Pancreatic cancer

Yeo, Theresa P.; Hruban, Ralph H.; Leach, Steven D.; Wilentz, Robb E.; Sohn, Taylor A.; Kern, Scott E.; Iacobuzio‐Donahue, Christine A.; Maitra, Anirban; Goggins, Michael; Canto, Marcia Irene; Abrams, Ross A.; Laheru, Daniel A.; Jaffee, Elizabeth M.; Hidalgo, Manuel; Yeo, Charles J.

doi:10.1067/mcn.2002.129579

Cited by 278 publications

(141 citation statements)

References 171 publications

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“…The distinct sex‐related difference in incidence reported on a worldwide basis, with incidence rates being higher among men, thus no longer applies to Sweden. Tobacco smoking,4, 5, 6 high age4, 7, 8 and heredity9, 10 seem to be the only truly validated risk factors for pancreatic cancer. Several other risk factors have been investigated, and numerous studies claim a significant impact of diabetes,11, 12, 13 pancreatitis,14, 15, 16 alcohol17, 18, 19, 20 and body mass index (BMI)13, 21, 22, 23; however, no consensus has yet been reached.…”

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confidence: 99%

Hormonal factors and pancreatic cancer risk in women: The Malmö Diet and Cancer Study

Andersson

Borgquist

Jirström

2018

Intl Journal of Cancer

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The incidence of pancreatic cancer is leveling between sexes. Smoking, high age and heredity are established risk factors, but evidence regarding the influence of hormonal factors is unclear. In this study, we investigated the associations of reproductive factors, use of oral contraceptives (OC) and hormone replacement therapy (HRT) with pancreatic cancer risk in the Malmö Diet and Cancer Study, a prospective, population‐based cohort encompassing 17,035 women. Up until 31 December 2015, 110 women were identified with incident pancreatic cancer through the Swedish Cancer Registry. Higher age at menarche was significantly associated with pancreatic cancer risk (age‐adjusted [hazard ratio] HR = 1.17; 95% confidence interval [CI] 1.04–1.32, and fully adjusted HR = 1.17; 95% CI 1.04–1.32). Ever use of OC was not significantly associated with pancreatic cancer risk but ever use of HRT was significantly associated with a decreased risk of pancreatic cancer (age‐adjusted HR = 0.47, 95% CI 0.23–0.97, and fully adjusted HR = 0.48, 95% CI 0.23–1.00), in particular use of estrogen‐only regimen (age‐adjusted HR = 0.21; 95% CI 0.05–0.87 and fully adjusted HR = 0.22; 95% CI 0.05–0.90). Age at menopause or first childbirth, parity and breastfeeding history were not significantly associated with pancreatic cancer risk. Collectively, these findings suggest a protective role of female hormones against pancreatic cancer. Further studies are needed, and potential modifying genetic factors and indirect hazardous effects of smoking should also be considered.

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confidence: 99%

Hormonal factors and pancreatic cancer risk in women: The Malmö Diet and Cancer Study

Andersson

Borgquist

Jirström

2018

Intl Journal of Cancer

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“…1,2 The major reasons for such high mortality rates are the late presentation of the disease and lack of effective therapies. The mainstay of chemotherapy for advanced pancreatic cancer is gemcitabine.…”

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confidence: 99%

Activated Epidermal Growth Factor Receptor as a Novel Target in Pancreatic Cancer Therapy

