Unresectable Locally Advanced Pancreatic Cancer: Treatment With Neoadjuvant Leucovorin, Fluorouracil, Irinotecan, and Oxaliplatin and Assessment of Surgical Resectability

Mondo, Esther; Noel, Marcus Smith; Katz, Alan W.; Schoeniger, Luke O.; Hezel, Aram F.

doi:10.1200/jco.2012.44.0339

Cited by 14 publications

(5 citation statements)

References 8 publications

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“…Treatment for human pancreatic carcinoma is primarily catered to surgical excision via partial pancreatectomy of the affected limb, followed by aggressive chemotherapy regimens 18 . However, the role of both neo‐adjuvant and adjuvant chemotherapy, especially in nonresectable or marginally resectable tumours is becoming more evident with various reported cytotoxic chemotherapy protocols 18 . As well, checkpoint inhibitors with PD‐1/PD‐L1 therapy have been gaining interest in patients with pancreatic carcinoma 19 .…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome in 23 dogs with exocrine pancreatic carcinoma

Pinard

Hocker

Weishaar

2020

Vet Comparative Oncology

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Exocrine pancreatic carcinoma is uncommon in the dog and the veterinary literature surrounding the disease is minimal. Twenty‐three cases of canine exocrine pancreatic carcinoma were reviewed in a retrospective manner to obtain information on clinical presentation, behaviour and survival associated with the disease. Presenting clinical signs were nonspecific and included anorexia, lethargy, vomiting and abdominal pain. The overall median survival time was only 1 day but was confounded by the large number of dogs that were euthanized shortly after diagnosis. Metastatic disease was detected in 78% of cases at the time of diagnosis, attesting to the aggressive nature of the disease. Neither lymph node metastasis, tumour size nor tumour location had an impact on overall survival. Only one patient was a previous diabetic who is contrary to reports of the disease in people and felines. This retrospective study reaffirms the need for early detection measures to optimize disease control. However, the benefits of therapy with surgery or radiation and adjuvant chemotherapy remain to be elucidated in dogs with exocrine pancreatic carcinoma.

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Section: Discussionmentioning

confidence: 99%

Clinical outcome in 23 dogs with exocrine pancreatic carcinoma

Pinard

Hocker

Weishaar

2020

Vet Comparative Oncology

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“…Recently, FOLFIRINOX or gemcitabine with nab-paclitaxel therapy has shown a high response rate for UR PC [5–8, 17]. FOLFIRINOX has also been used as a treatment for LAPC and resulting in a high conversion rate to surgical resection [18]. Although gemcitabine/nab-paclitaxel therapy also demonstrated a high response rate for metastatic PC [5], the evidence for its use in LAPC is now controversial.…”

Section: Discussionmentioning

confidence: 99%

Locally advanced pancreatic cancer successfully treated by distal pancreatectomy with celiac axis resection (DP-CAR) after S-1 with radiation therapy followed by gemcitabine/nab-paclitaxel therapy: a case report

et al. 2017

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BackgroundThe prognosis for pancreatic cancer remains dismal because many patients are diagnosed with unresectable cancer at the initial diagnosis. Recently, conversion surgery was reported as an effective treatment for initially unresectable pancreatic cancer with a favorable response to non-surgical treatment lasting over 240 days. Here, we describe a case of locally advanced pancreatic cancer (LAPC) successfully resected after treatment with S-1 and radiation followed by gemcitabine/nab-paclitaxel therapy.Case presentationA 73-year-old man with LAPC was referred to our hospital. Computed tomography findings revealed a 2.5-cm mass in the pancreatic body that had invaded the celiac artery, common hepatic artery, and splenic artery. Superior mesenteric artery (SMA) encasement was not observed, but tumor abutment over 180° with the main tumor was detected. Staging laparoscopy showed no findings of distant metastasis, and washing cytology revealed no malignancy. He was diagnosed with unresectable pancreatic cancer. Treatment with S-1 with radiation therapy followed by gemcitabine with nab-paclitaxel was performed. Six months after the initial treatment, the tumor size had decreased to 1.2 cm, and encasement of the main artery was diminished. Though abutment to the main artery, including the SMA, was still detected, distal pancreatectomy with celiac artery resection was performed. The histopathological findings around the celiac artery revealed fibrous changes with an Evans classification of grade IIb. There was no residual cancer at the periphery; thus, R0 resection was achieved. The patient has been healthy and without recurrence for more than 12 months since the initial treatment.ConclusionsGemcitabine/nab-paclitaxel therapy revealed high response rate for metastasic pancreatic cancer (PC), but the effect for LAPC proposing conversion surgery was not well discussed. In this case, we achieve R0 resection combined with chemoradiation therapy and gemcitabine/nab-paclitaxel therapy. This regimen was also effective for LAPC and may be used to increase the population of conversion surgery by its high response rate.

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“…The FOLFIRINOX regimen (folinic acid + 5-fluorouracil + irinotecan + oxaliplatin) has indeed been shown not only to increase the response rate but also to extend the overall survival (by more than 4 months) of individuals affected by metastatic pancreatic cancer, as compared with the nucleoside analog gemcitabine 61 - 64 . Although this chemotherapeutic regimen was also associated with an increased rate of adverse events, 62 it has generated a considerable clinical interest, as demonstrated by the consistent number (namely, 21) of clinical trials initiated during the last 13 months to test the antineoplastic profile of oxaliplatin-based chemotherapy in cohorts of pancreatic cancer patients (see below).…”

Section: Literature Updatementioning

confidence: 99%

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et al. 2013

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It is now clear that the immune system plays a critical role not only during oncogenesis and tumor progression, but also as established neoplastic lesions respond to therapy. Selected cytotoxic chemicals can indeed elicit immunogenic cell death, a functionally peculiar type of apoptosis that stimulates tumor-specific cognate immune responses. Such immunogenic chemotherapeutics include cyclophosphamide, doxorubicin and oxaliplatin (which are approved by FDA for the treatment of various hematological and solid malignancies), mitoxantrone (which is currently employed both as an anticancer agent and against multiple sclerosis) and patupilone (a microtubular poison in clinical development). One year ago, in the second issue of OncoImmunology, we discussed the scientific rationale behind immunogenic chemotherapy and reviewed the status of recent clinical trials investigating the off-label use of cyclophosphamide, doxorubicin, oxaliplatin and mitoxantrone in cancer patients. Here, we summarize the latest developments in this area of clinical research, covering both high-impact studies that have been published during the last 13 months and clinical trials that have been initiated in the same period to assess the antineoplastic profile of immunogenic chemotherapeutics.

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Unresectable Locally Advanced Pancreatic Cancer: Treatment With Neoadjuvant Leucovorin, Fluorouracil, Irinotecan, and Oxaliplatin and Assessment of Surgical Resectability

Cited by 14 publications

References 8 publications

Clinical outcome in 23 dogs with exocrine pancreatic carcinoma

Clinical outcome in 23 dogs with exocrine pancreatic carcinoma

Locally advanced pancreatic cancer successfully treated by distal pancreatectomy with celiac axis resection (DP-CAR) after S-1 with radiation therapy followed by gemcitabine/nab-paclitaxel therapy: a case report

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