Pancreatic Cancer Literature Review

Crafting a comprehensive literature review on pancreatic cancer is undoubtedly a challenging task.

Pancreatic cancer is a complex disease with multifaceted etiology, pathogenesis, diagnosis, and
treatment modalities. From exploring the molecular mechanisms underlying tumor initiation and
progression to evaluating the efficacy of various therapeutic interventions, a literature review must
cover a wide array of topics to provide a holistic understanding of the subject matter.

Navigating through the ever-expanding body of literature on pancreatic cancer requires not only time
and effort but also a keen eye for critical analysis and interpretation. Identifying relevant studies,
extracting key findings, and discerning between conflicting evidence are essential components of the
literature review process.

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J Clin Oncol. 2020;38(15 suppl):Abstract TPS4672. Studies have shown that resection of metastases
is of proven benefit in some types of tumors. B 31 For patients with locally advanced or metastatic
pancreatic cancer, chemoradiotherapy with gemcitabine provides clinical benefit and modest survival
improvement (two to three months). FOLFIRINOX versus gemcitabine for metastatic pancreatic
cancer. J Clin Oncol. 2021;39(15 suppl):Abstract TPS4174. The decision on resectability requires
multidisciplinary consultation. Some studies have addressed the use of chemoradiation with or
without chemotherapy to convert unresectable disease status to resectable. Modified FOLFIRINOX
as a second-line therapy following gemcitabine plus nab-paclitaxel therapy in metastatic pancreatic
cancer. In this section we explain what clinical trials are, what they involve and how to find a
clinical trial. All guidelines were reviewed for evidence of potential conflict, which might influence
the recommendation as well as the use of an evidence-based approach. A person viewing it online
may make one printout of the material and may use that printout only for his or her personal, non-
commercial reference. Phase 2 trial of oxaliplatin plus capecitabine (XELOX) as second-line therapy
for patients with advanced pancreatic cancer. Cancer. 2008;113:2046-2052. In patients with recurrent
disease, salvage chemotherapy has either limited or conflicting data. Stereotactic radiotherapy for
unresectable adenocarcinoma of the pancreas. Cancer. 2009;115(3):665-672. Risk factors include
family history, smoking, chronic pancreatitis, obesity, diabetes mellitus, heavy alcohol use, and
possible dietary factors. Concurrent chemoradiation was delivered 5 times weekly during cycles 2
and 3, followed by a 3-week treatment break before cycle 4. You can find some suggested questions
to ask your doctor or nurse later in this section. Value of three-dimensional reconstructions in
pancreatic carcinoma using multidetector CT: initial results. But the new treatments may not be any
better than the treatments that are already available. For patients with locally advanced or metastatic
disease, chemoradiotherapy with gemcitabine or irinotecan provides clinical benefit and modest
survival improvement. He is a member of several surgical societies (European Surgical Association;
European Society for Surgical Oncology; Society for Surgical Oncology; International Surgical
Society, Society for Surgery of the Alimentary tract; the European and international HPB societies
EAHPBA, IHPBA and more). He has published more than 40 papers on HPB topics and givenm
numerous lectures around the world on the same. Serological and immunohistochemical findings.
Pancreas. 1987;2(4):398-403. Relevant perioperative management strategies and emerging themes in
cancer biology critical to understanding and treating the disease are also described. Subcutaneous
areas of nodular fat necrosis (pancreatic panniculitis) may be evident in rare cases. 13. Different
regimens or schedules combining oxaliplatin, fluorouracil, and leucovorin, such as the OFF and
FOLFOX regimens, have been used but show conflicting efficacy data between the phase 3
CONKO-003 and PANCREOX trials. 17,18. Best Pract Res Clin Gastroenterol. 2010;24(3):337-
347. In symptomatic patients, it can help confirm the diagnosis and predict prognosis and recurrence
after resection. 3 However, cancer antigen 19-9 is not tumor-specific; therefore, it is not a sufficient
individual screening tool for asymptomatic patients. Hall, PharmD, FCCP, BCPS, BCOP JHOP -
June 2019 Vol 9, No 2 published on April 28, 2022 in Review Article A Review of CAR T-Cell
Therapies Approved for the Treatment of Relapsed and Refractory B-Cell Lymphomas Drew A.
Download PDF BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) accounts for the vast
majority of cases of pancreatic cancer and is a lethal cancer that is often diagnosed as late-stage
disease with a historically poor prognosis, as reflected in its status as the third leading cause of
cancer-related deaths in the United States.
