Chemoradiotherapy after curative surgery for locally advanced pancreatic cancer: A 20-year single center experience

Weibel, Pascal; Pavic, Matea; Lombriser, Norbert; Gutknecht, Stefan; Weber, Markus

doi:10.1016/j.suronc.2020.11.012

Cited by 8 publications

(8 citation statements)

References 18 publications

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“…Pancreatic cancer(PC) is one of the most prevalent diseases of the digestive system across the globe, with late diagnosis, rapid progression, and a poor prognosis (1,2). With a five-year survival rate of 10%, PC is currently the fourth leading cause of cancer-related deaths (3,4). A majority of PC patients show middle or advanced stage when they first consult a doctor owing to its insidious onset, rapid progression, and lack of typical clinical symptoms in the early stage; less than 20% of this patient group have a chance of receiving radical resection (5).…”

Section: Introductionmentioning

confidence: 99%

A real-world study of anlotinib combined with GS regimen as first-line treatment for advanced pancreatic cancer

Zhan

et al. 2023

Front. Endocrinol.

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BackgroundAnlotinib may boost the efficacy of pancreatic cancer (PC) treatment if timely added to the GS regimen (Gemcitabine, Tegafur-gimeracil-oteracil potassium); however, no data has been published. This study evaluated the safety and efficacy of anlotinib in combination with the GS regimen(hereafter referred to as the A+GS regimen) in the first-line treatment of patients with unresectable or metastatic PC.MethodsPatients with unresectable or metastatic PC treated at Yueyang Central Hospital and Yueyang People’s Hospital between October 2018 and June 2022 were enrolled in this retrospective real-world investigation. Treatment efficacy was evaluated based on the overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and objective response rate (ORR), while the treatment safety was assessed by the frequency of major adverse events (AEs).ResultsSeventy-one patients were included in this study, 41 in the GS group and 30 in the A+GS group. The A+GS group had a longer mPFS than the GS group (12.0 months (95% CI, 6.0–18.0) and 6.0 months (95% CI, 3.0–8.1)), respectively (P = 0.005). mOS was longer in the GS+A group) when compared with the GS group (17.0 months (95%CI, 14.0–20.0) and 10.0 months (95% CI, 7.5–12.5)), respectively (P = 0.018). The GS+A group had higher ORR (50.0% vs 26.8%, P = 0.045) and DCR (83.3% vs 58.5%, P = 0.026). Furthermore, there were no grade 4-5 AEs and no treatment-related deaths, and no discernible increase in AEs in the GS+A group when compared with the GS group.ConclusionThe A+GS regimen therapy holds great promise in managing treatment-naive advanced PC, except that future prospective studies with larger sample sizes and multiple centers are required to determine its efficacy and safety.

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Section: Introductionmentioning

confidence: 99%

A real-world study of anlotinib combined with GS regimen as first-line treatment for advanced pancreatic cancer

Zhan

et al. 2023

Front. Endocrinol.

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“…The two groups did not differ in term of both histological characteristics of the tumor and mean length of follow-up. Therefore, because all of them underwent complete surgical resection of PDAC, we evaluated the response to adjuvant chemotherapy using both the cancer recurrence rate and the DFS, in accordance with the methods used by oncologists to compare the efficacy of different chemotherapy schemes in patients who had previously undergone the complete surgical resection of the neoplasm [43][44][45]. Interestingly, we reported a statistically significant higher cancer recurrence rate in the non-responder-group with a cancer recurrence in 66.7% of cases in contrast to 14.3% of cases in the responder-group.…”

Section: Discussionmentioning

confidence: 99%

Zebrafish Patient-Derived Xenografts Identify Chemo-Response in Pancreatic Ductal Adenocarcinoma Patients

Usai

Franco

Piccardi

et al. 2021

Cancers

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It is increasingly evident the necessity of new predictive tools for the treatment of pancreatic ductal adenocarcinoma in a personalized manner. We present a co-clinical trial testing the predictiveness of zPDX (zebrafish patient-derived xenograft) for assessing if patients could benefit from a therapeutic strategy (ClinicalTrials.gov: XenoZ, NCT03668418). zPDX are generated xenografting tumor tissues in zebrafish embryos. zPDX were exposed to chemotherapy regimens commonly used. We considered a zPDX a responder (R) when a decrease ≥50% in the relative tumor area was reported; otherwise, we considered them a non-responder (NR). Patients were classified as Responder if their own zPDX was classified as an R for the chemotherapy scheme she/he received an adjuvant treatment; otherwise, we considered them a Non-Responder. We compared the cancer recurrence rate at 1 year after surgery and the disease-free survival (DFS) of patients of both groups. We reported a statistically significant higher recurrence rate in the Non-Responder group: 66.7% vs. 14.3% (p = 0.036), anticipating relapse/no relapse within 1 year after surgery in 12/16 patients. The mean DFS was longer in the R-group than the NR-group, even if not statistically significant: 19.2 months vs. 12.7 months, (p = 0.123). The proposed strategy could potentially improve preclinical evaluation of treatment modalities and may enable prospective therapeutic selection in everyday clinical practice.

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“…Of note, this study was published prior to introduction of intensive perioperative chemotherapy regimens such as FOLFIRINOX. Even if there are no head-to-head studies comparing intraoperative radiotherapy and postoperative FOLFIRINOX therapy, retrospective studies suggest that the latter is superior to intraoperative radiation [36].…”

Section: Surgery For Recurrent Pancreatic Cancer: Current Options and Obstaclesmentioning

confidence: 99%

Resection of Recurrent Pancreatic Cancer: Who Can Benefit?

Nienhüser¹,

Büchler²,

Schneider³

2021

Visc Med

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Background: Recurrence after resection of pancreatic cancer occurs in up to 80% of patients in the first 2 years after complete resection. While most patients are not eligible for surgical treatment due to disseminated disease, a certain group of patients can be evaluated for re-resection of local recurrence. This review summarizes the current literature on surgical treatment of recurrent pancreatic cancer and potential prognostic factors. Summary: Re-resection of recurrent pancreatic cancer provides a significant survival benefit to selected patients with acceptable procedure-related mortality. Median overall survival after re-resection of recurrent pancreatic cancer is up to 28 months. The most relevant clinical parameters associated with a prognostic benefit are young patient age (<65 years), time to initial resection (>10 months), and preoperative chemotherapy before re-resection. Molecular markers are currently under investigation and might help to improve patient selection in the future. Key Message: Re-resection of recurrent pancreatic cancer is safe and feasible in experienced hands. Selected patients benefit from surgical treatment, but future studies are needed to identify reliable prognostic markers predicting survival.

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Chemoradiotherapy after curative surgery for locally advanced pancreatic cancer: A 20-year single center experience

Cited by 8 publications

References 18 publications

A real-world study of anlotinib combined with GS regimen as first-line treatment for advanced pancreatic cancer

A real-world study of anlotinib combined with GS regimen as first-line treatment for advanced pancreatic cancer

Zebrafish Patient-Derived Xenografts Identify Chemo-Response in Pancreatic Ductal Adenocarcinoma Patients

Resection of Recurrent Pancreatic Cancer: Who Can Benefit?

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