Sustained CA19-9 response to neoadjuvant chemotherapy in borderline resectable pancreatic cancer predicts progression and survival.

Sustained CA19-9 response to neoadjuvant chemotherapy in borderline resectable pancreatic cancer predicts progression and survival. Oncologist. 2020 Apr 11;: Authors: Rose JB, Edwards AM, Rocha FG, Clark C, Alseidi AA, Biehl TR, Lin BS, Picozzi VJ, Helton WS Abstract BACKGROUND: As neoadjuvant therapy of borderline resectable pancreatic cancer (BRPC) is becoming more widely utilized, better indicators of progression are needed to help guide therapeutic decisions. METHODS: A retrospective review was performed on all patients with BRPC who received 24 weeks of neoadjuvant chemotherapy. Patients with chemotoxicity or medical comorbidities limiting treatment completion and non-expressors of CA19-9 were excluded. Serum CA19-9 response was analyzed as a predictor of disease progression, recurrence, and survival. RESULTS: One hundred and four patients were included, 39 (37%) progressed on treatment (18 local and 21 distant), and 65 (63%) were resected (68% R0). Multivariate logistic regression analysis determined that the percent decrease in CA19-9 from baseline to minimum value (OR 0.947, p=
Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Oncologist Source Type: research

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AbstractBackgroundPancreatic cancer is a  devastating disease with a 5-year survival rate of 20–25%. As approximately only 20% of patients diagnosed with pancreatic cancer are initially staged as resectable, it is necessary to evaluate new therapeutic approaches. Hence, neoadjuvant (radio)chemotherapy is a promising therapeutic option , especially in patients with a borderline resectable tumor. The aim of this non-randomized, monocentric, prospective, phase II clinical study was to assess the prognostic value of functional imaging techniques, i.e., [18F]2-fluoro-2-deoxy-d-glucose positron emi...
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease with poor survival rates. For borderline resectable or unresectable disease, intensive multi ‐drug chemotherapy regimens with either modified FOLFIRINOX (mFOLF) or nab‐paclitaxel plus gemcitabine are preferred. We retrospectively compared these two chemotherapy regimens in patients who completed resection and found the mFOLF group had better overall clinical and pathological response ra tes. Randomized clinical trials are needed, and this study provides valuable information in the interim. AbstractWe conducted an institutional study to compare the clinical and...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Abstract Due to the increasing prevalence pancreatic cancer represents a severe tumor burden to the population and will be ranked second for cancer-related mortality by the year 2030. If a curative approach is pursued a radical R0 resection of the tumor with sufficient cancer-free resection margins (≥1 mm) should be performed. This has been shown to be associated with a clear benefit for survival. For treatment planning of pancreatic cancer the tumor stage plays a pivotal role. In cases of distant metastases a palliative concept is normally initiated. If no distant metastases are...
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research
CONCLUSION: The 'triangle operation' for borderline resectable pancreatic head cancer can be achieved safely by laparoscopy in carefully selected patients.1-11 Proven experience in both open and laparoscopic pancreatic surgery is mandatory. PMID: 31802299 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
ConclusionThe ‘triangle operation’ forborderline resectable pancreatic head cancer can be achieved safely by laparoscopy in carefully selected patients.1–11 Proven experience in both open and laparoscopic pancreatic surgery is mandatory.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Although pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy, incremental progress has been realized over the past decade with new chemotherapeutic regimens, advanced surgical techniques, and an improved understanding of genetics. Although most patients are not candidates for surgical resection because of metastatic disease, many centers are focused on offering curative treatment for patients with borderline resectable (BR) or locally advanced (LA) tumors. These patients are treated with chemotherapy and radiation up front followed by surgical resection, and surgery often includes the resection and reconstr...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
Conclusions In patients with BRPC who undergo resection after induction treatment, the OS was significantly better than in patients with RPC. Neoadjuvant treatment should be considered for all localized PDACs.
Source: Pancreas - Category: Gastroenterology Tags: Original Articles Source Type: research
SummaryBackgroundPancreatic cancer is the third leading cause of cancer-related death in the Western world and is projected to soon become the second commonest cause of cancer mortality. During the past two decades, there have been important clinical developments in the fight against this aggressive disease.ObjectiveThe aim of this review article is to summarize the evolution of the multidisciplinary oncological and surgical management of pancreatic cancer.ResultsThe centralization of pancreatic surgery into specialized institutions has led to improvements in surgical techniques, with reduced surgical mortality rates of
Source: European Surgery - Category: Surgery Source Type: research
Conclusions: Neoadjuvant SBRT was well tolerated, however LFs were predominantly observed outside the PTV33 volume that would have been covered with conventional RT volumes. The durability of local control after SBRT in the neoadjuvant setting merits examination relative to chemoradiation before incorporation into routine practice.
Source: American Journal of Clinical Oncology - Category: Cancer & Oncology Tags: Original Articles: Gastrointestinal Source Type: research
CONCLUSIONS: Neoadjuvant SBRT was well tolerated, however LFs were predominantly observed outside the PTV33 volume that would have been covered with conventional RT volumes. The durability of local control after SBRT in the neoadjuvant setting merits examination relative to chemoradiation before incorporation into routine practice. PMID: 30724781 [PubMed - as supplied by publisher]
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Am J Clin Oncol Source Type: research
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