FOLFIRINOX Versus Gemcitabine/Nab-Paclitaxel for Neoadjuvant Treatment of Resectable and Borderline Resectable Pancreatic Head Adenocarcinoma

Dhir, Mashaal; Zenati, Mazen S.; Hamad, Ahmad; Singhi, Aatur D.; Bahary, Nathan; Hogg, Melissa E.; Zeh, Herbert J.; Zureikat, Amer H.

doi:10.1245/s10434-018-6512-8

Cited by 88 publications

(86 citation statements)

References 25 publications

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“…[ 21 ] Dhir et al also reported that neoadjuvant FOLFIRINOX was associated with a 4.9-month improvement in survival compared with G-nP after adjustment for covariates for resectable and BRPC. [ 22 ] As in previous reports, it has been shown that FOLFIRINOX may yield better results regarding oncological outcome in the current study even though there were no statistical differences in our study.…”

Section: Discussionsupporting

confidence: 76%

Arterial resection during pancreatectomy for pancreatic ductal adenocarcinoma with arterial invasion

et al. 2020

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Section: Discussionsupporting

confidence: 76%

Arterial resection during pancreatectomy for pancreatic ductal adenocarcinoma with arterial invasion

et al. 2020

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“…Individuals taking mFOLFIRINOX were also cancer‐free approximately 9 months longer than those taking gemcitabine. These results were obtain even if MVI was present, suggesting that patients may benefit from receiving chemotherapy to destroy undetectable micrometastases . The next step will be to explore the timing of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…These results were obtain even if MVI was present, suggesting that patients may benefit from receiving chemotherapy to destroy undetectable micrometastases. 20 The next step will be to explore the timing of chemotherapy. Patients may benefit from receiving chemotherapy before surgery (neoadjuvant chemotherapy), but another option may be to administer half of the chemotherapy cycles before surgery and the other half after surgery (perioperative chemotherapy).…”

Section: Recently a Meta-analysis Published By Han Et Al 19 Demonstrmentioning

confidence: 99%

Microvascular invasion is a major prognostic factor after pancreatico‐duodenectomy for adenocarcinoma

Panaro

Kellil

Vendrell

et al. 2019

Journal of Surgical Oncology

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Background Microvascular invasion (MVI) has been proved to be poor prognostic factor in many cancers. To date, only one study published highlights the relationship between this factor and the natural history of pancreatic cancer. The aim of this study was to assess the impact of MVI, on disease‐free survival (DFS) and overall survival (OS), after pancreatico‐duodenectomy (PD) for pancreatic head adenocarcinoma. Secondarily, we aim to demonstrate that MVI is the most important factor to predict OS after surgery compared with resection margin (RM) and lymph node (LN) status. Materials and Methods Between January 2015 and December 2017, 158 PD were performed in two hepato‐bilio‐pancreatic (HBP) centers. Among these, only 79 patients fulfilled the inclusion criteria of the study. Clinical‐pathological data and outcomes were retrospectively analyzed from a prospectively maintained database. Results Of the 79 patients in the cohort, MVI was identified in 35 (44.3%). In univariate analysis, MVI (P = .012 and P < .0001), RM (P = .023 and P = .021), and LN status (P < .0001 and P = .0001) were significantly associated with DFS and OS. A less than 1 mm margin clearance did not influence relapse (P = .72) or long‐term survival (P = .48). LN ratio > 0.226 had a negative impact on OS (P = .044). In multivariate analysis, MVI and RM persisted as independent prognostic factors of DFS (P = .0075 and P = .0098, respectively) and OS (P < .0001 and P = .0194, respectively). Using the likelihood ratio test, MVI was identified as the best fit to predict OS after PD for ductal adenocarcinomas compared with the margin status model (R0 vs R1) (P = .0014). Conclusion The MVI represents another major prognostic factor determining long‐term outcomes.

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“…Although the clinical benefits produced by 5-FU are lower than those of gemcitabine, 5-FU is still widely applied in treating pancreatic cancer partly due to its lower toxicity [139]. In recent years, increasing evidence has shown that the FOLFIRINOX regimen (5-FU, leucovorin, irinotecan and oxaliplatin) can achieve longer overall survival than gemcitabine-based therapy, especially in patients with good status [140][141][142][143][144]. Compared with other chemotherapy regimens, the underlying mechanism of gemcitabine resistance is relatively well documented [131].…”

Section: Chemoresistance and Metabolismmentioning

confidence: 99%

Metabolism of pancreatic cancer: paving the way to better anticancer strategies

et al. 2020

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Pancreatic cancer is currently one of the most lethal diseases. In recent years, increasing evidence has shown that reprogrammed metabolism may play a critical role in the carcinogenesis, progression, treatment and prognosis of pancreatic cancer. Affected by internal or external factors, pancreatic cancer cells adopt extensively distinct metabolic processes to meet their demand for growth. Rewired glucose, amino acid and lipid metabolism and metabolic crosstalk within the tumor microenvironment contribute to unlimited pancreatic tumor progression. In addition, the metabolic reprogramming involved in pancreatic cancer resistance is also closely related to chemotherapy, radiotherapy and immunotherapy, and results in a poor prognosis. Reflective of the key role of metabolism, the number of preclinical and clinical trials about metabolism-targeted therapies for pancreatic cancer is increasing. The poor prognosis of pancreatic cancer patients might be largely improved after employing therapies that regulate metabolism. Thus, investigations of metabolism not only benefit the understanding of carcinogenesis and cancer progression but also provide new insights for treatments against pancreatic cancer.

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FOLFIRINOX Versus Gemcitabine/Nab-Paclitaxel for Neoadjuvant Treatment of Resectable and Borderline Resectable Pancreatic Head Adenocarcinoma

Abstract: Both FOLFIRINOX and G-nP are viable options for neoadjuvant treatment of PDA. In this study, neoadjuvant FOLFIRINOX was associated with a 4.9-month improvement in survival compared with G-nP after adjustment for covariates.

Cited by 88 publications

References 25 publications

Arterial resection during pancreatectomy for pancreatic ductal adenocarcinoma with arterial invasion

Arterial resection during pancreatectomy for pancreatic ductal adenocarcinoma with arterial invasion

Microvascular invasion is a major prognostic factor after pancreatico‐duodenectomy for adenocarcinoma

Metabolism of pancreatic cancer: paving the way to better anticancer strategies

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