ObjectiveTo analyze the efficacy of gemcitabine with or without erlotinib for pancreatic cancer, and to determine the predictive role of epidermal growth factor receptor (EGFR) and KRAS mutations in these patients.MethodsThis was a single-center, randomized, open-label, prospective trial. Eighty-eight chemotherapy-naïve metastatic pancreatic cancer patients were randomized for treatment with gemcitabine or gemcitabine plus erlotinib. EGFR and KRAS mutations were analyzed, respectively. The primary endpoint was the disease control rate.ResultsDisease control rate (64% vs. 25%; P < 0.001), progression-free survival (median 3.8 vs. 2.4 months; P < 0.001), and overall survival (median 7.2 vs. 4.4 months; P < 0.001) were better in the gemcitabine plus erlotinib group than in the gemcitabine alone group. In the gemcitabine plus erlotinib group, disease control (85% vs. 33%; P = 0.001), progression-free survival (median 5.9 vs. 2.4 months; P = 0.004), and overall survival (median 8.7 vs. 6.0 months; P = 0.044) were better in patients with EGFR mutations than in those without EGFR mutations. KRAS mutation was not associated with treatment response or survival.ConclusionsGemcitabine plus erlotinib is more effective than gemcitabine alone for treating metastatic pancreatic cancer patients, especially those with EGFR mutations. ClinicalTrials.gov number, NCT01608841.

Surgery is the main treatment for curing gastric cancer. Early diagnosis provides an excellent survival outcome via an improved detection of early gastric cancer and an improved resection rate. The extent of lymphadenectomy surgery has been under debate for a long time. In East Asian countries, especially Japan, Korea, and Taiwan, gastrectomy with D2 dissection is routinely performed. By contrast, in most Western countries, gastrectomy with D1 dissection is performed, due to lower mortality and morbidity. Recently, acceptance of D2 surgery has increased in Western countries because: (1) modified D2 lymphadenectomy (preservation of pancreas and spleen) improves operative morbidity and mortality; (2) Western surgeons can be trained to performed D2 lymph node dissection on Western patients safely; and (3) D2 resection decreases locoregional recurrence and prolongs survival. Current guidelines in the United States and Europe suggest modified D2 dissection is recommended, but needs to be performed by high-volume centers with experienced surgeons. Adjuvant or perioperative chemotherapy should be prescribed for gastric cancer with Stage II or III disease, due to its marked benefits of reducing disease recurrence and increasing long-term survival. Patients with inoperable advanced gastric cancer should receive chemotherapy to improve their survival and quality of life if an acceptable performance status can be achieved. Targeted therapy with trastuzumab should be considered in patients with HER-2/neu overexpression who have a higher response rate and a longer survival.

TACE is associated with the modulation of serum angiogenic, inflammatory, and cell growth cytokines in HCC patients. Serum IL-6 correlates with post-TACE fever, and baseline serum VEGF independently predicts patient survival.

Tang were the most common herbal medicine prescriptions for significantly reducing overall mortality in patients with liver cancer (Liao et al., 2015). Herbal medicine has been shown as adjunctive therapy to effectively improve quality of life and prolong overall