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folfirinox for pancreatic cancer

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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
#1
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
#2
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
#3
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...
April 12, 2018: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/29616439/nab-paclitaxel-plus-gemcitabine-versus-folfirinox-as-the-first-line-chemotherapy-for-patients-with-metastatic-pancreatic-cancer-retrospective-analysis
#4
Jihoon Kang, Inhwan Hwang, Changhoon Yoo, Kyu-Pyo Kim, Jae Ho Jeong, Heung-Moon Chang, Sang Soo Lee, Do Hyun Park, Tae Jun Song, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim, Seung-Mo Hong, Sang Hyun Shin, Dae Wook Hwang, Ki Byung Song, Jae Hoon Lee, Song Cheol Kim, Baek-Yeol Ryoo
Purpose nab-paclitaxel plus gemcitabine (AG) and FOLFIRINOX have been established as standard first-line treatment in metastatic pancreatic cancer (mPC). We performed retrospective analysis comparing the efficacies of AG and FOLFIRINOX in daily practice setting. Materials and Methods We analyzed 308 patients who presented initially as mPC and received AG (n = 149) or FOLFIRINOX (n = 159) as first-line treatment between 2013 and 2016. Primary endpoints were progression-free survival (PFS) and overall survival (OS)...
April 3, 2018: Investigational New Drugs
https://www.readbyqxmd.com/read/29615310/meta-analysis-of-modified-folfirinox-regimens-for-patients-with-metastatic-pancreatic-cancer
#5
Pedro Luiz Serrano Usón Junior, Edna Terezinha Rother, Fernando Cotait Maluf, Diogo Diniz Gomes Bugano
BACKGROUND: We performed a meta-analysis of previous reports evaluating the effect of mFIO (modified FOLFIRINOX; leucovorin, 5-fluorouracil, irinotecan, oxaliplatin) regimens in advanced pancreatic cancer. MATERIALS AND METHODS: We performed a meta-analysis of reported studies in PubMed, Scopus, and Web of Science (1950-2016) in December 2016. The inclusion criteria were randomized trials, prospective or retrospective cohorts, patients with metastatic pancreatic adenocarcinoma, the use of mFIO or FOLFIRINOX (FIO) chemotherapy, and available information for ≥ 1 efficacy endpoint (response rate, progression-free survival, and/or overall survival)...
March 14, 2018: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29603014/impact-of-formulation-on-the-iontophoretic-delivery-of-the-folfirinox-regimen-for-the-treatment-of-pancreatic-cancer
#6
James D Byrne, Mohammad R N Jajja, Adrian T O'Neill, Allison N Schorzman, Amanda W Keeler, J Christopher Luft, William C Zamboni, Joseph M DeSimone, Jen Jen Yeh
PURPOSE: Effective treatment of patients with locally advanced pancreatic cancer is a significant unmet clinical need. One major hurdle that exists is inadequate drug delivery due to the desmoplastic stroma and poor vascularization that is characteristic of pancreatic cancer. The local iontophoretic delivery of chemotherapies provides a novel way of improving treatment. With the growing practice of highly toxic combination therapies in the treatment of pancreatic cancer, the use of iontophoresis for local delivery can potentiate the anti-cancer effects of these therapies while sparing unwanted toxicity...
March 30, 2018: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/29600384/paclitaxel-as-albumin-bound-nanoparticles-with-gemcitabine-for-untreated-metastatic-pancreatic-cancer-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#7
REVIEW
Angela Stainthorpe, Janette Greenhalgh, Adrian Bagust, Marty Richardson, Angela Boland, Sophie Beale, Rui Duarte, Eleanor Kotas, Lindsay Banks, Daniel Palmer
As part of the single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited Celgene Ltd to submit clinical and cost-effectiveness evidence for paclitaxel as albumin-bound nanoparticles (Nab-Pac) in combination with gemcitabine (Nab-Pac + Gem) for patients with untreated metastatic pancreatic cancer. The STA was a review of NICE's 2015 guidance (TA360) in which Nab-Pac + Gem was not recommended for patients with untreated metastatic pancreatic cancer...
