Review
Gastroenterology & Hepatology
Shigenori Ei, Shinichiro Takahashi, Toshihito Ogasawara, Taro Mashiko, Yoshihito Masuoka, Toshio Nakagohri
Summary: Resection is the only curative treatment for pancreatic ductal adenocarcinoma (PDAC), but the 5-year survival rate remains low and more effective therapy is needed. Recent studies have focused on perioperative treatment for resectable and borderline resectable PDAC, showing promising results. This review compares the difference between Asian and Western countries in perioperative treatment for PDAC.
Article
Oncology
Laura Maggino, Giuseppe Malleo, Stefano Crippa, Giulio Belfiori, Sara Nobile, Giulia Gasparini, Gabriella Lionetto, Claudio Luchini, Paola Mattiolo, Marco Schiavo-Lena, Claudio Doglioni, Aldo Scarpa, Claudio Bassi, Massimo Falconi, Roberto Salvia
Summary: This study investigated the incidence and pattern of recurrence in patients with initially resectable and borderline resectable pancreatic ductal adenocarcinoma who received post-neoadjuvant pancreatectomy. The results showed that preoperative tumor size <20 mm, normal posttreatment CA19.9 and Delta CA19.9 > 50% were associated with longer recurrence-free survival (RFS) in these patients.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Oncology
Shohei Takaichi, Yoshito Tomimaru, Shogo Kobayashi, Keisuke Toya, Kazuki Sasaki, Yoshifumi Iwagami, Daisaku Yamada, Takehiro Noda, Hidenori Takahashi, Tadafumi Asaoka, Masahiro Tanemura, Yuichiro Doki, Hidetoshi Eguchi
Summary: This study investigated the impact of changes in body composition on postoperative outcomes in patients with PDAC undergoing neoadjuvant chemoradiotherapy. The results showed that loss of skeletal muscle mass during NACRT was an independent risk factor for survival in PDAC patients.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Oncology
Jin Ho Choi, Min Kyu Kim, Sang Hyub Lee, Jin Woo Park, Namyoung Park, In Rae Cho, Ji Kon Ryu, Yong-Tae Kim, Jin-Young Jang, Wooil Kwon, Hongbeom Kim, Woo Hyun Paik
Summary: The study suggests that 5-fluorouracil-based adjuvant therapy is the proper choice for patients with borderline resectable and locally advanced pancreatic cancer who received neoadjuvant FOLFIRINOX. Preoperative assessment as locally advanced pancreatic cancer, positive resection margin, and presence of pathologic lymph node involvement were associated with decreased recurrence-free survival.
FRONTIERS IN ONCOLOGY
(2022)
Article
Oncology
Lei Zheng, Ding Ding, Barish H. Edil, Carol Judkins, Jennifer N. Durham, Dwayne L. Thomas, Katherine M. Bever, Guanglan Mo, Sara E. Solt, Jessica A. Hoare, Raka Bhattacharya, Qingfeng Zhu, Arsen Osipov, Beth Onner, Katrina A. Purtell, Hongyan Cai, Rose Parkinson, Amy Hacker-Prietz, Joseph M. Herman, Dung T. Le, Nilofer S. Azad, Ana M. C. De Jesus-Acosta, Alex B. Blair, Victoria Kim, Kevin C. Soares, Lindsey Manos, John L. Cameron, Martin A. Makary, Matthew J. Weiss, Richard D. Schulick, Jin He, Christopher L. Wolfgang, Elizabeth D. Thompson, Robert A. Anders, Elizabeth Sugar, Elizabeth M. Jaffee, Daniel A. Laheru
Summary: The study showed that neoadjuvant immunotherapy with GVAX for resectable PDAC is safe and feasible. Patients treated with GVAX had a longer overall survival, while those who received low-dose cyclophosphamide in addition to GVAX had significantly shorter disease-free survival.
CLINICAL CANCER RESEARCH
(2021)
Article
Gastroenterology & Hepatology
Ayaka Takaori, Daisuke Hashimoto, Tsukasa Ikeura, Takashi Ito, Koh Nakamaru, Masataka Masuda, Shinji Nakayama, So Yamaki, Tomohisa Yamamoto, Kosuke Fujimoto, Yoshiyuki Matsuo, Shohei Akagawa, Mitsuaki Ishida, Kiyoshi Yamaguchi, Seiya Imoto, Kiichi Hirota, Satoshi Uematsu, Sohei Satoi, Mitsugu Sekimoto, Makoto Naganuma
Summary: This study aimed to evaluate the changes in gut microbiota before and after neoadjuvant chemotherapy in patients with resectable and borderline resectable pancreatic ductal adenocarcinoma. The results showed that the diversity of gut microbiota was not significantly affected by neoadjuvant chemotherapy, but the relative abundance of Bifidobacterium genus was lower before neoadjuvant chemotherapy. This suggests that a lower abundance of Bifidobacterium genus before neoadjuvant chemotherapy may be associated with a poorer pathological response to the treatment.
