There is increasing interest in the use of adjuvant treatment for pancreatic cancer since although postoperative mortality is much improved, median long-term survival is only on the order of 11–15 mo. Despite a proliferation of studies in advanced pancreatic cancer indicating a benefit for chemotherapy, there has only been one small randomized adjuvant trial. A combination of 5-fluorouracil, doxorubicin, and mitomycin-C demonstrated a significantly improved median survival (23 vs 11 mo in controls) but no significant improvement in 5-yr survival (4 vs 8%, respectively). At present there is insufficient evidence to support the routine use of adjuvant chemotherapy (even with radiotherapy) outside of controlled trials. What is required is large randomized trials of adjuvant chemotherapy. A further important question that needs addressing is the role of adjuvant radiotherapy (with concomitant chemotherapy) with or without sequential chemotherapy.
#1Giampaolo Perri(University of Texas MD Anderson Cancer Center)H-Index: 9
#2Laura R. Prakash(University of Texas MD Anderson Cancer Center)H-Index: 15
Last. Matthew H.G. Katz(University of Texas MD Anderson Cancer Center)H-Index: 66
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Importance Fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) and gemcitabine plus nanoparticle albumin-bound (nab)–paclitaxel (GA) are first-line chemotherapy regimens for pancreatic cancer. Their relative efficacy in the setting of localized disease is unknown. Objective To evaluate radiographic and serologic measures of responses associated with first-line chemotherapy with FOLFIRINOX or GA, and to determine the association between these drug regimens, putative measures of res...
4505Background: Patients with borderline resectable pancreatic cancer have poor survival and low resection rates. Neoadjuvant therapy may improve the outcome for these patients. The aim of this tri...
4504Background: Clinical outcomes after curative treatment of resectable PDA remain suboptimal. To assess the potential of early control of systemic disease with multiagent peri-op CTx, we conducte...
PURPOSEPreoperative chemoradiotherapy may improve the radical resection rate for resectable or borderline resectable pancreatic cancer, but the overall benefit is unproven.PATIENTS AND METHODSIn th...
Background and aims The role of GATA factors in cancer has gained increasing attention recently, but the function of GATA6 in pancreatic ductal adenocarcinoma (PDAC) is controversial. GATA6 is amplified in a subset of tumours and was proposed to be oncogenic, but high GATA6 levels are found in well-differentiated tumours and are associated with better patient outcome. By contrast, a tumour-suppressive function of GATA6 was demonstrated using genetic mouse models. We aimed at clarifying GATA6 fun...
PurposeGemcitabine is standard of care in the adjuvant treatment of resectable pancreatic ductal adenocarcinoma (PDAC). The epidermal growth factor receptor tyrosine kinase inhibitor erlotinib in combination with gemcitabine has shown efficacy in the treatment of advanced PDAC and was considered to improve survival in patients with primarily resectable PDAC after R0 resection.Patients and MethodsIn an open-label, multicenter trial, patients were randomly assigned to one of two study arms: gemcit...
PurposeTo update the Potentially Curable Pancreatic Cancer: American Society of Clinical Oncology Clinical Practice Guideline published on May 31, 2016. The October 2016 update focuses solely on new evidence that pertains to clinical question 4 of the guideline: What is the appropriate adjuvant regimen for patients with pancreatic cancer who have undergone an R0 or R1 resection of their primary tumor?MethodsThe recently published results of a randomized phase III study prompted an update of this...
Summary Background The ESPAC-3 trial showed that adjuvant gemcitabine is the standard of care based on similar survival to and less toxicity than adjuvant 5-fluorouracil/folinic acid in patients with resected pancreatic cancer. Other clinical trials have shown better survival and tumour response with gemcitabine and capecitabine than with gemcitabine alone in advanced or metastatic pancreatic cancer. We aimed to determine the efficacy and safety of gemcitabine and capecitabine compared with gemc...
#1Werner Hartwig(LMU: Ludwig Maximilian University of Munich)H-Index: 50
#2Alexander Gluth(LMU: Ludwig Maximilian University of Munich)H-Index: 5
Last. M.W. Büchler(Heidelberg University)H-Index: 79
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Background In the recent International Study Group of Pancreatic Surgery (ISGPS) consensus on extended pancreatectomy, several issues on perioperative outcome and long-term survival remained unclear. Robust data on outcomes are sparse. The present study aimed to assess the outcome of extended pancreatectomy for borderline resectable and locally advanced pancreatic cancer. Methods A consecutive series of patients with primary pancreatic adenocarcinoma undergoing extended pancreatectomies, as defi...
Summary Chemotherapy is an important part of multimodality pancreatic cancer treatment. After curative resection, adjuvant chemotherapy can significantly improve disease free survival and overall survival. The current standard of care is six months adjuvant chemotherapy with modified folinic acid, 5-fluorouracil, irinotecan and oxaliplatin (mFOLFIRINOX) in patients fit enough for this protocol, otherwise six months of gemcitabine and capecitabine based on the European Study Group for Pancreatic ...