Better Outcome of XELOX Chemotherapy in Patients with Advanced Intestinal-Type Adenocarcinoma of the Ampulla of Vater

Kim, Han Sang; Shin, Sang Joon; Kim, Joo Hang; Kim, Hyunki; Choi, Hye Jin

doi:10.1620/tjem.231.21

Cited by 13 publications

(7 citation statements)

References 30 publications

(36 reference statements)

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“…Hence, it was stated that CAPOX should be regarded as a first-line standard treatment in this neoplasm. Very similar conclusions were drawn in 2013 by Kim et al [10]. This group used the same regimen on a cohort of 21 patients affected by Vater's ampulla intestinal-type cancers.…”

Section: Chemotherapy Combinationssupporting

confidence: 74%

Systemic Treatments for Advanced Small Bowel Adenocarcinoma: A Systematic Review

Nardo

Garattini

Torrisi

et al. 2022

Cancers

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Small bowel adenocarcinoma (SBA) is a rare disease for which scarce evidence is available. We summarized data available on systemic treatment of advanced SBA. Methods: Scientific literature was evaluated to find phase II or phase III clinical trials on systemic treatment for advanced SBA. MeSH terms were selected and combined for the initial search, then inclusion and exclusion criteria were set in a search protocol. Four medical oncologists looked for evidence on Medline, EMBASE and Cochrane databases. Moreover, abstracts from 2016 to June 2021 from the American Society for Clinical Oncology, European Society for Medical Oncology, Gastrointestinal Cancer Symposium and World Congress on Gastrointestinal Cancer were browsed. The selected studies, matching the inclusion and exclusion criteria, were finally tabulated and analyzed. Results: The trials finally selected were 18 phase II/III clinical trials. Four small phase II trials support the activity of oxaliplatin-based doublets in first-line treatment (CAPOX and mFOLFOX). Conclusion: No good level evidence is available on the use of bevacizumab, anti-epidermal growth factor receptor, targeted agents or immunotherapy. First-line treatments are largely derived from colorectal cancer protocols, mainly oxaliplatin-based doublets.

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Section: Chemotherapy Combinationssupporting

confidence: 74%

Systemic Treatments for Advanced Small Bowel Adenocarcinoma: A Systematic Review

Nardo

Garattini

Torrisi

et al. 2022

Cancers

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“…Prolonged survival for patients with SBA and IAA has been demonstrated for treatment with capecitabine and oxaliplatin, and fluorouracil, leucovorin and oxaliplatin combination chemotherapy. 15 , 21 , 63 In addition, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was reported to enhance survival in SBA with peritoneal metastases. 64 …”

Section: Discussionmentioning

confidence: 99%

“…Given the similarities between SBA and CRC, interchangeable radio- and chemotherapeutic strategies are frequently offered to patients with DA. 5 , 15 , 16 In CRC, palliative chemotherapy for metastatic disease and adjuvant chemotherapy for resected node-positive CRC have become standard of care. 17 – 19 Therefore, the effect of similar regimens has been investigated for adjuvant and palliative treatment in DA, including fluorouracil-based chemotherapy, often combined with a platinum analog or radiation therapy.…”

mentioning

confidence: 99%

Outcomes and Treatment Options for Duodenal Adenocarcinoma: A Systematic Review and Meta-Analysis