This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in
any medium, whether now known or later invented, except as authorized in writing by the AAFP.
However, there is no established standard dosage of radiation regimen for either of these techniques.
34 The decision on whether to choose up-front chemoradiation or induction chemotherapy followed
by consolidation chemoradiation should be based on disease response and patient tolerance. Adapted
with permission from Edge SB, American Joint Committee on Cancer. Keywords for search included
pancreatic cancer, pancreatic cancer diagnosis, and pancreatic cancer treatment. Although surgical
resection is the only potentially curative treatment for pancreatic ductal adenocarcinomas, less than
20% of surgical candidates survive five years. VCN-01 disrupts pancreatic cancer stroma and exerts
antitumor effects. He has been the editor of the Br J Surgery since 2010, one of the world most
premier surgical journals. Some studies have addressed the use of chemoradiation with or without
chemotherapy to convert unresectable disease status to resectable. A phase 1 dose-escalation study in
34 patients with unresectable, locally advanced PDAC analyzed the use of oral adavosertib as first-
line treatment in combination with gemcitabine and radiation therapy. 59. Studies have shown that
resection of metastases is of proven benefit in some types of tumors. Kedzior, PharmD, YoungYoon
Ham, PharmD, Joseph Bubalo, PharmD, BCPS, BCOP JHOP - April 2021 Vol 11, No 2 published
on April 27, 2021 in Review Article, Adverse Events, Antibiotics, Drug Resistance Chemotherapy
Administration Sequencing: An Update on the Current Literature Alanna D. B 31 For patients with
locally advanced or metastatic pancreatic cancer, chemoradiotherapy with gemcitabine provides
clinical benefit and modest survival improvement (two to three months). You can also find open
trials in the UK on our Clinical Trial Finder. NAPOLI-1 phase 3 study of liposomal irinotecan in
metastatic pancreatic cancer: final overall survival analysis and characteristics of long-term survivors.
Single agents under investigation are often combined with standard chemotherapy in the treatment of
locally advanced or metastatic PDAC. Increased survival in pancreatic cancer with nab-paclitaxel
plus gemcitabine. They help to improve future pancreatic cancer treatments and medical knowledge.
Importance of hospital volume in the overall management of pancreatic cancer. Ann Surg.
1998;228(3):429-438. Dose escalation trial of the Wee1 inhibitor adavosertib (AZD1775) in
combination with gemcitabine and radiation for patients with locally advanced pancreatic cancer.
Risk factors include family history, smoking, chronic pancreatitis, obesity, diabetes mellitus, heavy
alcohol use, and possible dietary factors. Error: Try Again Ok Sell Watchlist Expand Watch List
Loading. A 69-year-old female was evaluated for continuous epigastric pain and anorexia over the
last three months. The Precision Promise adaptive clinical trial platform is an innovative and
efficient approach to testing multiple novel therapies simultaneously. Value of three-dimensional
reconstructions in pancreatic carcinoma using multidetector CT: initial results. Cancer antigen 19-9
has a limited sensitivity of 50% to 75% and specificity of 80% to 85%; it cannot distinguish between
cancer and chronic pancreatitis and possibly other disease states with chronic inflammation. 17.
Lancet Oncol. 2017;18:1182-1191. Erratum in: Lancet Oncol. 2017;18:510. For patients with locally
advanced or metastatic disease, chemoradiotherapy with gemcitabine or irinotecan provides clinical
benefit and modest survival improvement. FOLFIRINOX versus gemcitabine for metastatic
pancreatic cancer. Nivolumab plus ipilimumab versus sunitinib in advanced renal-cell carcinoma.
They aim to find better treatments that can help people live longer and improve the quality of their
daily life.
They can also look at what may increase the risks of getting pancreatic cancer, how to prevent it and
find better ways to diagnose it. Patients may present in early stages with normal examination
findings or in advanced stages with manifestations of liver involvement such as abdominal
tenderness, jaundice, and cachexia. J Clin Oncol. 2020;38(15 suppl):Abstract TPS4672. Doz
Innsbruck, Austria; Department of Visceral, Transplantation and Thoracic Surgery, Medical
University of Innsbruck, Innsbruck, Austria. Pancreatic cancer. Lancet. 2004;363(9414):1049-1057.
