Articles related to PANCREATIC CANCER

Neoadjuvant Chemotherapy and Upfront Surgery: A Comparative Study in Resectable Pancreatic Cancer In a recent study presented at the 2023 ASCO Annual Meeting, researchers found no significant survival benefit of neoadjuvant chemotherapy over upfront surgery in patients with resectable pancreatic cancer. Key Points: “Results of this trial do not support neoadjuvant FOLFIRINOX as standard of care in resectable pancreatic cancer.” Knut Jørgen Labori, MD, PhD, Oslo University Hospital, Norway

Unraveling gene-specific cancer risks in first-degree relatives of PDAC probands sheds light on a higher uptake of genetic cascade testing. Recent data suggests that first-degree relatives of patients with pancreatic ductal adenocarcinoma (PDAC) who carry pathogenic germline variants (PGVs) in specific cancer syndrome-associated genes face heightened cancer risks. The study focuses on PDAC probands carrying PGVs in nine such genes: ATM, BRCA1, BRCA2, PALB2, MLH1, MSH2, MSH6, PMS2, and CDKN2A. To date, these risks hadn’t been comprehensively analyzed. The study analyzed 234 PDAC probands with PGVs, selected from a pool of 4,562 participants who underwent genetic testing. Findings suggest that different genes correlate to distinct types of cancer. For instance, female relatives of probands with BRCA1 and BRCA2 variants showed significantly increased risks of ovarian and breast cancer. First-degree relatives of probands with Lynch syndrome mismatch repair variants exhibited higher risks of uterine, endometrial, and colon cancer. Additionally, the risk of PDAC itself rose with variants in ATM, BRCA2, CDKN2A, and PALB2, with melanoma risk escalating for relatives of probands with CDKN2A variants. Overall, this research underscores that gene-specific PDAC and extra-PDAC cancer risks in first-degree relatives of PDAC probands are linked with the presence of PGVs in nine cancer […]

A small study on a pancreatic cancer vaccine has shown promising results, sparking cautious optimism among oncologists. The vaccine, when given alongside chemotherapy to 16 pancreatic cancer patients, stimulated an immune response in half of them, with no signs of disease recurrence after 18 months. Although the vaccine’s long-term success and market viability are yet to be determined, the study provides valuable insights into targeting pancreatic cancer and the potential use of the immune system in treating various types of tumors. Notably, the study demonstrates the feasibility of developing a personalized vaccine quickly enough to make a difference, utilizing technologies like inexpensive genome sequencing, AI, and mRNA. Additionally, the research suggests that an mRNA vaccine can generate an immune response even in cancers with few mutations, suggesting broader applications for personalized cancer vaccines. The study underscores the importance of early diagnosis and intervention for pancreatic cancer. Currently, pancreatic cancer has a five-year survival rate of just 12%, making it one of the deadliest cancers. By 2030, it is projected to become the second leading cause of cancer deaths in the US. However, recent advancements offer hope. Another study utilizing artificial intelligence analyzed medical records of millions of patients and identified […]

The authors present the findings of a large retrospective cohort study that used national data from the SEER-Medicare-linked database to better understand the relationship between antibiotics and PDAC survival. They discovered that perichemotherapy antibiotics were associated with improved survival in patients treated with first-line gemcitabine but not fluorouracil, implying that perichemotherapy antibiotic treatment may have a role in patients with metastatic PDAC receiving gemcitabine. Prospective studies on the effect of perichemotherapy antibiotics with high pancreatic penetration and gram-negative coverage on survival in diverse populations of patients with metastatic PDAC treated with gemcitabine are recommended.

Zev Wainberg, MD, professor of medicine and co-director of the UCLA GI Oncology Program at the University of California, Los Angeles, presented the results of the NAPOLI-3 trial at the ASCO Gastrointestinal Cancers Symposium last month, and in this podcast, he discusses the data with Bob Figlin, MD, the Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer. In addition, the physicians discuss what advances might be on the horizon in the metastatic setting and in earlier disease, as well as what factors influence Dr. Wainberg’s treatment decisions.

NAPOLI-3 began recruiting 770 patients with metastatic pancreatic ductal adenocarcinoma at the start of the COVID-19 pandemic. Until the disease progressed, there was unacceptable toxicity, or the patient withdrew from the study, the patients were randomly randomized to receive the combination of liposomal irinotecan with 5-fluorouracil/leucovorin and oxaliplatin (NALIRIFOX) or nab-paclitaxel plus gemcitabine therapy. OS served as the study’s primary endpoint, whereas progression-free survival (PFS) and the objective response rate (ORR) served as secondary objectives. The main goal of the study—prolonged overall survival—was achieved with NALIRIFOX. The survival curves split at around 3 months, and this divergence was maintained for the duration of the investigation. NALIRIFOX also increased the median PFS. Moreover, NALIRIFOX therapy was preferred in all previously identified categories in terms of both OS and PFS. The ORR with NALIRIFOX was 41.8%, and the ORR with nab-paclitaxel/gemcitabine was 36.2%, virtually entirely made up of incomplete responses.