March 29, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29596120/survival-in-locally-advanced-pancreatic-cancer-after-neoadjuvant-therapy-and-surgical-resection
#8
Georgios Gemenetzis, Vincent P Groot, Alex B Blair, Daniel A Laheru, Lei Zheng, Amol K Narang, Elliot K Fishman, Ralph H Hruban, Jun Yu, Richard A Burkhart, John L Cameron, Matthew J Weiss, Christopher L Wolfgang, Jin He
OBJECTIVE: The aim of the study was to identify the survival of patients with locally advanced pancreatic cancer (LAPC) and assess the effect of surgical resection after neoadjuvant therapy on patient outcomes. BACKGROUND: An increasing number of LAPC patients who respond favorably to neoadjuvant therapy undergo surgical resection. The impact of surgery on patient survival is largely unknown. MATERIALS AND METHODS: All LAPC patients who presented to the institutional pancreatic multidisciplinary clinic (PMDC) from January 2013 to September 2017 were included in the study...
March 28, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29560127/neoadjuvant-photodynamic-therapy-augments-immediate-and-prolonged-oxaliplatin-efficacy-in-metastatic-pancreatic-cancer-organoids
#9
Mans Broekgaarden, Imran Rizvi, Anne-Laure Bulin, Ljubica Petrovic, Ruth Goldschmidt, Iqbal Massodi, Jonathan P Celli, Tayyaba Hasan
Effective treatment of advanced metastatic disease remains the primary challenge in the management of inoperable pancreatic cancer. Current therapies such as oxaliplatin (OxPt)-based chemotherapy regimens (FOLFIRINOX) provide modest short-term survival improvements, yet with significant toxicity. Photodynamic therapy (PDT), a light-activated cancer therapy, demonstrated clinical promise for pancreatic cancer treatment and enhances conventional chemotherapies with non-overlapping toxicities. This study investigates the capacity of neoadjuvant PDT using a clinically-approved photosensitizer, benzoporphyrin derivative (BPD, verteporfin), to enhance OxPt efficacy in metastatic pancreatic cancer...
February 27, 2018: Oncotarget
https://www.readbyqxmd.com/read/29557103/chemotherapy-and-radiotherapy-for-advanced-pancreatic-cancer
#10
REVIEW
Venessa Chin, Adnan Nagrial, Katrin Sjoquist, Chelsie A O'Connor, Lorraine Chantrill, Andrew V Biankin, Rob Jpm Scholten, Desmond Yip
BACKGROUND: Pancreatic cancer (PC) is a highly lethal disease with few effective treatment options. Over the past few decades, many anti-cancer therapies have been tested in the locally advanced and metastatic setting, with mixed results. This review attempts to synthesise all the randomised data available to help better inform patient and clinician decision-making when dealing with this difficult disease. OBJECTIVES: To assess the effect of chemotherapy, radiotherapy or both for first-line treatment of advanced pancreatic cancer...
March 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29556385/phase-i-study-of-third-line-palliative-chemotherapy-with-low-dose-paclitaxel-for-pancreatic-cancer
#11
Hidehiro Tajima, Mitsuyoshi Okazaki, Takahisa Yamaguchi, Yoshinao Ohbatake, Koichi Okamoto, Shinichi Nakanuma, Shiro Terai, Seisho Sakai, Jun Kinoshita, Isamu Makino, Keishi Nakamura, Hironori Hayashi, Katsunobu Oyama, Masafumi Inokuchi, Tomoharu Miyashita, Hiroyuki Takamura, Itasu Ninomiya, Sachio Fushida, Tetsuo Ohta
The prognosis of patients with unresectable or recurrent pancreatic cancers is very poor. Prior to development of nab-paclitaxel (PTX) plus gemcitabine (GEM) therapy and FOLFIRINOX therapy, there was no recommended third-line chemotherapy after 5-fluorouracil (5-FU) and GEM-based regimens. The present study conducted a Phase I clinical trial of weekly low-dose PTX as a third-line palliative chemotherapy for patients with pancreatic cancer. PTX was administered on days 1, 8, 15, and 22 of each cycle, repeated twice as follows: Level 1, 40 mg/m2 (n=6); Level 2, 50 mg/m2 (n=4)...