et al. 2018

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BackgroundDuodenal adenocarcinoma (DA) is a rare tumor for which survival data per treatment modality and disease stage are unclear. This systematic review and meta-analysis aims to summarize the current literature on patient outcome after surgical, (neo)adjuvant, and palliative treatment in patients with DA.MethodsA systematic search was performed according to the preferred reporting items for systematic reviews and meta-analyses guidelines, to 25 April 2017. Primary outcome was overall survival (OS), specified for treatment strategy or disease stage. Random-effects models were used for the calculation of pooled odds ratios per treatment modality. Included papers were also screened for prognostic factors.ResultsA total of 26 observational studies, comprising 6438 patients with DA, were included. Of these, resection with curative intent was performed in 71% (range 53–100%) of patients, and 29% received palliative treatment (range 0–61%). The pooled 5-year OS rate was 46% after curative resection, compared with 1% in palliative-treated patients (OR 0.04, 95% confidence interval [CI] 0.02–0.09, p < 0.0001). Both segmental resection and pancreaticoduodenectomy allowed adequate assessment of lymph node involvement and resulted in similar OS. Lymph node involvement correlated with worse OS (pooled 5-year survival rate 21% for nodal metastases vs. 65% for node-negative disease; OR 0.17, 95% CI 0.11–0.27, p < 0.0001). In the current literature, no survival benefit for adjuvant therapy after curative resection was found.ConclusionResection with curative intent, either pancreaticoduodenectomy or segmental resection, and lack of nodal metastases, favors survival for DA. Further studies exploring multimodality (neo)adjuvant therapy are warranted to investigate their benefit.Electronic supplementary materialThe online version of this article (10.1245/s10434-018-6567-6) contains supplementary material, which is available to authorized users.

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“…19, 30, 31 In the present study, histopathologic subtype of AMPA (intestinal or pancreaticobiliary) was not a predictor of major pathologic response to preoperative therapy. Previous studies that have addressed this topic have produced inconsistent results; some have shown that histomorphologic subtypes predict response to specific chemotherapy, 9, 32 while others have shown no impact of subtype on chemotherapy response. 3, 8, 33 …”

Section: Discussionmentioning

confidence: 99%

Pathologic Response to Preoperative Therapy as a Novel Prognosticator for Ampullary and Duodenal Adenocarcinoma

et al. 2017

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Background: The prognostic impact of pathologic response to preoperative therapy in patients with duodenal adenocarcinoma (DA) and ampullary adenocarcinoma (AMPA) has not been established. Methods: A retrospective review of 266 patients who underwent curative resection for DA (n=97) or AMPA (n=169) during 1993–2015 was performed. For patients who underwent preoperative therapy, pathologic response was systematically evaluated and classified as major (0%−49% of viable residual tumor cells) or minor (≥50% of viable residual tumor cells). Univariable and multivariable analyses were performed to identify predictors of pathologic response and disease-specific survival (DSS). Results: In the 79 patients treated with preoperative therapy (DA n=34; AMPA n=45), concomitant use of radiation (67/79, 80%) was the sole independent predictor of major pathologic response (odds ratio: 8.17, 95% CI: 1.85–58.2, P=0.005). Patients with major pathologic response had a better 5-year DSS rate than patients with minor pathologic response (DA, 65% vs. 25%, P=0.028; AMPA, 85% vs. 43%, P=0.016). On multivariable analysis of DSS in the 79 patients who underwent preoperative therapy, major pathologic response was the sole predictor of improved DSS (hazard ratio: 2.88, 95% CI: 1.41–5.98, P=0.004). On multivariable analysis of DSS in the entire cohort, pathologic stage ≤II was the sole predictor of better DSS. Conclusion: Major pathologic response to preoperative therapy predicted improved DSS after resection of DA and AMPA and might represent a new prognosticator after resection of DA and AMPA.

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Better Outcome of XELOX Chemotherapy in Patients with Advanced Intestinal-Type Adenocarcinoma of the Ampulla of Vater

Cited by 13 publications

References 30 publications

Systemic Treatments for Advanced Small Bowel Adenocarcinoma: A Systematic Review

Systemic Treatments for Advanced Small Bowel Adenocarcinoma: A Systematic Review

Outcomes and Treatment Options for Duodenal Adenocarcinoma: A Systematic Review and Meta-Analysis

Pathologic Response to Preoperative Therapy as a Novel Prognosticator for Ampullary and Duodenal Adenocarcinoma

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