Combination therapy with gemcitabine and nab-paclitaxel for locally advanced unresectable pancreatic cancer

Saito, Takeshi; Ishido, Keinosuke; Kudo, Daisuke; Kimura, Norihisa; Wakiya, Taiichi; Nakayama, Yoshihito; Hakamada, Kenichi

doi:10.3892/mco.2017.1251

Cited by 23 publications

(18 citation statements)

References 24 publications

(24 reference statements)

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“…So far, several articles related to CS for UR-PC patients have been reported. [8][9][10][11][12][13][14][15][16] Our results in this study may be the best among these previous articles. These values seemed to indicate the possibility of prognostic improvement effect in CS for patients with UR-PC to a certain extent.…”

Section: Discussionsupporting

confidence: 56%

“…This surgical strategy is called 5 "conversion surgery (CS)." 6,7 Several articles have also been reported for CS in patients with unresectable PC (UR-PC), [8][9][10][11][12][13][14][15][16] and its prognostic effect to CS have been mentioned. Hereafter, because of the remarkable progress of NST, candidates with UR-PC for CS is expected to increase.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Survival benefit of conversion surgery for patients with initially unresectable pancreatic cancer who responded favorably to nonsurgical treatment

Asano

Hirano

Nakamura

et al. 2018

J Hepato Biliary Pancreat

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Survival benefit of conversion surgery for patients with initially unresectable pancreatic cancer who responded favorably to nonsurgical treatment

Asano

Hirano

Nakamura

et al. 2018

J Hepato Biliary Pancreat

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“…Conversion surgery represents a new therapeutic strategy which may improve short- and long-term outcomes of patients with UR-PDAC. Several articles have reported the utility of CS in such patients, as well as the positive effects on prognosis [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. In the present study, the rate of CS among patients with UR-LA and UR-M was similar to that reported previously [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Benefits of Conversion Surgery after Multimodal Treatment for Unresectable Pancreatic Ductal Adenocarcinoma

Yanagimoto

Satoi

Yamamoto

et al. 2020

Cancers

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Background: Traditionally, the treatment options for unresectable locally advanced (UR-LA) and metastatic (UR-M) pancreatic ductal adenocarcinoma (PDAC) are palliative chemotherapy or chemoradiotherapy. The benefits of surgery for such patients remains unknown. The present study investigated clinical outcomes of patients undergoing conversion surgery (CS) after chemo(radiation)therapy for initially UR-PDAC. Methods: We recruited patients with UR-PDAC who underwent chemo(radiation)therapy for initially UR-PDAC between April 2006 and September 2017. We analyzed resectability of CS, predictive parameters for overall survival, and early recurrence (within six months). Results: A total of 468 patients (108 with UR-LA and 360 with UR-M PDAC) were enrolled in this study, of whom, 17 (15.7%) with UR-LA and 15 (4.2%) with UR-M underwent CS. The median survival time (MST) and five-year survival of patients who underwent CS was 37.2 months and 34%, respectively; significantly better than non-resected patients (nine months and 1%, respectively, p < 0.0001). MST did not differ according to UR-LA or UR-M (50.5 vs. 29.0 months, respectively, p = 0.53). Early recurrence after CS occurred in eight patients (18.8%). Lymph node metastasis, positive washing cytology, large tumor size (>35 mm), and lack of postoperative adjuvant chemotherapy were statistically significant predictive factors for early recurrence. Moreover, the site of pancreatic lesion and administration of postoperative adjuvant chemotherapy were statistically significant prognostic factors for overall survival in the patients undergoing CS. Conclusion: Conversion surgery offers benefits in terms of increase survival for initially UR-PDAC for patients who responded favorably to chemo(radiation)therapy when combined with postoperative adjuvant chemotherapy.

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“…The trial resulted in the confirmed safety and tolerability of the full dose treatment. A small retrospective analysis was published in 2017 [47], where seven LAPC patients were treated with GemNab, of which two underwent a R0 resection, with a median survival for all the patients of 13.3 months.…”

Section: Resultsmentioning

confidence: 99%

Neoadjuvant Treatment in Locally Advanced Pancreatic Cancer (LAPC) Patients with FOLFIRINOX or Gemcitabine NabPaclitaxel: A Single-Center Experience and a Literature Review

Napolitano

Formisano

Giardino

et al. 2019

Cancers

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The optimal therapeutic strategy for locally advanced pancreatic cancer patients (LAPC) has not yet been established. Our aim is to evaluate how surgery after neoadjuvant treatment with either FOLFIRINOX (FFN) or Gemcitabine-NabPaclitaxel (GemNab) affects the clinical outcome in these patients. LAPC patients treated at our institution were retrospectively analysed to reach this goal. The group characteristics were similar: 35 patients were treated with the FOLFIRINOX regimen and 21 patients with Gemcitabine Nab-Paclitaxel. The number of patients undergoing surgery was 14 in the FFN group (40%) and six in the GemNab group (28.6%). The median Disease-Free Survival (DFS) was 77.10 weeks in the FFN group and 58.65 weeks in the Gem Nab group (p = 0.625), while the median PFS in the unresected group was 49.4 weeks in the FFN group and 30.9 in the GemNab group (p = 0.0029, 95% CI 0.138–0.862, HR 0.345). The overall survival (OS) in the resected population needs a longer follow up to be completely assessed, while the median overall survival (mOS) in the FFN group was 72.10 weeks and 53.30 weeks for the GemNab group (p = 0.06) in the unresected population. Surgery is a valuable option for LAPC patients and it is able to induce a relevant survival advantage. FOLFIRINOX and Gem-NabPaclitaxel should be offered as first options to pancreatic cancer patients in the locally advanced setting.

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Combination therapy with gemcitabine and nab-paclitaxel for locally advanced unresectable pancreatic cancer

Cited by 23 publications

References 24 publications

Survival benefit of conversion surgery for patients with initially unresectable pancreatic cancer who responded favorably to nonsurgical treatment

Survival benefit of conversion surgery for patients with initially unresectable pancreatic cancer who responded favorably to nonsurgical treatment

Benefits of Conversion Surgery after Multimodal Treatment for Unresectable Pancreatic Ductal Adenocarcinoma

Neoadjuvant Treatment in Locally Advanced Pancreatic Cancer (LAPC) Patients with FOLFIRINOX or Gemcitabine NabPaclitaxel: A Single-Center Experience and a Literature Review

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