Development and validation of a radiomics nomogram to discriminate advanced pancreatic cancer patients with liver metastases or other metastatic patterns.

435 Background: Pancreatic cancer patients with liver metastases had much poorer prognosis than those with other metastatic patterns. This study aimed to develop and validate a radiomics model to discriminate pancreatic cancer patients with liver metastases from patients with other metastatic patterns. Methods: We evaluated 77 patients advanced pancreatic cancer (APC) with different metastatic patterns and performed texture analysis on the region of interest (ROI). 58 patients and 19 patients were allocated randomly into the training cohort and the validation cohort with almost the same proportion of patients with liver metastases. An independent samples t-test was used for initial feature selection in the training cohort. Random Forest Classifier (RFC) was used to construct models based on these features in both cohorts and a radiomics signature (RS) was derived from the model. Then a nomogram was constructed based on RS and CA19-9, and validated with calibration plot and decision curve. The prognostic value of RS was evaluated by Kaplan-Meier methods. Results: A nomogram based on the RS and CA19-9 was constructed and it demonstrated good discrimination in the training cohort (AUC = 0.93) and validation cohort (AUC = 0.81). Kaplan-meier methods showed that patients with RS>0.61 had much poorer OS than patients with RS < 0.61 in both cohorts. Conclusions:This study presents a radiomics nomogram incorporating both RS and CA19-9, which can be used to discriminate advanced pancreatic cancer patients with liver metastases from patients with other metastatic patterns.

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Development and validation of a radiomics nomogram to discriminate advanced pancreatic cancer with liver metastases or other metastatic patterns

Cancer Biomarkers ◽

10.3233/cbm-210190 ◽

2021 ◽

pp. 1-10

Author(s):

Tianliang Zhang ◽

Xiao Dong ◽

Yang Zhou ◽

Muhan Liu ◽

Junjie Hang ◽

...

Keyword(s):

Pancreatic Cancer ◽

Liver Metastases ◽

Advanced Pancreatic Cancer ◽

Region Of Interest ◽

Random Forest Classifier ◽

Calibration Plot ◽

Good Discrimination ◽

Kaplan Meier ◽

Metastatic Patterns ◽

Development And Validation

BACKGROUND: Patients with advanced pancreatic cancer (APC) and liver metastases have much poorer prognoses than patients with other metastatic patterns. OBJECTIVE: This study aimed to develop and validate a radiomics model to discriminate patients with pancreatic cancer and liver metastases from those with other metastatic patterns. METHODS: We evaluated 77 patients who had APC and performed texture analysis on the region of interest. 58 patients and 19 patients were allocated randomly into the training and validation cohorts with almost the same proportion of liver metastases. An independentsamples t-test was used for feature selection in the training cohort. Random forest classifier was used to construct models based on these features and a radiomics signature (RS) was derived. A nomogram was constructed based on RS and CA19-9, and was validated with calibration plot and decision curve. The prognostic value of RS was evaluated by Kaplan-Meier methods. RESULTS: The constructed nomogram demonstrated good discrimination in the training (AUC = 0.93) and validation (AUC = 0.81) cohorts. In both cohorts, patients with RS > 0.61 had much poorer overall survival than patients with RS < 0.61. CONCLUSIONS: This study presents a radiomics nomogram incorporating RS and CA19-9 to discriminate patients who have APC with liver metastases from patients with other metastatic patterns.

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Multicenter Retrospective Analysis of Second-Line Therapy after Gemcitabine Plus Nab-Paclitaxel in Advanced Pancreatic Cancer Patients

Cancers ◽

10.3390/cancers12051131 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1131 ◽

Cited By ~ 2

Author(s):

Valeria Merz ◽

Alessandro Cavaliere ◽

Carlo Messina ◽

Massimiliano Salati ◽

Camilla Zecchetto ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cancer Patients ◽

Advanced Pancreatic Cancer ◽

Rank Test ◽

Second Line ◽

Second Line Therapy ◽

Clear Trend ◽

Line Therapy ◽

Kaplan Meier ◽

Number Of Patients

Pancreatic cancer is one of the most lethal solid tumors. In many European countries gemcitabine plus nab-paclitaxel is the preferred first-line treatment. An increasing number of patients are eligible for second-line therapy, but the best regimen is still controversial. This study aimed to evaluate the efficacy of oxaliplatin-based compared to irinotecan-based therapies in this setting. 181 advanced pancreatic cancer patients consecutively treated in three centers with a second-line therapy progressed on gemcitabine plus nab-paclitaxel were retrospectively enrolled. OS and PFS were calculated using the Kaplan-Meier method and survival of the two groups was compared using the log-rank test. The median PFS and OS were respectively 3.5 (95%CI 3.2–3.8) and 8.8 months (95%CI 7.9–9.8) from second-line therapy in the overall population. The median PFS and OS were respectively 3.3 (95%CI 3.1–3.5) and 8.2 months (95%CI 7.24–9.34) with an irinotecan-based combination compared to 4.0 (95%CI 2.4–5.7) and 10.3 months (95%CI 8.62–12.02) in patients receiving an oxaliplatin-based combination. We observed a clear trend for longer survival outcomes with platinum-based doublet compared to regimens including irinotecan or nal-IRI. Head-to-head trials are still lacking. The neutrophil-to-lymphocyte ratio and the presence of liver metastases could drive physicians in tailoring the treatment strategy.

