boninsegna, Riccardo Negrelli, Binit Sureka, Debora Bonamini, Roberto Salvia, Riccardo Manfredi, Roberto Pozzi Mucelli, Claudio Bassi
OBJECTIVES: To assess factors associated with radical resection (R0) of pancreatic ductal adenocarcinoma (PDAC) after induction treatment with FOLFIRINOX. METHODS: Patients with either locally advanced (LA) and borderline resectable (BR) PDAC undergoing surgical exploration after FOLFIRINOX were retrospectively enrolled. Two pancreatic radiologists reviewed the CT blinded to the final outcome and assessed chemotherapy response and resectability. Patients were then divided into R0 resected (group A) and not resected/R1 resected (group B), which were compared...
April 20, 2018: European Radiology
https://www.readbyqxmd.com/read/29651946/neoadjuvant-therapy-is-essential-for-resectable-pancreatic-cancer
#19
Jin-Zhi Xu, Wen-Quan Wang, Shi-Rong Zhang, Hua-Xiang Xu, Chun-Tao Wu, Zi-Hao Qi, He-Li Gao, Shuo Li, Quan-Xing Ni, Xian-Jun Yu, Liang Liu
BACKGROUND: Awareness of the benefits of neoadjuvant therapy is increasing, but its use as an initial therapeutic option for patients with resectable pancreatic cancer remains controversial, especially for those patients without high-risk prognostic features. Even for patients with high-risk features who are candidates to receive neoadjuvant therapy, no standard regimen exists. METHODS: In this review, we examined available data on neoadjuvant therapy in patients with resectable pancreatic cancer, including prospective studies, retrospective studies, and ongoing clinical trials, by searching PubMed/MEDLINE, ClinicalTrials...
April 12, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29651809/development-of-chemotherapy-and-significance-of-conversion-surgery-after-chemotherapy-in-unresectable-pancreatic-cancer
#20
REVIEW
Junji Furuse, Junji Shibahara, Masanori Sugiyama
While surgery currently remains the only potentially curative treatment available for pancreatic cancer, only 20% to 30% of patients have resectable disease at diagnosis. Recently, with the introduction of intensive chemotherapy regimens such as oxaliplatin, irinotecan, fluorouracil plus leucovorin (FOLFIRINOX) and gemcitabine plus nab-paclitaxel, for the treatment of unresectable pancreatic cancer, the antitumor activity and overall survival in patients with pancreatic cancer have dramatically improved. These advances in intensive chemotherapy have led to the possibility of conversion of unresectable disease to resectable disease, and it has been reported that more than 20% of pancreatic cancer patients with unresectable locally advanced disease at diagnosis undergo successful conversion surgery after FOLFIRINOX therapy...
May 2018: Journal of Hepato-biliary-pancreatic Sciences
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