Conversion Therapy for Advanced Pancreatic Cancer: The Case Series and Literature Review

Abstract

Background: Pancreatic cancer has a high incidence and mortality. Most patients are in an advanced stage at the time of initial diagnosis and cannot be cured by a single surgery. The ASCO clinical practice guideline emphasized the overall management and multidisciplinary comprehensive treatment which put forward the concept of conversion therapy. In this paper, the real-world observation and study were carried out to explore the conversion effect of chemotherapy in patients with advanced pancreatic cancer and their long-term survival. Methods: The subjects of this study are advanced pancreatic cancer patients who visited the oncology department of Zhejiang Provincial People's Hospital from 2015 to 2019. Collected and summarized the cases, and selected 5 representative patients for analysis, all of them received standard treatment (FOLFIRINOX, AS, AG, or GS). The progress, clinical evaluation, adverse reactions, and prognosis of these patients after conversion therapy were analyzed and discussed in conjunction with relevant literature. Results: Five patients with advanced pancreatic cancer received conversion therapy with an average survival time of 29.8 months, two of them received surgical treatment, and postoperative evaluations were pathological complete response (pCR). The tolerance of chemotherapy was good in five patients, and no serious adverse reactions of grade 3 or 4 occurred. Conclusion: Conversion therapy for patients with advanced pancreatic cancer strives for surgical opportunities of radical resection, prolongs survival and improves quality of life.

New Insights into LINC00346 and its Role in Disease

“…LINC00346 was also found to affect cell proliferation and survival by regulating the JAK-STAT3 signaling pathway (Yin et al, 2020). Pancreatic carcinoma is one of the most malignant tumors and has an extremely poor prognosis (Xu D. et al, 2020;Wang et al, 2020;Chen et al, 2021). Chemotherapy is an important method of adjuvant therapy in the comprehensive treatment of pancreatic cancer (Rahman et al, 2017;Zhu et al, 2019).…”

Conversion Therapy of Intrahepatic Cholangiocarcinoma Is Associated with Improved Prognosis and Verified by a Case of Patient-Derived Organoid

“…The concept of conversion therapy was proposed by Bismuth H. et al in 1996, which demonstrated that initially unresectable malignant tumors can be downstaged using systemic or local treatment, such that patients could likely undergo surgical resection [ 7 ]. This technique was first used in the treatment of colorectal cancers (CRC) and is currently used widely in the treatment of various cancers including gastric and pancreatic cancers (PC) and hepatocellular carcinoma (HCC) [ 8 , 9 , 10 ]. Recently, the efficacy of conversion therapy in patients with IHCC was verified using several studies, which indicated that adequate tumor downstaging was achieved by systemic or local treatment and patients could obtain a relatively satisfactory prognosis [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”