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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/28408000/cost-effectiveness-analysis-of-systemic-therapies-in-advanced-pancreatic-cancer-in-the-canadian-health-care-system
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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/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
#8
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/28144084/should-every-patient-with-pancreatic-cancer-receive-perioperative-neoadjuvant-therapy
#9
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
#10
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/28133194/-pancreatic-cancer-with-liver-metastasis-treated-with-radical-surgery-after-chemotherapy
#11
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/28133089/-strategy-for-unresectable-pancreatic-cancer-with-stenosis-of-the-duodenum-a-case-report
#12
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
#13
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
#14
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/28062950/efficacy-and-safety-of-folfirinox-in-locally-advanced-pancreatic-cancer-a-single-center-experience
#15
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
#16
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/28030863/real-world-clinical-practice-of-intensified-chemotherapies-for-metastatic-pancreatic-cancer-results-from-a-pan-european-questionnaire-study
#17
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
#18
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/27919186/economic-evaluation-for-the-us-of-nab-paclitaxel-plus-gemcitabine-versus-folfirinox-versus-gemcitabine-in-the-treatment-of-metastatic-pancreas-cancer
#19
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...
April 2017: 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
#20
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
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