Pancreatectomy with PV resection can be performed safely. Even in radiographic classification type B, pathological PV wall invasion was observed in 51% of patients. Long-term survival was observed in types A and B, and grades 0 and 1.
In 2005, we initiated a clinical trial that examined the efficacy of the oncolytic virus HF10 to treat pancreatic cancer. Pancreatic cancer continues to have a high mortality rate, despite multimodal treatments for patients, and new therapeutic methods are greatly needed. The current mainstream methods for cancer treatment include biological therapeutics such as trastuzumab (Herceptin) for breast cancer or erlotinib (Tarceva) for non-small cell lung cancer. Oncolytic virus therapy is a new and promising treatment strategy for cancer. Oncolytic viruses are novel biological therapeutics for advanced cancer that appear to have a wide spectrum of anticancer activity with minimal human toxicity. To examine the efficacy of oncolytic virus therapy for pancreatic cancer, we initiated pilot studies by injecting six patients with non-resectable pancreatic cancer with three doses of HF10. All patients were monitored for 30 days for local and systemic adverse effects and were not administered any other therapeutics during this period. There were no adverse side-effects, and we observed some therapeutic potential based on tumor marker levels, survival, pathological findings and diagnostic radiography. The tumors were classified as stable disease in three patients, partial response in one patient and progressive disease in two patients.
Pancreatic cancer frequently metastasized to distant LNs via a complex pathway and developed into systemic disease. Aggressive multimodality therapy, including neoadjuvant therapy, is essential to improve the long-term survival of patients at substantial risk of distant LN metastasis.
Our results suggest that preservation of the pyloric ring without vagal innervation has little significance, and that SSPPD with better perioperative and long-term outcomes is more suitable as a standard procedure for patients with pancreatic head cancer.
PF was statistically significantly related to peritoneal recurrence, and patients with PF developed peritoneal recurrence earlier than those without PF. With regard to the development of peritoneal recurrence, PF may be considered to be a negative prognostic factor.
Breast cancer is one of the most common and feared cancers faced by women. The prognosis of patients with advanced or recurrent breast cancer remains poor despite refinements in multimodality therapies involving chemotherapeutic and hormonal agents. Multimodal therapy with more specific and effective strategy is urgently needed. The oncolytic herpes simplex virus (HSV) has potential to become a new effective treatment option because of its broad host range and tumor selective viral distribution. Bevacizumab is a monoclonal antibody against VEGFA, which inhibits angiogenesis and therefore tumor growth. Our approach to enhance the antitumor effect of the oncolytic HSV is to combine oncolytic HSV HF10 and bevacizumab in the treatment of breast cancer. Our results showed that bevacizumab enhanced viral distribution as well as tumor hypoxia and expanded the population of apoptotic cells and therefore induced a synergistic antitumor effect. HF10 is expected to be a promising agent in combination with bevacizumab in the anticancer treatment.Breast cancer is one of the most common and feared cancers faced by women worldwide. According to the latest statistics on cancer, breast cancer has already been the second leading cause of death for women in the United States. 1 However, the treatment of patients who are diagnosed at an advanced stage and curative surgical treatments are sometimes difficult due to the presence of recurrence and metastases. Furthermore, the long-term prognosis of curatively resected advanced breast cancer remains unsatisfactory because of its high recurrence rate after surgery. Currently, the available chemotherapeutic reagents have only limited efficacy against these recurrent diseases. In particular, the prognosis of patients with advanced or recurrent breast cancer remains poor despite refinements in multimodality therapies involving chemotherapeutic and hormonal agents. 1-7 Multimodal therapy with more specific and effective strategy is urgently needed.So far, the increasing evidence from preclinical and clinical data suggests that the oncolytic viral therapy could be an effective therapeutic modality in the treatment of advanced cancer. Various strains of viruses, such as adenovirus, herpes simplex virus, Newcastle disease virus, measles virus, vesicular stomatitis virus and vaccinia virus are being evaluated for their oncolytic capability and many of them have already progressed to the clinical trial phase. Among them, the oncolytic herpes simplex virus (HSV) is an ideal candidate because of its broad host range, tumor selective viral distribution and the characteristic of being controlled by antiviral drugs. 6-9 HF10 is a highly attenuated, replication-competent mutant strain of HSV-1 and displays strong tumor killing activity in vivo and in vitro. [10][11][12] We previously performed a phase I dose-escalation clinical trial using HF10 for the patients with recurrent breast cancer or unresectable pancreatic cancer and demonstrated its safety and efficacy. 13,14 However, studies with the oncol...
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