Resectability After First-Line FOLFIRINOX in Initially Unresectable Locally Advanced Pancreatic Cancer: A Single-Center Experience

Nitsche, Ulrich; Wenzel, Patrick; Siveke, Jens T.; Braren, Rickmer; Holzapfel, Konstantin; Schlitter, Anna Melissa; Stöß, Christian; Kong, Bo; Espósito, Irene; Erkan, Mert; Michalski, Christoph; Frieß, Helmut; Kleeff, Jörg

doi:10.1245/s10434-015-4851-2

Cited by 86 publications

(61 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Beyond the standard cancer treatment options, chemotherapy and radiation, there has been minimal progress made in improving PaCa patient survival. One of the latest attempts is the development of FOLFIRINOX, a combination of five chemotherapeutic agents, which has shown some progress but is associated with toxic side effects if not managed properly [3][4][5][6][7][8]. With the need to develop more effective treatment options, alternative approaches, such as thermal therapy, may offer a viable strategy [9].…”

Section: Introductionmentioning

confidence: 99%

Dual thermal ablation of pancreatic cancer cells as an improved combinatorial treatment strategy

Baumann¹,

Baust²,

Snyder³

et al. 2017

Liver Pancreat Sci

View full text Add to dashboard Cite

Pancreatic cancer (PaCa) is one of the leading causes of cancer related deaths in the world today. It is estimated that 95% of patients diagnosed with PaCa will die because of limited treatment options. As standard treatments have not yielded an improvement in patient outcome, alternative approaches, such as thermal ablation, may offer a new treatment path. We previously reported the lethal temperatures necessary for PaCa ablation for both freeze and heat based treatments. In this study, we investigated the response of PaCa cells in vitro to a combination treatment of heating and freezing, dual thermal ablation (DTA), in an effort to further improve ablation efficacy.PaCa cell lines, PANC-1 and BxPC-3, were subjected to heating (45 to 50°C), freezing (-10 to -20°C), or DTA exposure. Post-exposure viability was assessed over a 7-day recovery interval. Modes of cell death were analyzed using fluorescence microscopy and flow cytometry.Our results indicated that in comparison to single thermal modalities, DTA resulted in greater cell destruction at a more rapid rate. Specifically, -15°C had a moderate impact on day one cell viability (PANC-1=80%; BxPC-3=21%) and 50°C (PANC-1=74%; BxPC-3=18%) caused a slow decline in cell number post-treatment. The combination of these treatments resulted in an increased cell death one-day post-treatment (PANC-1=28%; BxPC-3=5%) and achieved complete cell destruction within three days. Overall, these data suggest that a combination of heat and freeze ablation, DTA, may provide for an improved treatment strategy for PaCa.

show abstract

Section: Introductionmentioning

confidence: 99%

Dual thermal ablation of pancreatic cancer cells as an improved combinatorial treatment strategy

Baumann¹,

Baust²,

Snyder³

et al. 2017

Liver Pancreat Sci

View full text Add to dashboard Cite

show abstract

“…In dCCA, a differential diagnostic problem exists versus other periampullary tumours, such as PDAC and ampullary carcinoma. Several studies are investigating the place of neoadjuvant regimes for PDAC [26,27] and the need of separation between dCCA and PDAC preoperatively will be warranted for optimal management.…”

Section: Cholangiocarcinoma -Current Classification and Challenges Tomentioning

confidence: 99%

Cholangiocarcinoma – current classification and challenges towards personalised medicine

Byrling

Andersson

et al. 2016

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

“…[8] However, re-classification during or after (neoadjuvant) treatment has turned out to be difficult as radiological findings are often not able to discriminate between vital tumor cells and fibrotic nonmalignant stroma, which may result from effective neoadjuvant treatment. [39] Thus, if in doubt, liberal indication for surgical exploration can be beneficial for those patients with radiological unclear response. Indeed, some centers advocate exploration in all patients whose tumors do not progress during therapy.…”

Section: Treatment Response and Surgical Resectabilitymentioning

confidence: 99%

“…[2] Another 30–40% of patients present with borderline resectable or locally advanced/unresectable tumors. [3] Here, the risk of occult distant metastasis is higher than in patients with smaller resectable tumors, and perioperative/neoadjuvant treatment is generally recommended to downsize the primary tumor and estimate tumor biology. [45] Depending on the patient's performance status and preferences, more or less aggressive regimens can be chosen.…”

Section: Introductionmentioning

confidence: 99%

Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?

Nitsche

Kong

Balmert

et al. 2016

Indian J Med Paediatr Oncol

Self Cite

View full text Add to dashboard Cite

Pancreatic ductal adenocarcinoma is a highly aggressive disease, and medical as well as surgical therapeutic options are limited. This article reviews stage dependent treatment options, with a special focus on the current controversy of perioperative treatment regimens in initially borderline resectable or locally advanced patients. Neoadjuvant treatment can potentially increase the rate of complete tumor resection and may be more effective than adjuvant systemic therapy. Further, in the case of disease progression during or after neoadjuvant therapy, patients can be spared extensive surgery. Today, common therapeutic regimens include gemcitabine/nab-paclitaxel and FOLFIRINOX, as well as chemoradiation. However, because of the paucity of evidence from randomized trials, most guidelines do not recommend neoadjuvant therapy in resectable tumors, and for borderline or locally advanced tumors only within clinical trials. Importantly, every patient should be discussed in multidisciplinary tumor boards.

show abstract

Resectability After First-Line FOLFIRINOX in Initially Unresectable Locally Advanced Pancreatic Cancer: A Single-Center Experience

Abstract: FOLFIRINOX is a powerful first-line regimen that leads to resectability in a substantial portion of patients with initially unresectable pancreatic cancer.

Cited by 86 publications

References 31 publications

Dual thermal ablation of pancreatic cancer cells as an improved combinatorial treatment strategy

Dual thermal ablation of pancreatic cancer cells as an improved combinatorial treatment strategy

Cholangiocarcinoma – current classification and challenges towards personalised medicine

Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy?

Contact Info

Product

Resources

About