et al. 2008

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Pancreatic cancer is one of the most fatal among all solid malignancies. Targeted therapeutic approaches have the potential to transform cancer therapy as exemplified by the success of several tyrosine kinase inhibitors. Prompted by this, comprehensive profiling of tyrosine kinases and their substrates was carried out using a panel of low passage pancreatic cancer cell lines. One of the pancreatic cancer cell lines, P196, which showed dramatic upregulation of tyrosine kinase activity as compared to non-neoplastic cells, was systematically studied using a quantitative proteomic approach called stable isotope labeling with amino acids in cell culture (SILAC). A careful analysis of activated tyrosine kinase pathways revealed aberrant activation of epidermal growth factor receptor pathway in this cell line. Mouse xenograft based studies using EGFR inhibitor erlotinib confirmed EGFR pathway to be responsible for proliferation in these tumors. By a systematic study across low passage pancreatic cancer cell lines and mice carrying pancreatic cancer xenografts, we have demonstrated activated epidermal growth factor receptor as an attractive candidate for targeted therapy in a subset of pancreatic cancers. Further, we propose immunohistochemical labeling of activated EGFR (pEGFR 1068 ) as an efficient screening tool to select patients who are more likely to respond to EGFR inhibitors.

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“…Pancreatic cancer accounts for 3% of all cancers, but is the fifth leading cause of cancer death in Western countries (Yeo et al, 2005). At the time of diagnosis, approximately half of the patients have metastases, and the median survival time barely exceeds 6 months, whereas approximately one-third of patients diagnosed with locally advanced disease have median survival times ranging between 6 and 9 months.…”

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confidence: 99%

A randomised phase II study of modified FOLFIRI.3 vs modified FOLFOX as second-line therapy in patients with gemcitabine-refractory advanced pancreatic cancer

et al. 2009

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BACKGROUND: Only a few clinical trials have been conducted in patients with advanced pancreatic cancer after failure of first-line gemcitabine-based chemotherapy. Therefore, there is no current consensus on the treatment of these patients. We conducted a randomised phase II study of the modified FOLFIRI.3 (mFOLFIRI.3; a regimen combining 5-fluorouracil (5-FU), folinic acid, and irinotecan) and modified FOLFOX (mFOLFOX; a regimen combining folinic acid, 5-FU, and oxaliplatin) regimens as second-line treatments in patients with gemcitabine-refractory pancreatic cancer. METHODS: The primary end point was the 6-month overall survival rate. The mFOlFIRI.3 regimen consisted of irinotecan (70 mg m À2 ; days 1 and 3), leucovorin (400 mg m À2 ; day 1), and 5-FU (2000 mg m À2 ; days 1 and 2) every 2 weeks. The mFOLFOX regimen was composed of oxaliplatin (85 mg m À2 ; day 1), leucovorin (400 mg m À2 ; day 1), and 5-FU (2000 mg m À2 ; days 1 and 2) every 2 weeks. RESULTS: Sixty-one patients were randomised to mFOLFIRI.3 (n ¼ 31) or mFOLFOX (n ¼ 30) regimen. The six-month survival rates were 27% (95% confidence interval (CI) ¼ 13 -46%) and 30% (95% CI ¼ 15 -49%), respectively. The median overall survival periods were 16.6 and 14.9 weeks, respectively. Disease control was achieved in 23% (95% CI ¼ 10 -42%) and 17% patients (95% CI ¼ 6 -35%), respectively. The number of patients with at least one grade 3/4 toxicity was identical (11 patients, 38%) in both groups: neutropenia (7 patients under mFOLFIRI.3 regimen vs 6 patients under mFOLFOX regimen), asthaenia (1 vs 4), vomiting (3 in both), diarrhoea (2 vs 0), and mucositis (1 vs 2). CONCLUSION: Both mFOLFIRI.3 and mFOLFOX regimens were tolerated with manageable toxicity, offering modest activities as second-line treatments for patients with advanced pancreatic cancer, previously treated with gemcitabine.

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Pancreatic cancer

Cited by 278 publications

References 171 publications

Hormonal factors and pancreatic cancer risk in women: The Malmö Diet and Cancer Study

Hormonal factors and pancreatic cancer risk in women: The Malmö Diet and Cancer Study

Activated Epidermal Growth Factor Receptor as a Novel Target in Pancreatic Cancer Therapy

A randomised phase II study of modified FOLFIRI.3 vs modified FOLFOX as second-line therapy in patients with gemcitabine-refractory advanced pancreatic cancer

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