April 2018: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29549862/efficacy-of-gemcitabine-plus-erlotinib-in-rash-positive-patients-with-metastatic-pancreatic-cancer-selected-according-to-eligibility-for-folfirinox-a-prospective-phase-ii-study-of-the-arbeitsgemeinschaft-internistische-onkologie
#12
M Haas, J T Siveke, M Schenk, M M Lerch, K Caca, J Freiberg-Richter, L Fischer von Weikersthal, F Kullmann, A Reinacher-Schick, M Fuchs, S Kanzler, V Kunzmann, T J Ettrich, S Kruger, C B Westphalen, S Held, V Heinemann, S Boeck
INTRODUCTION: In metastatic pancreatic ductal adenocarcinoma (mPDAC) treatment, erlotinib is known to be more effective in patients developing skin rash. Treatment with the FOLFIRINOX regimen is only performed in fit patients following defined inclusion criteria. The present study investigates the efficacy of gemcitabine plus erlotinib (gem/erlotinib) in rash-positive patients fit for FOLFIRINOX. PATIENTS AND METHODS: For this prospective phase II study, 150 patients were recruited in 20 centres...
March 14, 2018: European Journal of Cancer
https://www.readbyqxmd.com/read/29515757/swi-snf-aberrations-sensitize-pancreatic-cancer-cells-to-dna-crosslinking-agents
#13
Jean Davidson, Zhewei Shen, Xue Gong, Jonathan R Pollack
While gemcitabine has been the mainstay therapy for advanced pancreatic cancer, newer combination regimens (e.g. FOLFIRINOX) have extended patient survival, though carry greater toxicity. Biomarkers are needed to better stratify patients for appropriate therapy. Previously, we reported that one-third of pancreatic cancers harbor deletions or deleterious mutations in key subunits of the SWItch/Sucrose NonFermentable (SWI/SNF) chromatin remodeling complex. The SWI/SNF complex mobilizes nucleosomes on DNA, and plays a key role in modulating DNA transcription and repair...
February 9, 2018: Oncotarget
https://www.readbyqxmd.com/read/29483456/-a-case-of-long-term-survival-of-the-pancreatic-tail-cancer-with-the-concomitant-small-liver-metastasis
#14
Koji Kase, Ryo Okada, Makoto Muto, Junichiro Watanabe, Naoya Sato, Yasuhide Kofunato, Teruhide Ishigame, Takashi Kimura, Akira Kenjo, Tatsuo Shimura, Shigeru Marubashi
We hereby report a case of long-term survival of the pancreatic tail cancer with a synchronous small liver metastasis. A 62- year-old male with pancreatic tail cancer was incidentally diagnosed with single tiny metastasis in the left medial section of the liver duringthe distal pancreatectomy. The lesion was also resected together with primary lesion. Since then, systemic chemotherapies such as gemcitabine(GEM)plus S-1 combination therapy, GEM alone therapy and S-1 alone therapy had been given to escape from recurrence...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29483447/-a-case-of-resection-for-lymph-node-recurrence-around-the-inferior-vena-cava-after-radical-surgery-of-undifferentiated-carcinoma-of-the-pancreatic-head-region
#15
Masahiko Kubo, Daisaku Yamada, Hidetoshi Eguchi, Yoshifumi Iwagami, Takehiro Noda, Tadafumi Asaoka, Hiroshi Wada, Kouichi Kawamoto, Kunihito Gotoh, Shogo Kobayashi, Masaki Mori, Yuichiro Doki
A 60-year-old man underwent palliative surgery with a diagnosis of unresectable cancer, and he visited our hospital for further treatment. Since the cancer was unresectable and multiple hepatic tumors were revealed in CT images that were not metastases, we decided to perform curative surgery for the pancreatic cancer accompanied by partial liver invasion. Pancreaticoduodenectomy plus partial hepatectomy were performed, and 2 tumors were detected in the resected specimen: one in the pancreas-duodenum region and a submucosal tumor in the duodenum bulb...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29475787/added-value-of-ca19-9-response-in-predicting-resectability-of-locally-advanced-pancreatic-cancer-following-induction-chemotherapy
#16
Eran van Veldhuisen, Jantien A Vogel, Sjors Klompmaker, Olivier R Busch, Hanneke W M van Laarhoven, Krijn P van Lienden, Johanna W Wilmink, Hendrik A Marsman, Marc G Besselink
BACKGROUND: Determining the resectability of locally advanced pancreatic cancer (LAPC) after induction chemotherapy is complex since CT-imaging cannot accurately portray tumor response. We hypothesized that CA19-9 response adds to RECIST-staging in predicting resectability of LAPC. METHODS: Post-hoc analysis within a prospective study on LAPC (>90° arterial or >270° venous involvement). CA19-9 response was determined after induction chemotherapy. Surgical exploration was performed in RECIST-stable or -regressive disease...
