Cancers, Vol. 11, Pages 1547: Is There a Standard Adjuvant Therapy for Resected Pancreatic Cancer?

Cancers, Vol. 11, Pages 1547: Is There a Standard Adjuvant Therapy for Resected Pancreatic Cancer? Cancers doi: 10.3390/cancers11101547 Authors: Fenocchio Filippi Lombardi Quarà Milanesio Aimar Leone Aglietta Surgical resection remains the only treatment that offers a potential chance of long-term survival. Unfortunately, about 80% of patients treated with curative intent will develop recurrence. Since 2001, adjuvant therapy with gemcitabine or 5-fluorouracyle was recommended. This approach allows a median overall survival (OS) of around 23 months, and 5-year survival of 22%. In recent years, two phase-3 trials investigating new chemotherapy regimens resulted in considerably improved survival times. The doublet gemcitabine–capecitabine has shown improvement in OS from 25.5 to 28 months (p = 0.032) compared to gemcitabine, in the ESPAC-4 trial. Later, preliminary results of PRODIGE 24 trial presented at the 2018 ASCO meeting showed a superiority of a combination chemotherapy regimen with fluorouracil, leucovorin, irinotecan, and oxaliplatin (mFOLFIRINOX) when compared to gemcitabine alone, both in terms of median disease-free survival (21.6 vs. 12.8 months, p < 0.0001) and OS (54.4 vs. 35 months, p = 0.003). Contrary to chemotherapy, the role of adjuvant radiotherapy is still controversial, even in the case of R1 surgery. A randomized trial exploring the role of chemoradiotherapy in this setting is now ongoing in the US (RT...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research

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Pancreatic adenocarcinoma (PDAC) is the most common type of pancreatic cancer (PC) [1 –3]. PDAC incidence is rising; it is expected to become the second cause of cancer-related death by 2030 and has a very poor prognosis[4]. More than 80% of patients have an advanced disease at diagnosis, and the 5-year overall survival rate is approximately 7% [5]. Poor survival is attributed to h igh aggressiveness, intrinsic chemotherapeutics resistance and lack of effectively targetable oncogenic drivers. Systemic chemotherapy is the mainstay of locally advanced (LAPC) and metastatic (MPC) patients treatment and single-agent gemc...
Source: Cancer Treatment Reviews - Category: Cancer & Oncology Authors: Tags: Tumour Review Source Type: research
Conditions:   Pancreatic Adenocarcinoma;   Pancreatic Cancer Intervention:   Biological: Autologous DC vaccine Sponsors:   Baylor College of Medicine;   Cancer Cures for Kids Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Authors: Sanford NN, Aguilera TA, Folkert MR, Ahn C, Mahal BA, Zeh H, Beg MS, Mansour J, Sher DJ Abstract BACKGROUND: Adjuvant therapy for resected pancreatic adenocarcinoma was given a category 1 NCCN recommendation in 2000, yet many patients do not receive chemotherapy after definitive surgery. Whether sociodemographic disparities exist for receipt of adjuvant chemotherapy is poorly understood. METHODS: The National Cancer Database was used to identify patients diagnosed with nonmetastatic pancreatic adenocarcinoma who underwent definitive surgery from 2004 through 2015. Multivariable logistic regression defi...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
-Chuan Hung Both gemcitabine and fluoropyrimidine are recommended backbones in the first-line treatment of pancreatic ductal adenocarcinoma (PDAC). To compare the efficacy and safety of these two therapeutic backbones, and to investigate the optimal therapies, we conducted a network meta-analysis. By retrospective analysis of randomized controlled trials (RCT), the most preferred therapeutic regimen may be predicted. The eligible RCTs of the gemcitabine-based therapies and fluoropyrimidine-based therapies were searched up to 31 August 2019. In a frequentist network meta-analysis, treatments were compared and ranked acc...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
CONCLUSIONS: Pelareorep and pembrolizumab added to chemotherapy did not add significant toxicity and showed encouraging efficacy. Further evaluation of pelareorep and anti-PD-1 therapy is ongoing in follow-up studies. This research highlights the potential utility of several pre-treatment and on-treatment biomarkers for pelareorep therapy warranting further investigation. PMID: 31694832 [PubMed - as supplied by publisher]
Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research
ConclusionRates of surgical resection after upfront chemotherapy are relatively low, and the proportion of patients who eventually undergo resection varies considerably between hospitals. The use of surgery after upfront chemotherapy in resectable pancreatic cancer should be considered as an internal quality-of-cancer-care measure.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Conclusions Ascites-derived xenograft models represent a valuable experimental system for testing the efficacy of currently available therapeutic compounds on chemotherapy-resistant PDAC cells and for elucidation of the mechanisms underlying chemotherapy resistance.
Source: Pancreas - Category: Gastroenterology Tags: Original Articles Source Type: research
This study aimed to explore the prognostic significance of the resection margin (R) status of pancreatic ductal adenocarcinoma (PDAC) patients receiving neoadjuvant therapy (NAT) or adjuvant chemotherapy (AC).MethodsWe retrospectively reviewed 427 consecutive patients, and the overall survival (OS) and disease-free survival (DFS) were analyzed based on the R status by a propensity score analysis (PSA).ResultsThe R0 ratio of the NAT (+) group was significantly higher than that of the NAT ( −) group (97.2% vs. 69.6%,P 
Source: Surgery Today - Category: Surgery Source Type: research
Lukas Cerveny Evidence on equilibrative nucleoside transporter 1 (ENT1) and microRNA-21 (miR‑21) is not yet sufficiently convincing to consider them as prognostic biomarkers for patients with pancreatic ductal adenocarcinoma (PDAC). Here, we investigated the prognostic value of ENT1/ENT1, miR-21, and neurogenic locus homolog protein 3 gene (NOTCH3) in a well-defined cohort of resected patients treated with adjuvant gemcitabine chemotherapy (n = 69). Using a combination of gene expression quantification in microdissected tissue, immunohistochemistry, and univariate/multivariate statistical analyses we did not confirm ...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Article Source Type: research
Publication date: Available online 18 October 2019Source: Advances in Biological RegulationAuthor(s): Shaw M. Akula, Saverio Candido, Stephen L. Abrams, Linda S. Steelman, Kvin Lertpiriyapong, Lucio Cocco, Giulia Ramazzotti, Stefano Ratti, Matilde Y. Follo, Alberto M. Martelli, Ramiro M. Murata, Pedro L. Rosalen, Bruno Bueno-Silva, Severino Matias de Alencar, Marco Falasca, Giuseppe Montalto, Melchiorre Cervello, Monica Notarbartolo, Agnieszka Gizak, Dariusz RakusAbstractImproving the effects of chemotherapy and reducing the side effects are important goals in cancer research. Various approaches have been examined to enhan...
Source: Advances in Biological Regulation - Category: Biology Source Type: research
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