Article
Oncology
Mohamed Abdelgadir Adam, Ibrahim Nassour, Richard Hoehn, Callie A. Hlavin, Nathan Bahary, David L. Bartlett, Kenneth K. W. Lee, Amer H. Zureikat, Alessandro Paniccia
Summary: This study found that the use of neoadjuvant chemotherapy (NAC) can compensate for the survival disadvantage caused by omission of adjuvant chemotherapy (AC) for resected pancreatic adenocarcinoma patients. NAC is associated with improved overall survival for patients who did not receive AC, and the median overall survival for these patients is comparable to those who received AC alone.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Review
Oncology
Susanna W. L. de Geus, Teviah E. Sachs
Summary: Over the past decade, neoadjuvant therapy has become the standard of care for borderline resectable and locally advanced pancreatic cancer. However, there is still debate regarding its value for clearly resectable disease. Meta-analyses suggest that neoadjuvant therapy can be offered as an acceptable standard of care, with recent studies showing superior survival for patients who tolerate neoadjuvant FOLFIRINOX. Ongoing randomized controlled trials are expected to provide more conclusive recommendations.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Medicine, General & Internal
Takehiro Okabayashi, Kenta Sui, Motoyasu Tabuchi, Takahiro Murokawa, Shinichi Sakamoto, Jun Iwata, Sojiro Morita, Nobuto Okamoto, Tatsuo Iiyama, Yasuhiro Shimada, Toshiyoshi Fujiwara
Summary: This study evaluated the efficacy of neoadjuvant therapy for resectable pancreatic cancer and found that it can reduce the recurrence rate and improve the consistency of clinical and pathological staging.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Oncology
Quisette P. Janssen, Jacob L. van Dam, Laura R. Prakash, Deesje Doppenberg, Christopher H. Crane, Casper H. J. van Eijck, Susannah G. Ellsworth, William R. Jarnagin, Eileen M. O'Reilly, Alessandro Paniccia, Marsha Reyngold, Marc G. Besselink, Matthew H. G. Katz, Ching-Wei D. Tzeng, Amer H. Zureikat, Bas Groot Koerkamp, Alice C. Wei
Summary: The value of neoadjuvant radiotherapy (RT) after (m)FOLFIRINOX for borderline resectable pancreatic ductal adenocarcinoma (PDAC) is uncertain. A retrospective cohort study showed that RT following (m)FOLFIRINOX was associated with more node-negative disease and better pathologic response in patients who underwent resection, but there was no difference in overall survival (OS).
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK
(2022)
Article
Oncology
Toshitaka Sugawara, Salvador Rodriguez Franco, Samantha Sherman, Michael J. Kirsch, Kathryn Colborn, Jun Ishida, Samuele Grandi, Mohammed H. Al-Musawi, Ana Gleisner, Richard D. Schulick, Marco Del Chiaro
Summary: The role of adjuvant chemotherapy (AC) in patients with pancreatic ductal adenocarcinoma (PDAC) who receive neoadjuvant chemotherapy (NAC) is unclear. This study aimed to evaluate the association of AC with overall survival (OS) in PDAC patients after surgical resection. The results showed that AC was associated with improved survival compared to no AC. AC may benefit patients with aggressive tumors in achieving prolonged survival.
Article
Oncology
Jacob L. van Dam, Quisette P. Janssen, Marc G. Besselink, Marjolein Y. Homs, Hjalmar C. van Santvoort, Geertjan van Tienhoven, Roeland F. de Wilde, Johanna W. Wilmink, Casper H. J. van Eijck, Bas Groot Koerkamp
Summary: This study found that neoadjuvant therapy can improve overall survival in patients with borderline resectable pancreatic cancer. However, more evidence is needed to determine whether it also improves survival in patients with resectable pancreatic cancer.
EUROPEAN JOURNAL OF CANCER
(2022)
Article
Oncology
Amro M. Abdelrahman, Ajit H. Goenka, Roberto Alva-Ruiz, Jennifer A. Yonkus, Jennifer L. Leiting, Rondell P. Graham, Kenneth W. Merrell, Cornelius A. Thiels, Christopher L. Hallemeier, Susanne G. Warner, Michael G. Haddock, Travis E. Grotz, Nguyen H. Tran, Rory L. Smoot, Wen Wee Ma, Sean P. Cleary, Robert R. McWilliams, David M. Nagorney, Thorvardur R. Halfdanarson, Michael L. Kendrick, Mark J. Truty
Summary: Among patients with post-NAT resected BR/LA PDAC, FDG-PET highly predicts pathologic response and survival, superior to biochemical responses alone. Given the poor ability of anatomic imaging or biochemical markers to assess NAT responses in these patients, FDG-PET is a preoperative metric of NAT efficacy, thereby allowing potential therapeutic alterations and surgical treatment decisions. We suggest that FDG-PET should be an adjunct and recommended modality during the NAT phase of care for these patients.
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK
(2022)
Article
Oncology
George Molina, Thomas E. Clancy, Thomas C. Tsai, Miranda Lam, Jiping Wang
Summary: Analysis of data from patients with borderline resectable pancreatic adenocarcinoma showed that non-White patients were less likely to undergo pancreatic resection compared to White patients. This racial disparity was attributed to variation in care within hospitals, but disappeared if non-White patients received neoadjuvant therapy.
ANNALS OF SURGICAL ONCOLOGY
(2021)
Article
Oncology
Roberto Alva-Ruiz, Lavanya Yohanathan, Jennifer A. Yonkus, Amro M. Abdelrahman, Lindsey A. Gregory, Thorvadur R. Halfdanarson, Amit Mahipal, Robert R. McWilliams, Wen Wee Ma, Christopher L. Hallemeier, Rondell P. Graham, Travis E. Grotz, Rory L. Smoot, Sean P. Cleary, David M. Nagorney, Michael L. Kendrick, Mark J. Truty
Summary: This study reviewed patients with borderline resectable/locally advanced pancreatic ductal adenocarcinoma who underwent neoadjuvant chemotherapy followed by either continued first-line chemotherapy or chemotherapy switch. The results showed that patients undergoing chemotherapy switch with subsequent curative-intent surgical resection did not have significantly different recurrence-free survival and overall survival compared to those receiving first-line chemotherapy. However, patients undergoing chemotherapy switch without subsequent resection had significantly worse overall survival.
ANNALS OF SURGICAL ONCOLOGY
(2022)