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P31-7 Clinical outcomes of cerebral infarction associated with Trousseau’s syndrome in advanced pancreatic cancer patients

Annals of Oncology ◽

10.1016/j.annonc.2021.05.748 ◽

2021 ◽

Vol 32 ◽

pp. S350

Author(s):

Tomoyo Oguri ◽

Hiroyuki Takeda ◽

Kumiko Umemoto ◽

Ayako Doi ◽

Hiroyuki Arai ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cerebral Infarction ◽

Cancer Patients ◽

Clinical Outcomes ◽

Advanced Pancreatic Cancer ◽

Trousseau’S Syndrome

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Failure patterns and outcomes of dose escalation of stereotactic body radiotherapy for locally advanced pancreatic cancer: a multicenter cohort study

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835920977155 ◽

2020 ◽

Vol 12 ◽

pp. 175883592097715

Author(s):

Xiaofei Zhu ◽

Yangsen Cao ◽

Tingshi Su ◽

Xixu Zhu ◽

Xiaoping Ju ◽

...

Keyword(s):

Pancreatic Cancer ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Progression Free Survival ◽

Locally Advanced Pancreatic Cancer ◽

Multicenter Cohort Study ◽

Failure Patterns ◽

Kaplan Meier ◽

Prescription Dose ◽

Contrast Ct

Objective: This study aims to compare recurrence patterns and outcomes of biologically effective dose (BED10, α/β = 10) of 60–70 Gy with those of a BED10 >70 Gy for locally advanced pancreatic cancer (LAPC). Methods: Patients from three centers with a biopsy and a radiographically proven LAPC were retrospectively included and data were prospectively collected from June 2012 to June 2019. Radiotherapy was delivered by stereotactic body radiation therapy. Recurrences were categorized as in-field, marginal, and outside-the-field recurrence. Patients in two groups were required to receive abdominal enhanced contrast CT or MRI every 2–3 months and CA19-9 examinations every month during follow-up. Treatment-related toxicities were evaluated every month. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Results: After propensity score matching, there were 486 patients in each group. The median prescription dose of the two groups was 37 Gy/5–8 f (range: 36–40.8 Gy/5–8 f) and 42 Gy/5–8 f (range: 40–49.6 Gy/5–8 f), respectively. The median OS of patients with a BED10 >70 Gy and a BED10 60–70 Gy was 20.3 months (95% CI: 19.1–21.5 months) and 18.2 months (95% CI: 17.8–18.6 months) respectively ( p < 0.001). The median PFS of the two cohorts was 15.4 months (95% CI: 14.2–16.6 months) and 13.3 months (95% CI: 12.9–13.7 months) respectively ( p < 0.001). A higher incidence of in-field and marginal recurrence was found in patients with BED10 of 60–70 Gy (in-field: 97/486 versus 72/486, p = 0.034; marginal: 109/486 versus 84/486, p = 0.044). However, more patients with BED10 >70 Gy had grade 2 or 3 acute (87/486 versus 64/486, p = 0.042) and late gastrointestinal toxicities (77/486 versus 55/486, p = 0.039) than those with BED10 of 60–70 Gy. Conclusion: BED10 >70 Gy was found to have the best survival benefits along with a higher incidence of acute and late gastrointestinal toxicities. Therefore, a higher dose may be required in the case of patients’ good tolerance.

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2315 A phase Ib study of the FGFR/VEGFR inhibitor dovitinib (D) combined with gemcitabine (G) and Capecitabine (C) in advanced pancreatic cancer patients

European Journal of Cancer ◽

10.1016/s0959-8049(16)31231-x ◽

2015 ◽

Vol 51 ◽

pp. S438 ◽

Cited By ~ 2

Author(s):

W.W. Ma ◽

G. Fetterly ◽

C. LeVea ◽

Y. Zhao ◽

G.K. Dy ◽

...

Keyword(s):

Pancreatic Cancer ◽

Cancer Patients ◽

Advanced Pancreatic Cancer ◽

Phase Ib ◽

Vegfr Inhibitor

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Efficacy of mistletoe extract as a complement to standard treatment in advanced pancreatic cancer: study protocol for a multi-centre, parallel group, double-blind, randomised controlled clinical trial (MISTRAL)

10.21203/rs.3.rs-21825/v1 ◽

2020 ◽

Author(s):

Kathrin Wode ◽

Johanna Hök Nordberg ◽

Gunver Sophia Kienle ◽

Nils Elander ◽

Britt-Marie Bernhardson ◽

...

