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folfirinox for pancreatic cancer

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https://www.readbyqxmd.com/read/28820270/second-line-treatment-options-for-pancreatic-cancer
#1
Frank C Passero, Muhammad Wasif Saif
ABTRACT Introduction: Patients with advanced pancreatic cancer (APC) refractory to first-line therapy have a dismal prognosis and limited therapeutic options, with only one option consisting of nanoliposomal irinotecan in combination with fluorouracil and folinic acid which was approved by FDA based upon results of the phase III NAPOLI-1 study. Areas covered: We performed a literature search for relevant published clinical trials, abstracts of trials in progress and ongoing or planned trials for the second line treatment of APC using Pubmed...
August 18, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28808501/evolving-treatment-landscape-for-early-and-advanced-pancreatic-cancer
#2
REVIEW
Sally C Lau, Winson Y Cheung
Pancreatic ductal adenocarcinoma is an infrequent cancer with a high disease related mortality rate, even in the context of early stage disease. Until recently, the rate of death from pancreatic cancer has remained largely similar whereby gemcitabine monotherapy was the mainstay of systemic treatment for most stages of disease. With the discovery of active multi-agent chemotherapy regimens, namely FOLFIRINOX and gemcitabine plus nab-paclitaxel, the treatment landscape of pancreatic cancer is slowly evolving...
July 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28804517/update-on-the-role-of-nanoliposomal-irinotecan-in-the-treatment-of-metastatic-pancreatic-cancer
#3
REVIEW
Fnu Asad Ur Rahman, Saeed Ali, Muhammad Wasif Saif
Median survival for patients with metastatic pancreatic cancer (MPC) treated with combination chemotherapeutic agents such as gemcitabine-based regimens and FOLFIRINOX is currently less than 12 months. This highlights the need for more efficacious first-line, as well as second-line therapies. Nanoliposomal irinotecan, in combination with 5-fluorouracil (5-FU)/folinic acid has recently been assessed as second-line therapy after initial gemcitabine-based therapy. It is the first, second-line treatment approved by the US Food and Drug Administration to treat patients with MPC based on results of the NAnoliPOsomaL Irinotecan (NAPOLI-1) study, which showed that this regimen significantly prolonged progression-free survival (3...
July 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28795609/comparison-of-treatment-patterns-and-economic-outcomes-among-metastatic-pancreatic-cancer-patients-initiated-on-nab-paclitaxel-gemcitabine-or-folfirinox
#4
Ali McBride, Machaon Bonafede, Qian Cai, Nicole Princic, Oth Tran, Corey Pelletier, Monika Parisi, Manish Patel
ABSRTACT Background: The economic burden of metastatic pancreatic cancer (mPC) is substantial while treatment options are limited. Little is known about the treatment patterns and healthcare costs among mPC patients who initiated first-line gemcitabine plus nanoparticle albumin-bound paclitaxel (nab-P+G) and FOLFIRINOX. RESEARCH DESIGN AND METHODS: The MarketScan® claims databases were used to identify adults with ≥2 claims for pancreatic cancer, 1 claim for a secondary malignancy, completed ≥1 cycle of nab-P+G or FOLFIRINOX during 4/1/2013 and 3/31/2015, and had continuous plan enrollment for ≥6 months pre- and 3 months after the first-line treatment...
August 10, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28750659/alliance-for-clinical-trials-in-oncology-alliance-trial-a021501-preoperative-extended-chemotherapy-vs-chemotherapy-plus-hypofractionated-radiation-therapy-for-borderline-resectable-adenocarcinoma-of-the-head-of-the-pancreas
#5
Matthew H G Katz, Fang-Shu Ou, Joseph M Herman, Syed A Ahmad, Brian Wolpin, Robert Marsh, Spencer Behr, Qian Shi, Michael Chuong, Lawrence H Schwartz, Wendy Frankel, Eric Collisson, Eugene J Koay, JoLeen M Hubbard, James L Leenstra, Jeffrey Meyerhardt, Eileen O'Reilly
BACKGROUND: Borderline resectable pancreatic cancers infiltrate into adjacent vascular structures to an extent that makes an R0 resection unlikely when pancreatectomy is performed de novo. In a pilot study, Alliance for Clinical Trials in Oncology Trial A021101, the median survival of patients who received chemotherapy and radiation prior to anticipated pancreatectomy was 22 months, and 64% of operations achieved an R0 resection. However, the individual contributions of preoperative chemotherapy and radiation therapy to therapeutic outcome remain poorly defined...
