Impact of intensified chemotherapy in metastatic pancreatic ductal adenocarcinoma (PDAC) in clinical routine in Europe

Markers of pancreatic cancer stem cells and their clinical and therapeutic implications

“…The molecular observations described above may be suitable for use in clinical practice. A retrospective multicenter study including 1056 patients with metastatic PC showed that the median overall survival is dependent on the palliative chemotherapeutic cycle used, and on the use of FOLFIRINOX for up to 9.9 months, nab-paclitaxel with gemcitabine for 7.9 months, and 4.9 months of gemcitabine monotherapy [168]. Similarly, an adjuvant treatment study Fig.…”

Meta-analysis of the clinical efficacy of FOLFIRINOX in the treatment of inoperable advanced pancreatic cancer and gemcitabine-based regimen

“…Javed MA conducted a multivariate analysis of the data to conclude that males and poor physical strength were factors associated with poor prognosis. 10 In terms of safety, this meta-analysis included five indicators of neutropenia, thrombocytopenia, vomiting, diarrhea, and infection fever. The results suggest that there is no significant difference in hematological toxicity between the two groups.…”

“…Among the 7 articles included, 4 were prospective, randomized controlled trials, and 3 were retrospective analyses of clinical data. [5][6][7][8][9][10][11] Three kinds of literature presented FOLFIRINOX and different intergroup studies containing the gemcitabine protocol, which were grouped to collect data and analysis. The gemcitabine-containing regimens involved include the gemcitabine monotherapy regimen, the gemcitabine plus capecitabine regimen, the gemcitabine plus tegafur regimen, and the gemcitabine combined with the albumin-bound paclitaxel regimen.…”

Pancreatic Cancer Malnutrition and Pancreatic Exocrine Insufficiency in the Course of Chemotherapy in Unresectable Pancreatic Cancer

“…This is particularly important in PDAC; not more than 20% of patients are eligible for the resection at the time of the diagnosis (3), while the rest might have an indication for chemotherapy. In this setting, while Gemcitabine monochemotherapy has for a long time been the standard treatment for unresectable PDAC with relatively poor effect represented by a median overall survival (OS) around 6 months (11), intensified regimens, such as the combination of 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX), or the addition of Nab-Paclitaxel to gemcitabine, are nowadays more frequently used, with substantially improved survival (12)(13)(14)(15)(16)(17). However, due to their side effects, particularly encountered in FOLFIRINOX, intensified regimens can be less tolerable, leading to dose reduction or therapy discontinuation (13)(14)(15), which makes their use limited to the patients with ECOG status of 0, 1, and 2 (15,16).…”