Letter comments re: Multi-agent neoadjuvant chemotherapy improves survival in early-stage pancreatic cancer: A NCDB analysis

2021 ◽  
Vol 158 ◽  
pp. 36-37
Author(s):  
Eduard Jonas ◽  
Jessica Lindemann ◽  
Marc Bernon ◽  
Jake Krige
2021 ◽  
Vol 147 ◽  
pp. 17-28
Author(s):  
Aileen Deng ◽  
Chun Wang ◽  
Steven J. Cohen ◽  
Jordan M. Winter ◽  
James Posey ◽  
...  

Pancreas ◽  
2020 ◽  
Vol 49 (3) ◽  
pp. 393-407 ◽  
Author(s):  
Teresa Macarulla ◽  
Andrew E. Hendifar ◽  
Chung-Pin Li ◽  
Michele Reni ◽  
Hanno Riess ◽  
...  

2020 ◽  
Vol 11 (5) ◽  
pp. 1078-1089
Author(s):  
Paige Blinn ◽  
Ravi Shridhar ◽  
Taylor Maramara ◽  
Jamie Huston ◽  
Kenneth Meredith

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S66
Author(s):  
S.W.L. de Geus ◽  
G.G. Kasumova ◽  
S.C. Ng ◽  
D. McAneny ◽  
T.E. Sachs ◽  
...  

2021 ◽  
Vol 10 (12) ◽  
pp. 2700
Author(s):  
Sarah Maloney ◽  
Malinda Itchins ◽  
Jennifer Arena ◽  
Sumit Sahni ◽  
Viive M. Howell ◽  
...  

Pancreatic adenocarcinoma is a devastating disease with only 15–20% of patients resectable at diagnosis. Neoadjuvant chemotherapy for this cohort is becoming increasingly popular; however, there are no published randomized trials that support the use of neoadjuvant chemotherapy over upfront surgery in resectable disease. This retrospective cohort analysis was conducted to compare both treatment pathways and to identify any potential prognostic markers. Medical records from one large volume pancreatic cancer center from 2013–2019 were reviewed and 126 patients with upfront resectable disease were analyzed. Due to a change in practice in our center patients treated prior to December 2016 received upfront surgery and those treated after this date received neoadjuvant chemotherapy. Of these, 86 (68%) patients were treated with upfront surgery and 40 (32%) of patients were treated with neoadjuvant chemotherapy. Our results demonstrated that patients treated with upfront surgery with early-stage (1a) disease had a longer median OS compared to those treated with neoadjuvant chemotherapy (24 vs. 21 months, p = 0.028). This survival difference was not evident for all patients (regardless of stage). R0 resections were similar between groups (p = 0.605). We identified that both tumor viability (in neoadjuvant chemotherapy-treated patients) and tumor grade were useful prognostic markers. Upfront surgery for certain patients with low volume disease may be suitable despite the global trend towards neoadjuvant chemotherapy for all upfront resectable patients. A prospective clinical trial in this cohort incorporating biomarkers is needed to determine optimal therapy pathway.


2020 ◽  
Vol 14 ◽  
Author(s):  
Subhajit Makar ◽  
Abhrajyoti Ghosh ◽  
Divya ◽  
Shalini Shivhare ◽  
Ashok Kumar ◽  
...  

: Despite advances in the development of cytotoxic and targeted therapies, pancreatic adenocarcinoma (PAC) remains a significant cause of cancer mortality worldwide. It is also difficult to detect it at an early stage due to numbers of factors. Most of the patients are present with locally advanced or metastatic disease, which precludes curative resection. In the absence of effective screening methods, considerable efforts have been made to identify better systemic treatments during the past decade. This review describes the recent advances in molecular mechanisms involved in pancreatic cancer initiation, progression, and metastasis. Additionally, the importance of deregulated cellular signalling pathways and various cellular proteins as potential targets for developing novel therapeutic strategies against incurable forms of pancreatic cancer is reported. The emphasis is on the critical functions associated with growth factors and their receptors viz. c-MET/HGF, CTHRC1, TGF-β, JAK-STAT, cyclooxygenase pathway, WNT, CCK, MAPK-RAS-RAF, PI3K-AKT, Notch, src, IGF-1R, CDK2NA and chromatin regulation for the sustained growth, survival, and metastasis of pancreatic cancer cells. It also includes various therapeutic strategies viz. immunotherapy, surgical therapy, radiation therapy and chemotherapy.


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