Metastatic Pancreatic Cancer: Emerging Strategies in Chemotherapy and Palliative Care

Kamar, François G.; Grossbard, Michael L.; Kozuch, Peter

doi:10.1634/theoncologist.8-1-18

Cited by 72 publications

(63 citation statements)

References 121 publications

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“…The high mortality rate recorded in our present study is in keeping with documentation in the literature [1][2][3][4][5][6][7][8][9][10][11][12] . Apart from the 4 patients (31%), who were lost to follow up, the rest died within 18months of diagnosis.…”

Section: Discussionsupporting

confidence: 91%

Presentation of Pancreatic Cancer in a Dedicated HepatoPancreato-Biliary Surgery Unit of a Tertiary Health Facility, South-South, Nigeria: A Four Year Prospective Study.

OENgim¹,

ADMarwa²,

MEkong³

et al. 2014

IOSRJDMS

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Carcinoma of the pancreas is a common gastrointestinal neoplasm (July, 2008 -June, 2012.A total of fourteen patients were seen with this condition during the study period. There were more females than males with a ratio of 2.5:1. The age range was 40-80years with a mean age of 58yrs. The commonest mode of presentation was a combination of jaundice, pruritus and weight loss. The presence of jaundice with pruritus were the principal symptoms that brought these patients to the hospital. Late presentation is common in our environment and prognosis is poor.

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Section: Discussionsupporting

confidence: 91%

Presentation of Pancreatic Cancer in a Dedicated HepatoPancreato-Biliary Surgery Unit of a Tertiary Health Facility, South-South, Nigeria: A Four Year Prospective Study.

OENgim¹,

ADMarwa²,

MEkong³

et al. 2014

IOSRJDMS

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“…Gem, for the last couple of decades in a lot of clinical trials [19][20][21][22][23] has been considered the reference standard treatment in advanced pancreatic cancer as a first line treatment or a Gem based combination regimen in improving QoL of patients, but all of them have provided disappointing results in the way of survival possibility.…”

Section: Discussionmentioning

confidence: 99%

“…Even though there are differences in the above studies, [19][20][21][22][23][24][25][26][27][28][29][30][31][32] most of them conclude that Fol compared to Gem improves the overall QOL.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Murtezani

2017

AJP

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Objective: The aim of this study is to assess the clinical effectiveness of folfirinox (Fol) compared with gemcitabine (Gem) on quality of life (QOL) that predicts survival in patients with Stage IV of pancreatic cancer. Materials and Methods: A total of 34 patients suffering from metastatic pancreatic adenocarcinoma were randomized into two groups, the Gem group (n = 17) and Fol group (n = 17). The first group was treated with Gem in a dose of 1000 mg/m 2 once weekly for 7 weeks, followed by 1 week of rest during the first cycle and subsequently 1000 mg/m 2 once weekly for 3 weeks followed by 1 week of rest. The second group was treated with Fol (oxaliplatin 85 mg/m 2 , irinotecan 180 mg/m 2 , leucovorin 400 mg/m 2 , and fluorouracil 400 mg/m 2 bolus, followed by 2400 mg/m 2 on 46-h continuous infusion) once every 2 weeks. The QOL was measured by the functional assessment of cancer therapy (FACT)-hepatobiliary cancer scale. Results: Thirty-four of randomized patients completed the study, and there were no significant differences among the two groups at baseline demographic characteristics. Overall QOL, P value shows the significance of correlation for components of FACT in all scales between Fol-group and Gem-group. Median survival time for the entire cohort was 14.1 months for Fol-group compared to Gem-group which was 9.2 months. P value shows the significance of the correlation between survival rate and stage of tumor, in Fol-group versus Gem-group (P = 0.0001). Conclusions: We conclude that Fol significantly improves QOL, physical functioning and survival time in advanced pancreatic cancer patients in comparison with Gem.

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“…These programs can provide essential dietary suggestions as well as recommendations for oral nutritional supplementation, enteral nutrition, and parenteral nutrition [93][94][95][96].…”

Section: Nutritional Supportmentioning

confidence: 99%

Pancreatic Cancer Cachexia: Current Concepts and Clinical Management

Guan¹,

Shinde²,

Hendifar³

2017

Frailty and Sarcopenia - Onset, Development and Clinical Challenges

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There has been great progress over the last decade in understanding the pathophysiology of cachexia associated with pancreatic cancer. However, there is a large need to ind better therapeutic options to successfully manage this complex and challenging condition. Patients with pancreatic cancer have some of the highest prevalence and often the most severe degrees of cachexia, which is described as a multifactorial metabolic syndrome that is associated with unintended weight loss of adipose tissue and skeletal muscle in the seting of anorexia. This chapter will review the current concepts surrounding pancreatic cancer cachexia, its clinical diagnosis, pathophysiology, and its known and proposed therapeutics. A multimodal approach utilizing nutritional support and pharmaceutical therapies is proposed to lead to the most successful management of pancreatic cancer cachexia.Keywords: pancreatic cancer, cachexia, anorexia, metabolic syndrome, catabolism IntroductionIn western countries, pancreatic cancer represents the fourth leading cause of cancer-related death [1]. Among the many complications associated with this disease, cachexia marked by progressive weight loss represents one of the most distressing features related to pancreatic cancer. Cachexia is a multidimensional wasting syndrome that is characterized by unintended loss of both adipose tissue and lean body mass (LBM) that cannot be fully reversed through conventional nutritional support. It is a complex metabolic disorder frequently described in pancreatic cancer and represents a signiicant physical and psychological burden in approximately 80% of pancreatic cancer patients during the disease progression [2]. The complications © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. associated with cachexia, which include immobility, impaired immunity, and severe respiratory muscle impairment leading to cardiopulmonary failure, result in death in up to one-third of pancreatic cancer patients [3]. Cachectic patients are observed to have lower physical function, decreased tolerance to chemotherapy and radiation treatment, and generally worse prognosis than those with stable weight. Poorer outcomes after pancreaticoduodenectomy have also been observed in patients with preoperative signs of cachexia [4].While research over the past decade has provided new insights regarding the pathogenesis of pancreatic cancer cachexia, the mechanistic pathology of this condition is still not entirely understood. In this chapter, we will provide a review of the current concepts, potential therapeutic targets, and management of this signiicant clinical condition. Classiication and progression of cancer cachexiaCachexia has been established to be a common adverse efect of cancer. An international consensus in 2011 deined cachexia as a ...

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Metastatic Pancreatic Cancer: Emerging Strategies in Chemotherapy and Palliative Care

Cited by 72 publications

References 121 publications

Presentation of Pancreatic Cancer in a Dedicated HepatoPancreato-Biliary Surgery Unit of a Tertiary Health Facility, South-South, Nigeria: A Four Year Prospective Study.

Presentation of Pancreatic Cancer in a Dedicated HepatoPancreato-Biliary Surgery Unit of a Tertiary Health Facility, South-South, Nigeria: A Four Year Prospective Study.

Untitled

Pancreatic Cancer Cachexia: Current Concepts and Clinical Management

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