July 27, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28736642/gemcitabine-nab-paclitaxel-as-second-line-therapy-following-folfirinox-in-metastatic-advanced-pancreatic-cancer-retrospective-analysis-of-response
#6
Khanh T Nguyen, Aparna Kalyan, H Scott Beasley, Aatur D Singhi, Weijing Sun, Herbert J Zeh, Daniel Normolle, Nathan Bahary
BACKGROUND: Given the tolerability of nPG in first-line therapy, we desired to evaluate the response and toxicity profiles of second-line gemcitabine with nab-paclitaxel (nPG) following FOLFIRINOX. Methods: We retrospectively identified 30 patients who received first-line FOLFIRINOX for unresectable or metastatic pancreatic adenocarcinoma followed by second-line nPG. Response was evaluated by RECIST criteria and carbohydrate antigen 19-9 (CA19-9) change. RESULTS: Median age was 63 years with 77% percent having metastatic disease...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28729048/modified-folfirinox-in-metastatic-pancreatic-cancer-a-prospective-study-in-chinese-population
#7
Xiang Li, Tao Ma, Qi Zhang, Yi-Gang Chen, Cheng-Xiang Guo, Yi-Nan Shen, Pei-Wei Sun, Guo-Gang Li, Shun-Liang Gao, Ri-Sheng Que, Jian-Ying Lou, Ri-Sheng Yu, Ying Yuan, Qi-Chun Wei, Shu-Mei Wei, Yun Zhang, Lei Zheng, Xue-Li Bai, Ting-Bo Liang
FOLFIRINOX chemotherapy has shown remarkable responses in patients with metastatic pancreatic cancer (MPC), and has significantly improved prognosis. However, FOLFIRINOX is currently not frequently applied in China because of its high incidence of adverse events, and there is no recognized optimization for this therapy in Chinese population. Modification of FOLFIRINOX may be better for its acceptance in China. In this study, we evaluated the efficacy and safety of modified-FOLFIRINOX in patients with MPC. A total of 62 MPC patients were treated with modified-FOLFIRINOX (no Fluorouracil bolus, 85% Oxaliplatin and 75% Irinotecan) between April 2014 and April 2017 in our institute...
July 17, 2017: Cancer Letters
https://www.readbyqxmd.com/read/28723668/a-rare-case-of-esophageal-metastasis-from-pancreatic-ductal-adenocarcinoma-a-case-report-and-literature-review
#8
Lauren M Rosati, Megan N Kummerlowe, Justin Poling, Amy Hacker-Prietz, Amol K Narang, Eun J Shin, Dung T Le, Elliot K Fishman, Ralph H Hruban, Stephen C Yang, Matthew J Weiss, Joseph M Herman
PURPOSE: We report a very unique case of an esophageal metastasis from a pancreatic ductal adenocarcinoma (PDAC) primary. METHODS: After obtaining consent from the patient, all relevant records of the case were obtained and retrospectively reviewed. RESULTS: At presentation, the patient was diagnosed with synchronous pancreatic and esophageal cancer. He received six months of neoadjuvant therapy including FOLFIRINOX (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) and stereotactic body radiation therapy (SBRT) to the pancreatic tumor followed by a combined pancreaticoduodenectomy and Ivor Lewis esophagectomy...
June 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28705006/best-practices-for-the-treatment-of-metastatic-pancreatic-adenocarcinoma-the-therapeutic-landscape-in-2017
#9
Pelin Cinar, Andrew H Ko
The vast majority of patients diagnosed with pancreatic adenocarcinoma have inoperable, most commonly metastatic, disease at the time of initial presentation, at which point systemic therapy becomes the mainstay of treatment. Although survival rates remain very poor in this clinical setting, patients currently have a greater number of therapeutic options available to them than ever before, and consequently individuals are more frequently able to be sequenced through multiple lines of treatment. In this review, we will provide an overview of the current treatment landscape for metastatic pancreatic cancer in 2017, focusing on best practices and the various factors that should be considered in selecting the most appropriate regimen for a given individual...
June 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28685089/comparing-the-cost-effectiveness-of-folfirinox-nab-paclitaxel-plus-gemcitabine-gemcitabine-and-s-1-for-the-treatment-of-metastatic-pancreatic-cancer
#10
Machiko Kurimoto, Michio Kimura, Eiseki Usami, Mina Iwai, Tatsuya Hirose, Shiori Kawachi, Tomoaki Yoshimura
The recommended chemotherapy regimens for pancreatic cancer include the combination of 5-fluorouracil/leucovorin, oxaliplatin and irinotecan (FOLFIRINOX), nab-paclitaxel (nab-PTX) plus gemcitabine (GEM), GEM alone and tegafur/gimeracil/oteracil potassium (S-1) alone. Although the cost-effectiveness of metastatic pancreatic cancer chemotherapies has been extensively investigated, to the best of our knowledge, no study has specifically compared the cost-effectiveness among FOLFIRINOX, nab-PTX + GEM, GEM and S-1 regimens to date...
July 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28681936/toxicity-of-chemotherapy-regimens-in-advanced-and-metastatic-pancreatic-cancer-therapy-a-network-meta-analysis
#11
Xiao-Fang Wang, Wen-Feng Huang, Jian Nie, Yong Zhou, Ding-Wu Tan, Ji-Hao Jiang
This network meta-analysis is adopted in order to compare the toxicity of different chemotherapy regimens in the treatment of advanced/metastatic pancreatic cancer (PC). Randomized controlled trials (RCTs) about different chemotherapy regimens for advanced/metastatic PC were included in this network meta-analysis using Cochrane Library and PubMed electronic databases. The network meta-analysis was performed to combine direct and indirect evidence in order to calculate the odd ratios (OR) and draw a surface under the cumulative ranking (SUCRA) curve...
July 6, 2017: Journal of Cellular Biochemistry
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
#12
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). 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
#13
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
#14
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
#15
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...
October 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
#16
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...
July 11, 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
#17
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
#18
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
#19
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...
June 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
#20
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)
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