Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up of Exocrine Pancreatic Ductal Adenocarcinoma: Evidence Evaluation and Recommendations by the Italian Association of Medical Oncology (AIOM)

Silvestris, Nicola; Brunetti, Oronzo; Bittoni, Alessandro; Cataldo, Ivana; Corsi, Domenico; Crippa, Stefano; D’Onofrio, Mirko; Fiore, Michele; Giommoni, Elisa; Milella, Michèle; Pezzilli, Raffaele; Vasile, Enrico; Reni, Michele

doi:10.3390/cancers12061681

Cited by 25 publications

(22 citation statements)

References 76 publications

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“…Incidence and mortality are increasing steadily, and PC is predicted to become the second leading cause of cancer-related death by 2030 [ 2 ]. According to the Italian Association of Medical Oncology (AIOM), in 2019, approximately 13,500 new PC cases were diagnosed in Italy [ 3 ]. These dramatic numbers are due largely to late diagnosis, lack of effective therapies, and a poor understanding of PC biology.…”

Section: Introductionmentioning

confidence: 99%

The Revolutionary Roads to Study Cell–Cell Interactions in 3D In Vitro Pancreatic Cancer Models

Cave

Rizzo

Sáinz

et al. 2021

Cancers

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Pancreatic cancer, the fourth most common cancer worldwide, shows a highly unsuccessful therapeutic response. In the last 10 years, neither important advancements nor new therapeutic strategies have significantly impacted patient survival, highlighting the need to pursue new avenues for drug development discovery and design. Advanced cellular models, resembling as much as possible the original in vivo tumor environment, may be more successful in predicting the efficacy of future anti-cancer candidates in clinical trials. In this review, we discuss novel bioengineered platforms for anticancer drug discovery in pancreatic cancer, from traditional two-dimensional models to innovative three-dimensional ones.

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Section: Introductionmentioning

confidence: 99%

The Revolutionary Roads to Study Cell–Cell Interactions in 3D In Vitro Pancreatic Cancer Models

Cave

Rizzo

Sáinz

et al. 2021

Cancers

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Section: Methodsmentioning

confidence: 99%

“…Indication for and proposal of neoadjuvant, adjuvant or palliative treatments were based on tumor staging, patients' performance status, age and patients' comorbidities, according to the ESMO 16 and the Italian Medical Oncology Association guidelines. 17 With regards to intraductal papillary mucinous neoplasms (IPMNs), follow-up or indication for surgical resection was based on the current International Consensus Guidelines 2016. 18 In case of discrepancies among the members of the MDTB, decisions were taken on the basis of the abovementioned guidelines.…”

Section: Pc-mdtbmentioning

confidence: 99%

The impact of the multidisciplinary tumor board (MDTB) on the management of pancreatic diseases in a tertiary referral center

et al. 2021

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Background: The implementation of multidisciplinary tumor board (MDTB) meetings significantly ameliorated the management of oncological diseases. However, few evidences are currently present on their impact on pancreatic cancer (PC) management. The aim of this study was to evaluate the impact of the MDTB on PC diagnosis, resectability and tumor response to oncological treatment compared with indications before discussion. Patients and methods: All patients with a suspected or proven diagnosis of PC presented at the MDTB from 2017 to 2019 were included in the study. Changes of diagnosis, resectability and tumor response to oncological/radiation treatment between pre-and post-MDTB discussion were analyzed. Results: A total of 438 cases were included in the study: 249 (56.8%) were presented as new diagnoses, 148 (33.8%) for resectability assessment and 41 (9.4%) for tumor response evaluation to oncological treatment. MDTB discussion led to a change in diagnosis in 54/249 cases (21.7%), with a consequent treatment strategy variation in 36 cases (14.5%). Change in resectability was documented in 44/148 cases (29.7%), with the highest discrepancy for borderline lesions. The treatment strategy was thus modified in 27 patients (18.2%). The MDTB brought a modification in the tumor response assessment in 6/41 cases (14.6%), with a consequent protocol modification in four (9.8%) cases. Conclusions: MDTB discussion significantly impacts on PC management, especially in high-volume centers, with consistent variations in terms of diagnosis, resectability and tumor response assessment compared with indications before discussion.

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“…The incidence of this cancer has surged in the last decade due to the increased spread of risk factors such as smoking, obesity, and inappropriate dietary habits [ 2 , 3 ]. Life expectancy for pancreatic cancer patients is generally very low, with a 5-year survival rate < 10% [ 4 ]. Despite the high incidence and severe mortality rates, the available therapeutic strategies are very limited, making the treatment of this cancer an unmet clinical need [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Use of FOLFIRINOX or Nab-Paclitaxel Plus Gemcitabine for the Treatment of Locally Advanced Pancreatic Adenocarcinoma: A Single Institution Observational Study

Servetto

Santaniello

Napolitano

et al. 2021

Cancers

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Patients with locally advanced (LA) pancreatic ductal adenocarcinoma (PDAC) do not present distant metastases but are not eligible for surgery upfront. Chemotherapy regimens, such as FOLFIRINOX (FFN) or nab-paclitaxel plus gemcitabine (GemNab) in combination with loco-regional treatments are generally used in this setting. However, the best treatment choice is unknown. We retrospectively analyzed the information of 225 patients with stage II–III PDAC treated at our institution between October 2011 and December 2020. A total of 94 patients with LA PDAC who are non-eligible for surgery upfront received neoadjuvant FFN or GemNab. Of the 67 patients receiving FFN, 28 (41.8%) underwent surgery after neoadjuvant therapy. Of the 27 patients treated with GemNab, 6 (22.2%) became eligible for resection. The median overall survival (OS) was 85.1 weeks and 54.3 weeks in the FFN and GemNab groups, respectively (HR = 0.54, p = 0.0109). The median OS was 189.7 weeks and 76.4 weeks in the resected and unresected cohorts, respectively (HR = 0.25, p < 0.0001). Neutropenia (37.3%), anemia (6.0%), and diarrhea (6.0%) in the FFN group and neutropenia (22.2%) and thrombocytopenia (18.5%) in the GemNab groups were the most frequent grade 3–4 side effects. Higher rates of thrombocytosis (p < 0.0001) and peripheral edema (p < 0.0001) were observed in the GemNab group. Our results suggest that the use of FFN is associated with more favorable clinical outcomes than GemNab for patients with LA PDAC. Future randomized and controlled clinical trials are needed to further elucidate the role of these regimens and loco-regional treatments in this setting.

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Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up of Exocrine Pancreatic Ductal Adenocarcinoma: Evidence Evaluation and Recommendations by the Italian Association of Medical Oncology (AIOM)

Cited by 25 publications

References 76 publications

The Revolutionary Roads to Study Cell–Cell Interactions in 3D In Vitro Pancreatic Cancer Models

The Revolutionary Roads to Study Cell–Cell Interactions in 3D In Vitro Pancreatic Cancer Models

The impact of the multidisciplinary tumor board (MDTB) on the management of pancreatic diseases in a tertiary referral center

Use of FOLFIRINOX or Nab-Paclitaxel Plus Gemcitabine for the Treatment of Locally Advanced Pancreatic Adenocarcinoma: A Single Institution Observational Study

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