February 20, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29394764/-the-treatment-outcomes-of-folfirinox-for-unresectable-and-recurrent-pancreatic-cancer
#17
Takuya Sakamoto, Yutaka Takeda, Yoshiaki Ohmura, Yoshiteru Katsura, Ryota Mori, Yohei Nose, Kenji Kawai, Kohei Murakami, Atsushi Naito, Junichi Inatome, Yoshinori Kagawa, Toru Masuzawa, Atsushi Takeno, Chiyomi Egawa, Kohei Murata
FOLFIRINOX is now considered to be a highly effective regimen for patients with metastatic pancreatic cancer. We administered FOLFIRINOX therapy in 18 patients between October 2014 and April 2017 as follows: 2-hour infusion of L-OHP at a dose of 85mg/m2, 2-hour infusion of LV at a dose of 200 mg/m2, infusion of CPT-11 for over 90 minutes at a dose of 150 mg/m2, followed by continuous infusion of 5-FU over 46 hours at a dose of 2,400mg/m2. The median age of the patients was 66.5 years. There were 15 patients with performance status(PS)0, and 3 with PS 1...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29394630/-neoadjuvant-folfirinox-for-unresectable-adenocarcinoma-of-the-pancreas-a-case-report
#18
Toshiya Ochiai, Hiroyuki Inoue, Hiroki Nakatsuji, Nobuyuki Watanabe, Atsushi Yoshiyama, Hiroshi Ito, Atsushi Toma, Kenji Nakamura
A 38-year-old male presented to our hospital with complaint of vomiting. A CT demonstrated a mass sized 42mm in the pancreatic head invading to the duodenum and a liver mass sized 15mm in the medial segment. Biopsy revealed adenocarcinoma. Due to liver metastasis, he was deemed surgically unresectable. He was started on FOLFIRINOX therapy after gastrojejunum bypass operation. After 15 courses of the therapy, restaging showed a decrease in pancreatic tumor size and a disappearance of a liver mass along with PET-CT revealing no FDG-avid uptake...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29340058/a-multicenter-prospective-phase-ii-study-of-first-line-modified-folfirinox-for-unresectable-advanced-pancreatic-cancer
#19
Kensaku Yoshida, Takuji Iwashita, Shinya Uemura, Akinori Maruta, Mitsuru Okuno, Nobuhiro Ando, Keisuke Iwata, Junji Kawaguchi, Tsuyoshi Mukai, Masahito Shimizu
Background: FOLFIRINOX (FX) has been reported as an effective treatment for unresectable advanced pancreatic cancer. However, FX is associated with a high incidence of adverse events (AEs). A previous phase II study in Japan showed high incidences of hematological AEs, including febrile neutropenia (22.2%). A modified FX regimen (mFX) may decrease the rates of AEs and be more effective than FX by improving the treatment compliance. Aims: To assess the safety and efficacy of first-line mFX for unresectable advanced pancreatic cancer...
December 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/29335228/irreversible-electroporation-for-locally-advanced-pancreatic-cancer-through-a-minimally-invasive-surgery-supported-by-laparoscopic-ultrasound
#20
Ernesto Tartaglia, Massimiliano Fabozzi, Antonia Rizzuto, Anna Settembre, Roberta Abete, Ludovica Guerriero, Pasqualino Favoriti, Diego Cuccurullo, Francesco Corcione
INTRODUCTION: Pancreatic cancer is one of the most lethal cancers worldwide, with 5-years survival rate as low as 6%. The majority of pancreatic cancer patients present locally advanced or metastatic disease at diagnosis. Typically, patients affected by locally advanced pancreatic cancer (LAPC) do not undergo radical surgery but are treated with focal ablative therapies. However, a high rate of morbidity due to the heat sink effect has limited the application of ablative techniques on a routine basis in LAPC patients...
2018: International Journal of Surgery Case Reports
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