CASE REPORT A 58-year-old female underwent an emergency left hemicolectomy for an
obstructing descending colon growth. Occupational exposures and pancreatic cancer: a meta-
analysis. For patients with locally advanced or metastatic disease, chemoradiotherapy with
gemcitabine or irinotecan provides clinical benefit and modest survival improvement. First-in-human
phase 1 dose-escalation study of CAN04, a first-in-class interleukin-1 receptor accessory protein
(IL1RAP) antibody in patients with solid tumours. Overall survival with combined nivolumab and
ipilimumab in advanced melanoma. A greater proportion of patients who received pamrevlumab were
eligible for surgical exploration and had resection compared with those who received only standard
chemotherapy. 88. Engineering a smart agent for enhanced immunotherapy effect by simultaneously
blocking PD-L1 and CTLA-4. Ms Ganjam is a BS Candidate, Rutgers University; Dr Ahmed is
Clinical Staff Pharmacist, University of Florida Health Shands Children’s Hospital, Gainesville, FL.
N Engl J Med. 2017;377:1345-1356. Erratum in: N Engl J Med. 2018;379:2185. You can find some
suggested questions to ask your doctor or nurse later in this section. RNAi therapy targeting KRAS
in combination with chemotherapy for locally advanced pancreatic cancer patients. Therefore, these
syndromes account for 10% or less of pancreatic cancers. 4. JHOP - August 2023 Vol 13, No 4
published on August 17, 2023 in Review Article Comparison of Second-Generation Antiandrogens
for the Treatment of Prostate Cancer Seon Jo Park, PharmD, BCOP, Benjamin Yoder, PharmD,
Tammy Li, PharmD JHOP - April 2022 Vol 12, No 2 published on May 3, 2022 in Review Article,
Prostate Cancer, Antiandrogens Blinatumomab: A Step Forward in the Treatment of B-Cell Precursor
Acute Lymphoblastic Leukemia Lauren Drawdy, PharmD, Lee Ann Jones, PharmD, MBA, Philip D.
Combinations of immunotherapies that target the programmed cell death (PD)-1 or PD ligand 1 are
being explored in the induction and maintenance settings. Accessibility, User Agreement, Privacy,
Payments Terms of Use, Cookies, CA Privacy Notice, Your Privacy Choices and AdChoice. The
effects of regionalization on clinical outcomes for a high risk surgical procedure: a study of the
Whipple procedure in New York State. FOLFIRI as second-line chemotherapy for advanced
pancreatic cancer: a GISCAD multicenter phase II study. In familial pancreatic cancer, two or more
first-degree relatives have pancreatic cancer in the absence of other cancer syndromes or other
known genetic defects. Pancreatic enzyme replacement therapy in chronic pancreatitis. We hope for
future data that will signal improved survival benefits for patients with PDAC and await a new
breakthrough therapy to change clinical practice. Maintenance olaparib for germline BRCA-mutated
metastatic pancreatic cancer. The KRASG12C inhibitor MRTX849 provides insight toward
therapeutic susceptibility of KRAS-mutant cancers in mouse models and patients. VCN-01 is a
genetically modified oncolytic adenovirus that selectively replicates within tumor cells that carry
mutations in the retinoblastoma tumor suppressor protein. 63 A phase 1 dose-escalation study in 8
patients with unresectable, locally advanced or metastatic PDAC analyzed an intratumoral injection
of VCN-01 in conjunction with nab-paclitaxel plus gemcitabine as first-line treatment. 63. Keywords
for search included pancreatic cancer, pancreatic cancer diagnosis, and pancreatic cancer treatment.
Advances in counseling and surveillance of patients at risk for pancreatic cancer. Gut.
2007;56(10):1460-1469.
But the new treatments may not be any better than the treatments that are already available. This
approval was based on the phase 3 MPACT study of 861 patients with metastatic pancreatic cancer
who were randomized to nab-paclitaxel plus gemcitabine or to gemcitabine monotherapy. 10 The
combination regimen showed improvement in median OS (8.5 months vs 6.7 months, respectively;
HR, 0.72; 95% CI, 0.62-0.83; P P P 10. It remains the fourth leading cause of cancer-related deaths.
