S3-Guideline “Exocrine Pancreatic Carcinoma” 2007

Adler, Guido; Seufferlein, T; Bischoff, Sven; Brambs, Hans‐Jürgen; Feuerbach, Stefan; Grabenbauer, Gerhard G.; Hahn, Susanne; Hohenberger, Werner; Langrehr, J. M.; Lutz, M. P.; Micke, Oliver; Neuhaus, Horst; Oettle, Helmut; Schlag, P. M.; Schmid, R; Schmiegel, W.; Schlottmann, Klaus; Werner, Jochen A.; Wiedenmann, B.; Kopp, I.

doi:10.1055/s-2008-1027420

Cited by 27 publications

(44 citation statements)

References 134 publications

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“…10 ( Cetuximab, gemcitabine and oxaliplatin in pancreatic cancer F Kullmann et al numerous trials evaluated a variety of combination protocols with two and even three drug regimens (Adler et al, 2007). In a phase II study of Louvet et al (2002), gemcitabine combined with oxaliplatin resulted in a high response rate (31%), and median OS was also promising for patients with metastatic and locally advanced disease with 8.7 and 11.5 months, respectively.…”

Section: Discussionmentioning

confidence: 99%

Cetuximab plus gemcitabine/oxaliplatin (GEMOXCET) in first-line metastatic pancreatic cancer: a multicentre phase II study

Kullmann

Hollerbach

Dollinger³

et al. 2009

Br J Cancer

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Targeting the epidermal growth factor receptor pathway in pancreatic cancer seems to be an attractive therapeutic approach. This study assessed the efficacy of cetuximab plus the combination of gemcitabine/oxaliplatin in metastatic pancreatic cancer. Eligible subjects had histological or cytological diagnosis of metastatic pancreatic adenocarcinoma. The primary end point was response according to RECIST. Patients received cetuximab 400 mg m À2 at first infusion followed by weekly 250 mg m À2 combined with gemcitabine 1000 mg m À2 as a 100 min infusion on day 1 and oxaliplatin 100 mg m À2 as a 2-h infusion on day 2 every 2 weeks. Between January 2005 and August 2006, a total of 64 patients (22 women (34%), 42 men (66%); median age 64 years (range 31 -78)) were enrolled at seven study centres. On October 2007, a total of 17 patients were alive. Sixty-two patients were evaluable for baseline and 61 for assessment of response to treatment in an intention-to-treat analysis. Six patients had an incomplete drug combination within the first cycle of the treatment plan (n ¼ 4 hypersensitivity reactions to the first cetuximab infusion, n ¼ 2 refused to continue therapy). Reported grade 3/4 toxicities (% of patients) were leukopaenia 15%, anaemia 8%, thrombocytopaenia 10%, diarrhoea 7%, nausea 18%, infection 18% and allergy 7%. Cetuximab-attributable skin reactions occurred as follows: grade 0: 20%, grade 1: 41%, grade 2: 30% and grade 3: 10%. The intention-to-treat analysis of 61 evaluable patients showed an overall response rate of 33%, including 1 (2%) complete and 19 (31%) partial remissions. There were 31% patients with stable and 36% with progressive disease or discontinuation of the therapy before re-staging. The presence of a grade 2 or higher skin rash was associated with a higher likelihood of achieving objective response. Median time to progression was 118 days, with a median overall survival of 213 days. A clinical benefit response was noted in 24 of the evaluable 61 patients (39%). The addition of cetuximab to the combination of gemcitabine and oxaliplatin is well tolerated but does not increase response or survival in patients with metastatic pancreatic cancer.

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Section: Discussionmentioning

confidence: 99%

Cetuximab plus gemcitabine/oxaliplatin (GEMOXCET) in first-line metastatic pancreatic cancer: a multicentre phase II study

Kullmann

Hollerbach

Dollinger³

et al. 2009

Br J Cancer

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“…Wichtig ist bei der Beurteilung der Differentialdiagnose von soliden Pankreastumoren, dem klinischen «Workflow» mehr Viszeralmedizin 2011; 27:194-204 Endosonographie zystischer Pankreasläsionen 195 mit der jeweiligen klinischen Konstellation eine belastbare Aussage machen [13][14][15]. Die im klinischen Alltag hilfreichen kontrastverstärkten endosonographischen Techniken sind in diesen Empfehlungen bisher nicht enthalten [15].…”

Section: Optimierte Präoperative Diagnostik Von Pankreastumorenunclassified

“…Die im klinischen Alltag hilfreichen kontrastverstärkten endosonographischen Techniken sind in diesen Empfehlungen bisher nicht enthalten [15]. «Wenn eine Zyste als abklärungsbedürftig angesehen wird, sollte eine endosonographisch gesteuerte Punktion erfolgen» (Empfehlungsgrad: B, Evidenzstärke 3, Konsens).…”

Section: Optimierte Präoperative Diagnostik Von Pankreastumorenunclassified

Endosonographie zystischer Pankreasläsionen

Dietrich¹,

Hocke²

2011

Viszeralmedizin

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Die Therapie von duktalen Adenokarzinomen ist weitgehend standardisiert und wurde in Leitlinien dokumentiert. Die Abklärung unklarer zystischer Pankreasläsionen stellt weiterhin eine Herausforderung dar. Diese Übersichtsarbeit erläutert einerseits die Empfehlungen der DGVS (Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten) zur Abklärung zystischer Läsionen des Pankreas und andererseits die Bedeutung sonographischer und endosonographischer Techniken zur Abklärung von zystischen Pankreastumoren.

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“…Owing to this observation, an involvement of the mesenteric or portal vein seems to be rather a consequence of the tumor located close to these structures than a reflection of a uncommonly aggressive tumor biology. Venous resections should therefore be performed in a routine setting to achieve a complete removal of the tumor, which has meanwhile been explicitly stated in national guidelines, such as the German consensus publication of 2007 [10].…”

Section: Venous Resectionsmentioning

confidence: 99%