Keyword(s):

Quality Of Life ◽

Pancreatic Cancer ◽

Overall Survival ◽

Cancer Patients ◽

Advanced Pancreatic Cancer ◽

Health Related Quality ◽

Mistletoe Extract ◽

Related Quality ◽

Health Related

Abstract Background Most pancreatic cancer patients present with advanced stage at diagnosis with extremely short expected survival and few treatment options. A multimodal palliative approach is necessary for symptom relief and optimisation of health-related quality of life. In a recent open-label trial of mistletoe extract for advanced pancreatic cancer patients not eligible for chemotherapy, promising results on improved overall survival and better health-related quality of life were reported. The objective of the present study is to assess the value of mistletoe extract as a complement to standard 18 treatment (palliative chemotherapy or best supportive care) in advanced pancreatic cancer patients with 19 regard to overall survival and health-related quality of life. Methods The trial is prospective, randomised, double-blind, multicentre, parallel group and placebo-controlled. In total 290 participants are randomly assigned to placebo or mistletoe extract given subcutaneously in increasing dosage from 0.01mg to 20mg three times per week for nine months. Stratification is performed for site and palliative chemotherapy. Main inclusion criteria are advanced pancreatic cancer and Eastern Cooperative Oncology Group performance status zero to two; main exclusion criteria are life expectancy less than four weeks and neuroendocrine tumour of the pancreas. Two ancillary studies on sub-sets of participants are nested in the trial: a biomarker study collecting blood samples and a cross-sectional qualitative study with semi-structured face-to-face interviews. Discussion To our knowledge, this is the first placebo-controlled randomised trial assessing the impact of mistletoe extract as a complement to standard treatment on overall survival and health-related quality of life in patients with advanced pancreatic cancer. The presented trial with its two nested ancillary studies exploring biomarkers and patient experiences is expected to give new insights into the treatment of advanced pancreatic cancer. Trial registration EU Clinical Trial Register, EudraCT Number 2014-004552-64. Registered 19 January 2016, https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-004552-64/SE

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Neoadjuvant radiation followed by resection versus upfront resection for locally advanced pancreatic cancer patients: a propensity score matched analysis

Oncotarget ◽

10.18632/oncotarget.18091 ◽

2017 ◽

Vol 8 (29) ◽

pp. 47831-47840 ◽

Cited By ~ 3

Author(s):

Xing Chen ◽

Geng Liu ◽

Kaiqiang Wang ◽

Guodong Chen ◽

Jinjin Sun

Keyword(s):

Pancreatic Cancer ◽

Propensity Score ◽

Cancer Patients ◽

Locally Advanced ◽

Advanced Pancreatic Cancer ◽

Locally Advanced Pancreatic Cancer

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Integrated immune-related gene signature to predict clinical outcome for patients with luminal B breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e12526 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e12526-e12526

Author(s):

Xiaying Kuang ◽

Du Cai ◽

Ying Lin ◽

Feng Gao

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Validation Cohort ◽

Risk Groups ◽

Gene Signature ◽

Breast Cancer Patients ◽

Training Cohort ◽

Luminal B ◽

Immune Related Gene ◽

Immune Related Genes

e12526 Background: Luminal B breast cancer is always routinely treated with chemotherapy and endocrine therapy but heterogeneous with respect to sensitivity to treatment, identification of patients who may most benefit remains a matter of controversy. Immune-related genes (IRGs) was found to be associated with the prognosis of breast cancer. The aim of this study is to evaluate the impact of IRGs in predicting the outcome of luminal B breast cancer patients. Methods: According to the Metabric microarray dataset also as a training cohort, 488 luminal B breast cancer patients were selected for generation of immune-related gene signature (IRGS). Another independent dataset (n=250) of patients with complete prognostic information was analyzed as a validation cohort. Prognostic analysis was assessed to test the predictive value of IRGS. Results: A model of prognostic IRGS containing 12 immune-related genes was developed. In both training and validation cohorts, IRGS significantly stratified luminal B breast cancer patients into immune low- and high-risk groups in terms of disease free survival (DFS, HR=4.95, 95% CI=3.22-7.62, P<0.001 in training cohort, HR=2.47, 95% CI=1.29-4.75, P<0.001 in validation cohort). Multivariate analysis revealed IRGS as an independent prognostic factor (HR=4.96, 95% CI=3.00-8.18, P<0.001 in training cohort, HR=2.56, 95% CI=1.28-5.09, P=0.007 in validation cohort). Furthermore, those 12 genes mostly related with response to chemical, and the expression levels of them were completely opposite in patients of immune low- and high-risk groups. Conclusions: The proposed IRGS is a satisfactory prognostic model for estimating DFS of luminal B breast cancer patients. Further studies are needed to assess the clinical effectiveness of this system in predicting prognosis and treatment options for luminal B breast cancer patients. This work was supported by National Natural Science Foundation of China (No. 81602520), Natural Science Foundation of Guangdong Province (No. 2017A030313596).

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