Management strategies in pancreatic cancer

Campen, C. M. C. van; Dragovich, Tomislav; Baker, Amanda F.

doi:10.2146/ajhp100254

Cited by 24 publications

(21 citation statements)

References 69 publications

(85 reference statements)

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“…A multidrug combination of FOLFIRINOX has demonstrated considerable activity in a population of younger and ft patients (median OS of 11.2 months) but with some considerable toxicity [4]. In the second-line therapy setting, options are even more limited in terms of available and effective therapies [5]. …”

Section: Introductionmentioning

confidence: 99%

Phase II trial of vatalanib in patients with advanced or metastatic pancreatic adenocarcinoma after first-line gemcitabine therapy (PCRT O4-001)

Dragovich

Laheru

Dayyani

et al. 2014

Cancer Chemother Pharmacol

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Purpose Vatalanib (PTK 787/ZK22584) is an oral polytyrosine kinase inhibitor with strong affinity for platelet-derived growth factor and vascular endothelial growth factor (VEGF) receptors. We conducted an open-label, phase II multicenter therapeutic trial investigating the efficacy and tolerability of vatalanib in patients with metastatic or advanced pancreatic cancer who failed first-line gemcitabine-based therapy. Methods Vatalanib treatment consisted of a twice daily oral dosing using a “ramp-up schedule,” beginning with 250 mg bid during week 1,500 mg bid during week 2, and 750 mg bid on week three and thereafter. the primary objective of this study was to evaluate the 6-month survival rate. Results Sixty-seven patients were enrolled. The median age was 64, and 66 %(N = 43) had only one prior regimen. Common grade 3/4 adverse events included hypertension (20 %; N = 13), fatigue (17 %; N = 11), abdominal pain (17 %; N = 11), and elevated alkaline phosphatase (15 %; N = 10). among the 65 evaluable patients, the 6-month survival rate was 29 % (95 % CI 18–41 %) and the median progression-free survival was 2 months. Fifteen patients survived 6 months or more. two patients had objective partial responses, and 28 % of patients had stable disease. Changes in biomarkers including soluble VEGF and vascular endothelial growth factor receptor did not correlate with response to drug. Conclusion Vatalanib was well tolerated as a second-line therapy and resulted in favorable 6-month survival rate in patients with metastatic pancreatic cancer, compared with historic controls.

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Section: Introductionmentioning

confidence: 99%

Phase II trial of vatalanib in patients with advanced or metastatic pancreatic adenocarcinoma after first-line gemcitabine therapy (PCRT O4-001)

Dragovich

Laheru

Dayyani

et al. 2014

Cancer Chemother Pharmacol

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“…Surgical resection is the only cure for pancreatic adenocarcinoma although 80% of patients have unresectable disease at the time of presentation (Campen et al, 2011). Pancreaticoduodenectomy and distal pancreatectomy with or without splenectomy are performed in patients with tumors in the head and body/tail of the pancreas, respectively (De La Cruz et al, 2014).…”

Section: Standards Of Therapymentioning

confidence: 99%

Diabetes, pancreatic cancer, and metformin therapy

et al. 2014

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Pancreatic cancer carries a poor prognosis as most patients present with advanced disease and preferred chemotherapy regimens offer only modest effects on survival. Risk factors include smoking, obesity, heavy alcohol, and chronic pancreatitis. Pancreatic cancer has a complex relationship with diabetes, as diabetes can be both a risk factor for pancreatic cancer and a result of pancreatic cancer. Insulin, insulin-like growth factor-1 (IGF-1), and certain hormones play an important role in promoting neoplasia in diabetics. Metformin appears to reduce risk for pancreatic cancer and improve survival in diabetics with pancreatic cancer primarily by decreasing insulin/IGF signaling, disrupting mitochondrial respiration, and inhibiting the mammalian target of rapamycin (mTOR) pathway. Other potential anti-tumorigenic effects of metformin include the ability to downregulate specificity protein transcription factors and associated genes, alter microRNAs, decrease cancer stem cell proliferation, and reduce DNA damage and inflammation. Here, we review the most recent knowledge on risk factors and treatment of pancreatic cancer and the relationship between diabetes, pancreatic cancer, and metformin as a potential therapy.

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“…8,[143][144][145] The administration of chemotherapy has increased over time and improves survival and QOL. 3,12,91,124,146 Clinical practice guidelines recommend adjuvant chemotherapy to reduce the risk of recurrence following resection of the primary pancreatic tumour.…”

Section: Chemotherapymentioning

confidence: 99%

“…6 Despite these publications it is apparent that there is considerable variation in the quality of management and care of patients with pancreatic cancer. [7][8][9] There have been few attempts to describe management of pancreatic cancer at a population level, but evidence from the limited population-based studies that have been conducted in Australia (2011), Europe (2009) and the United States (2007) suggest that multimodality therapies are underutilised and that this may be related to patient and/or health-service characteristics. 12,13,15 Data reflecting the current status of the variability in the management of patients with pancreatic cancer and the factors associated with the choice of different treatments is required.…”

Section: 103 272mentioning

confidence: 99%

“…Despite these publications there is evidence from a range of countries that there is variability in management and under-use of treatment for patients diagnosed with pancreatic cancer. [7][8][9] Rurality of residence, socio-economic status, marital status and age have all been shown to influence the treatment and management of care that patients receive. [10][11][12][13] In Australia there appears to be variability in survival according to location of residence, with people living in rural areas having poorer survival than those in cities.…”

Section: Introductionmentioning

confidence: 99%

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Patterns of care in patients with pancreatic cancer

Burmeister¹

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Management strategies in pancreatic cancer

Cited by 24 publications

References 69 publications

Phase II trial of vatalanib in patients with advanced or metastatic pancreatic adenocarcinoma after first-line gemcitabine therapy (PCRT O4-001)

Phase II trial of vatalanib in patients with advanced or metastatic pancreatic adenocarcinoma after first-line gemcitabine therapy (PCRT O4-001)

Diabetes, pancreatic cancer, and metformin therapy

Patterns of care in patients with pancreatic cancer

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