1 The age-adjusted annual incidence rates of pancreatic cancer in men and women have been slowly
increasing, but it remains an uncommon cancer. The mesenchymal metastatic cancer to the pancreas
has been a case of pleomorphic sarcoma of retroperitoneum. FOLFIRINOX versus gemcitabine for
metastatic pancreatic cancer. The need for cross-discipline collaboration to facilitate and enhance
innovation within the discipline is reinforced throughout the text. Pang, PharmD; Valassia Antigone
Theocharides; Yuxi Lei; Shivani K. The patient died 16 months after the diagnosis of pancreatic
cancer and 12 months after the diagnosis of rectal cancer. Pretreatment assessment of resectable and
borderline resectable pancreatic cancer: expert consensus statement. Overall survival with combined
nivolumab and ipilimumab in advanced melanoma. Radiochemotherapy in the management of
pancreatic cancer—part I: neoadjuvant treatment. Lancet Oncol. 2020;21:271-282. Errata in: Lancet
Oncol. 2020;21:e70; Lancet Oncol. 2020;21:e341; Lancet Oncol. 2020;21:e372; Lancet Oncol.
2021;22:e428. He is chairing several symposia on surgical oncology topics and is currently on the
education and training comittees of both the EAHPBA and ESSO (the European societies for HPB
surgery and Surgical Oncology). We hope for future data that will signal improved survival benefits
for patients with PDAC and await a new breakthrough therapy to change clinical practice. A case of
colonic metastasis to the pancreas is reported and the literature is reviewed to assess the role and
outcome of pancreatic resection for metastatic tumors from colorectal malignancy. A CT scan
revealed a 6.8x4.8 cm mixed consistency lesion in the tail of the pancreas which, on fine needle
aspiration cytology, was confirmed to be adenocarcinoma. Chaplaincy services should be offered to
patients whose spirituality and religion play an important role. 43. The therapeutic approaches
currently in early-phase development for PDAC include dual immune checkpoint inhibition,
monoclonal antibodies, cellular therapy, oncolytic adenoviruses, oligonucleotides, and multiple small-
molecule inhibitors. Subcutaneous areas of nodular fat necrosis (pancreatic panniculitis) may be
evident in rare cases. 13. Download Free PDF View PDF Synchronous Pancreatic and Rectal
Carcinoma in the Same Patient: Case Report and Review of the Literature Fortune Journals We
report a patient with an exceptionally rare combination of synchronous pancreatic and rectal cancer
diagnosed within a 4 months' interval. Expert opinion recommends screening and surveillance with
computed tomography (CT) or endoscopic ultrasonography. 8. Hall, PharmD, FCCP, BCPS, BCOP
JHOP - June 2019 Vol 9, No 2 published on April 28, 2022 in Review Article A Review of CAR T-
Cell Therapies Approved for the Treatment of Relapsed and Refractory B-Cell Lymphomas Drew A.
C 14, 15 The decision on resectability requires multidisciplinary consultation, and distinction should
be made between tumors that are resectable, borderline resectable, or unresectable. Our report is the
first study about pancreatic metastatic tumors from Iran. Engineering a smart agent for enhanced
immunotherapy effect by simultaneously blocking PD-L1 and CTLA-4. PD ligand 1 (PD-L1)
expression in the entire patient population was scarce, and approximately 52% of all patients had
previously received second-line or later treatment. Patients may present in early stages with normal
examination findings or in advanced stages with manifestations of liver involvement such as
abdominal tenderness, jaundice, and cachexia. Lehman, PharmD, BCOP, Anna Howard, PharmD,
BCOP, Robert Mancini, PharmD, BCOP, FHOPA JHOP - December 2019 Vol 9, No 4 published on
December 13, 2019 in Review Article. Once a mass is identified and fine-needle aspiration confirms
the diagnosis, endoscopic ultrasonography can determine tumor size and extent of lymph node
metastases, and assess for portal venous system involvement to complete staging. 3 In addition to
endoscopic ultrasonography, chest CT and serum liver enzyme tests are useful to determine if a
patient is a candidate for surgery. 3 Diagnostic staging laparoscopy can be considered for detection
of occult peritoneal metastases. Maintenance olaparib for germline BRCA-mutated metastatic
pancreatic cancer.
Management of pancreatic ductal adenocarcinomas should be approached from a multidisciplinary
stance, with consideration of enrollment in clinical studies, and with goals of care and palliation
routinely reassessed. The lesion was reported to be adenocarcinoma, Dukes C, with involvement of
the serosa and 3 lymph nodes. Ms Ganjam is a BS Candidate, Rutgers University; Dr Ahmed is
Clinical Staff Pharmacist, University of Florida Health Shands Children’s Hospital, Gainesville, FL.
