Prognostic and predictive markers in pancreatic adenocarcinoma

Le, Nha; Sund, Malin; Vinci, Alessio

doi:10.1016/j.dld.2015.11.001

Cited by 107 publications

(94 citation statements)

References 93 publications

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“…CA19-9 is the pancreatic cancer biomarker currently recommended for clinical use, and numerous reports have revealed that elevated CA 19-9 levels are associated with a worse survival rate, which are concordant with the results of the current study (35,40). In addition, CA19-9 levels in stage IVB patients were significantly higher compared with those in stage IVA patients (P=0.0060), as determined in the present study, which indicates that this biomarker effectively reflects tumor status.…”

Section: Discussionsupporting

confidence: 82%

Effect of pretreatment psoas muscle mass on survival for patients with unresectable pancreatic cancer undergoing systemic chemotherapy

et al. 2017

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Abstract. To the best of our knowledge, there are few previous studies that have investigated the effect of decreased skeletal muscle mass (DSMM) on survival in patients with unresectable advanced pancreatic cancer (APC) who are undergoing systemic chemotherapy. Thus, the present study aimed to investigate the impact of DSMM, as determined by the psoas muscle index (PMI) following computed tomography and prior to systemic chemotherapy, on the outcomes of patients with unresectable APC (n=61). The primary endpoint used was the overall survival (OS) rate. The OS rates in the PMI-High group (exceeds the median PMI value in each gender) were retrospectively compared with those in the PMI-Low group (below the median PMI value in each gender), and factors associated with OS were investigated using univariate and multivariate analyses. The study cohort included 31 male and 30 female patients with a median age of 72 years, 13 of whom were stage IVA, and 48 were stage IVB. ). The proportion of patients with performance status 0 in the PMI-High group was significantly high, compared with that in the PMI-Low group [83.3% (25/30) vs. 58.1% (18/31); P=0.0486]. Body mass index in the PMI-High group was significantly higher compared with that in the PMI-Low group (P=0.0154). The 1-year cumulative survival rate was 43.3% in the PMI-High group and 12.9% in the PMI-Low group (P=0.0027). Following multivariate analysis, PMI (P=0.0036), prothrombin time (P=0.0044) and carbohydrate antigen 19-9 (P= 0.0451) were identified to be significant predictors of OS. In conclusion, DSMM, as determined by the PMI, could be a significant predictor of prognosis in patients with unresectable APC who are receiving systemic chemotherapy.

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Section: Discussionsupporting

confidence: 82%

Effect of pretreatment psoas muscle mass on survival for patients with unresectable pancreatic cancer undergoing systemic chemotherapy

et al. 2017

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“…We next analyzed the association between PFS and both DTH and well-known prognostic factors in PDAC (29). In the univariate analysis, DTH-positivity in the GEMWT1 group was associated with longer PFS than in the GEM group (HR 0.25, 95% CI 0.10-0.62, P = 0.003).…”

Section: Wt1-specific Immune Responses: Dthmentioning

confidence: 99%

Combination Gemcitabine and WT1 Peptide Vaccination Improves Progression-Free Survival in Advanced Pancreatic Ductal Adenocarcinoma: A Phase II Randomized Study

Nishida

Ishikawa

Egawa

et al. 2018

Cancer Immunology Research

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Conflict of interestThe authors declare no potential conflicts of interest with respect to this manuscript. AbstractWe investigated the efficacy of a Wilms' tumor gene 1 (WT1) vaccine combined with gemcitabine (GEMWT1) and compared it to gemcitabine (GEM) monotherapy for advanced pancreatic ductal adenocarcinoma (PDAC) in a randomized phase II study. We randomly assigned HLA-A*02:01-or HLA-A*24:02-positive patients with advanced PDAC to receive GEMWT1 or GEM. We assessed WT1-specific immune responses via delayed-type hypersensitivity (DTH) to the WT1 peptide and a tetramer assay to detect WT1-specific cytotoxic T lymphocytes (WT1-CTLs). Of 91 patients enrolled, 85were evaluable (GEMWT1: n = 42; GEM: n = 43). GEMWT1 prolonged progression-free survival (PFS) (hazard ratio [HR], 0.66; P = 0.084) and improved overall survival rate at 1 year (1-year OS%) (GEMWT1: 35.7%; GEM: 20.9%). However, the difference in OS was not significant (HR: 0.82; P = 0.363).These effects were particularly evident in metastatic PDAC (PFS: HR 0.51, P = 0.0017; 1-year OS%: GEMWT1 27.3%; GEM 11.8%). The combination was well-tolerated, with no unexpected serious adverse events. In patients with metastatic PDAC, PFS in the DTH-positive GEMWT1 group was significantly prolonged, with a better HR of 0.27 compared to the GEM group, whereas PFS in the DTH-negative GEMWT1 group was similar to that in the GEM group (HR 0.86) (P = 0.001). DTH positivity was associated with an increase in WT1-CTLs induced by the WT1 vaccine. GEM plus the WT1 vaccine prolonged PFS and may improve 1-year OS% in advanced PDAC. These clinical effects were associated with the induction of WT1-specific immune responses.

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“…13 An elevated level of serum CA 19-9 has been found in benign biliary tract disease, as well as in other gastrointestinal malignant diseases.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10] Because of this uncertain diagnostic accuracy, use of CA 19-9 is limited to the diagnosis of tumor recurrence and prognosis of pancreatic cancer. [11][12][13] The aims of this study were to determine the clinical interpretation and the diagnostic value of an elevated CA 19-9 serum level in pancreatobiliary diseases with coexistent obstructive jaundice. We investigated the diagnostic accuracy of CA 19-9 and the correlation between CA 19-9 and serum bilirubin levels before and after biliary drainage.…”

Section: Introductionmentioning

confidence: 99%

Clinical Interpretation of Elevated CA 19-9 Levels in Obstructive Jaundice Following Benign and Malignant Pancreatobiliary Disease

Kim

Jeon

Park

et al. 2017

Korean J Gastroenterol

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Prognostic and predictive markers in pancreatic adenocarcinoma

Cited by 107 publications

References 93 publications

Effect of pretreatment psoas muscle mass on survival for patients with unresectable pancreatic cancer undergoing systemic chemotherapy

Effect of pretreatment psoas muscle mass on survival for patients with unresectable pancreatic cancer undergoing systemic chemotherapy

Combination Gemcitabine and WT1 Peptide Vaccination Improves Progression-Free Survival in Advanced Pancreatic Ductal Adenocarcinoma: A Phase II Randomized Study

Clinical Interpretation of Elevated CA 19-9 Levels in Obstructive Jaundice Following Benign and Malignant Pancreatobiliary Disease

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