C 14, 15 The decision on resectability requires multidisciplinary consultation, and distinction should
be made between tumors that are resectable, borderline resectable, or unresectable. Doz Innsbruck,
Austria; Department of Visceral, Transplantation and Thoracic Surgery, Medical University of
Innsbruck, Innsbruck, Austria. A 69-year-old female was evaluated for continuous epigastric pain
and anorexia over the last three months. KRYSTAL-1: updated activity and safety of adagrasib
(MRTX849) in patients (Pts) with unresectable or metastatic pancreatic cancer (PDAC) and other
gastrointestinal (GI) tumors harboring a KRASG12C mutation. Nanoliposomal irinotecan with
fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy
(NAPOLI-1): a global, randomised, open-label, phase 3 trial. Lancet. 2016;387:545-557. Erratum in:
Lancet. 2016;387:536. Our report is the first study about pancreatic metastatic tumors from Iran.
Risk factors include family history, smoking, chronic pancreatitis, obesity, diabetes mellitus, heavy
alcohol use, and possible dietary factors. Postresection, these patients have survival rates similar to
those with disease initially determined to be resectable. 3. Pancreatic enzyme replacement therapy in
chronic pancreatitis. Cancer antigen 19-9 has a limited sensitivity of 50% to 75% and specificity of
80% to 85%; it cannot distinguish between cancer and chronic pancreatitis and possibly other
disease states with chronic inflammation. 17. Adapted with permission from Edge SB, American
Joint Committee on Cancer. In some patients who have good performance status (i.e., adequate
nutrition and pain control and patent biliary stent), some effect on survival may be achieved.
Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic
cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. Results: For
the duration of 5 years in our center, there were 131 cases of pancreatic tumors with different
diagnoses, 9 of which were diagnosed as metastatic cancers from other organs. JHOP - August 2023
Vol 13, No 4 published on August 17, 2023 in Review Article Comparison of Second-Generation
Antiandrogens for the Treatment of Prostate Cancer Seon Jo Park, PharmD, BCOP, Benjamin Yoder,
PharmD, Tammy Li, PharmD JHOP - April 2022 Vol 12, No 2 published on May 3, 2022 in Review
Article, Prostate Cancer, Antiandrogens Blinatumomab: A Step Forward in the Treatment of B-Cell
Precursor Acute Lymphoblastic Leukemia Lauren Drawdy, PharmD, Lee Ann Jones, PharmD, MBA,
Philip D. Improved hospital morbidity, mortality, and survival after the Whipple procedure. Ann
Surg. 1987;206(3):358-365. Each chapter presents the relevant current clinical standards along with
areas of controversy in both research and clinical practice within “pearls and pitfalls” sections. Mark
H. Mansour; Meghana K. Ganjam; Jennifer Ahmed, PharmD Dr Pang is Associate Oncology
Scientist and Medical Writer, National Comprehensive Cancer Network, Plymouth Meeting, PA.
Chaplaincy services should be offered to patients whose spirituality and religion play an important
role. 43. Patients with a life expectancy longer than three to six months can receive an open or
laparoscopic gastrojejunostomy with or without a jejunostomy tube, but an enteral stent is also an
option. 39, 40. Multicenter randomized phase III trial comparing protracted venous infusion (PVI)
fluorouracil (5-FU) with PVI 5-FU plus mitomycin in inoperable pancreatic cancer. J Clin Oncol.
2020;38(15 suppl):Abstract TPS4672. The median OS was 15.1 months (95% CI, 10.2-18.4) and the
18-month OS was 38.5%. 81. Value of three-dimensional reconstructions in pancreatic carcinoma
using multidetector CT: initial results. Immune-mediated adverse events occurred more often with
nivolumab plus ipilimumab than with nivolumab monotherapy in other disease states, including
unresectable melanoma, 42 NSCLC, 43-45 renal-cell carcinoma, 46,47 hepatocellular carcinoma,
48,49 and colorectal cancer. 50,51 Across multiple studies, the incidence of high-grade immune-
mediated adverse events with combination therapy was more than double that of nivolumab
monotherapy within the same disease state. 42,45,47,49,51. Engineering a smart agent for enhanced
immunotherapy effect by simultaneously blocking PD-L1 and CTLA-4. Therefore, these syndromes
account for 10% or less of pancreatic cancers. 4.
A digital rectal examination revealed the presence of a mass starting 7-8cm from the anal margin.
Single agents under investigation are often combined with standard chemotherapy in the treatment of
locally advanced or metastatic PDAC. Brand RE, Lerch MM, Rubinstein WS, et al.; Participants of
the Fourth International Symposium of Inherited Diseases of the Pancreas. Although surgical
resection is the only potentially curative treatment for pancreatic ductal adenocarcinomas, less than
20% of surgical candidates survive five years. No differences in morbidity, mortality, or survival
between the two procedures have been found. 27. Monoclonal antibodies are increasingly of interest
in solid tumors, and PDAC can serve as its own cohort in basket trials. JHOP - August 2023 Vol 13,
No 4 published on August 17, 2023 in Review Article Comparison of Second-Generation
Antiandrogens for the Treatment of Prostate Cancer Seon Jo Park, PharmD, BCOP, Benjamin Yoder,
PharmD, Tammy Li, PharmD JHOP - April 2022 Vol 12, No 2 published on May 3, 2022 in Review
Article, Prostate Cancer, Antiandrogens Blinatumomab: A Step Forward in the Treatment of B-Cell
Precursor Acute Lymphoblastic Leukemia Lauren Drawdy, PharmD, Lee Ann Jones, PharmD, MBA,
Philip D. Phase 2 trial of oxaliplatin plus capecitabine (XELOX) as second-line therapy for patients
with advanced pancreatic cancer. Cancer. 2008;113:2046-2052. A case of colonic metastasis to the
pancreas is reported and the literature is reviewed to assess the role and outcome of pancreatic
resection for metastatic tumors from colorectal malignancy. Expert consensus recommends history
and physical examination every three to six months for two years, then annually. 44 Monitoring for
recurrence with cancer antigen 19-9 levels, CT, and endoscopic ultrasonography every three to six
months can also be considered, although there is limited evidence showing that earlier treatment
leads to improved patient outcomes. 45. Nine years after the colectomy during a routine follow-up,
there was a sudden rise in her CEA levels. Therefore, these syndromes account for 10% or less of
pancreatic cancers. 4. All guidelines were reviewed for evidence of potential conflict, which might
influence the recommendation as well as the use of an evidence-based approach. We suggest that
clinicians should be aware about the possibility of the existence of multiple primary tumors in the
same patient and subsequently to optimize their investigational plans. They can also look at what
may increase the risks of getting pancreatic cancer, how to prevent it and find better ways to
diagnose it. Dose escalation trial of the Wee1 inhibitor adavosertib (AZD1775) in combination with
gemcitabine and radiation for patients with locally advanced pancreatic cancer. NAPOLI-1 phase 3
study of liposomal irinotecan in metastatic pancreatic cancer: final overall survival analysis and
characteristics of long-term survivors. Three phase II trials have assessed up-front chemoradiation in
locally advanced cancer with median survival rates ranging from 8.2 to 9 months. 3. Overall survival
with combined nivolumab and ipilimumab in advanced melanoma. Magnetic resonance imaging, as
well as magnetic resonance cholangiopancreatography, can be performed as an adjunct to CT in
detecting extrapancreatic disease. 3. Kedzior, PharmD, YoungYoon Ham, PharmD, Joseph Bubalo,
PharmD, BCPS, BCOP JHOP - April 2021 Vol 11, No 2 published on April 27, 2021 in Review
Article, Adverse Events, Antibiotics, Drug Resistance Chemotherapy Administration Sequencing: An
Update on the Current Literature Alanna D. There is an unmet medical need in recurrent PDAC in
which only select populations are eligible to receive the preferred treatment, and salvage
chemotherapy has mixed or limited data. In this study, we retrieved all of the cases with the
diagnosis of secondary cancer of pancreas in the affiliated hospitals of Shiraz University of Medical
Sciences. Improved hospital morbidity, mortality, and survival after the Whipple procedure. Ann
Surg. 1987;206(3):358-365. A person viewing it online may make one printout of the material and
may use that printout only for his or her personal, non-commercial reference. Stent versus
gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. The lesion was
reported to be adenocarcinoma, Dukes C, with involvement of the serosa and 3 lymph nodes.
Because more than two-thirds of adenocarcinomas occur in the head of the pancreas, abdominal
pain, jaundice, pruritus, dark urine, and acholic stools may be presenting symptoms. In symptomatic
patients, the serum tumor marker cancer antigen 19-9 can be used to confirm the diagnosis and to
predict prognosis and recurrence after resection. This approval was based on the phase 3 MPACT
study of 861 patients with metastatic pancreatic cancer who were randomized to nab-paclitaxel plus
gemcitabine or to gemcitabine monotherapy. 10 The combination regimen showed improvement in
median OS (8.5 months vs 6.7 months, respectively; HR, 0.72; 95% CI, 0.62-0.83; P P P 10. Adapted
with permission from Edge SB, American Joint Committee on Cancer.
C 20 Pancreatic resections should be performed at institutions that complete at least 15 of these
surgeries annually. Pancreatic carcinoma: differences between patients with or without diabetes
mellitus. Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced
pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group.
But the new treatments may not be any better than the treatments that are already available. Cystic
lesions of the pancreas: challenging issues in clinical practice. They aim to find better treatments that
can help people live longer and improve the quality of their daily life. Overall survival with
combined nivolumab and ipilimumab in advanced melanoma. Negative margin status, tumor DNA
content, tumor size, and absence of lymph node metastasis are the strongest prognostic indicators for
long-term survival. 3. It is also unclear if SBRT potentiated the immune checkpoint blockade,
because SBRT was included in both treatment arms. 41. Therefore, it is crucial resource for all
practicing and trainee professionals who encounter these patients in their day-to-day clinical practice.
Insightful descriptions are then provided detailing how to perform critical surgical procedures when
treating these patients. KRASG12C inhibition with sotorasib in advanced solid tumors.
Subcutaneous areas of nodular fat necrosis (pancreatic panniculitis) may be evident in rare cases. 13.
Different regimens or schedules combining oxaliplatin, fluorouracil, and leucovorin, such as the OFF
and FOLFOX regimens, have been used but show conflicting efficacy data between the phase 3
CONKO-003 and PANCREOX trials. 17,18. Ms Ganjam is a BS Candidate, Rutgers University; Dr
Ahmed is Clinical Staff Pharmacist, University of Florida Health Shands Children’s Hospital,
Gainesville, FL. Pretreatment assessment of resectable and borderline resectable pancreatic cancer:
expert consensus statement. Some studies have addressed the use of chemoradiation with or without
chemotherapy to convert unresectable disease status to resectable. FOLFIRI regimen in metastatic
pancreatic adenocarcinoma resistant to gemcitabine and platinum-salts. In some patients who have
good performance status (i.e., adequate nutrition and pain control and patent biliary stent), some
effect on survival may be achieved. Randomized phase II study of nivolumab with or without
ipilimumab combined with stereotactic body radiotherapy for refractory metastatic pancreatic cancer
(CheckPAC). Download PDF BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC)
accounts for the vast majority of cases of pancreatic cancer and is a lethal cancer that is often
diagnosed as late-stage disease with a historically poor prognosis, as reflected in its status as the
third leading cause of cancer-related deaths in the United States. In familial pancreatic cancer, two or
more first-degree relatives have pancreatic cancer in the absence of other cancer syndromes or other
known genetic defects. However, there is no established standard dosage of radiation regimen for
either of these techniques. 34 The decision on whether to choose up-front chemoradiation or
induction chemotherapy followed by consolidation chemoradiation should be based on disease
response and patient tolerance. Each chapter presents the relevant current clinical standards along
with areas of controversy in both research and clinical practice within “pearls and pitfalls” sections.
Preliminary results of a phase 1 study of sea-CD40, gemcitabine, nab-paclitaxel, and pembrolizumab
in patients with metastatic pancreatic ductal adenocarcinoma (PDAC). KRYSTAL-1: updated
activity and safety of adagrasib (MRTX849) in patients (Pts) with unresectable or metastatic
pancreatic cancer (PDAC) and other gastrointestinal (GI) tumors harboring a KRASG12C mutation.
Systemic administration of the hyaluronidase-expressing oncolytic adenovirus VCN-01 in patients
with advanced or metastatic pancreatic cancer: first-in-human clinical trial. Ann Oncol.
2019;30(suppl 5):v271-v272. The need for cross-discipline collaboration to facilitate and enhance
innovation within the discipline is reinforced throughout the text. The effects of regionalization on
clinical outcomes for a high risk surgical procedure: a study of the Whipple procedure in New York
State. A phase 1 dose-escalation study in 34 patients with unresectable, locally advanced PDAC
analyzed the use of oral adavosertib as first-line treatment in combination with gemcitabine and
radiation therapy. 59.