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Pancreatic Neoplasms: HELP
Articles from Indiana University Indianapolis
Based on 225 articles published since 2008
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These are the 225 published articles about Pancreatic Neoplasms that originated from Indiana University Indianapolis during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9
1 Editorial Impact of preoperative EUS-guided FNA for pancreatic cancer on overall and cancer-free survival: Is the jury still out? 2018

El Hajj, Ihab I / Al-Haddad, Mohammad. ·Division of Gastroenterology and Hepatology, Section of Interventional Endoscopy, Indiana University School of Medicine, Indianapolis, Indiana, USA. ·Gastrointest Endosc · Pubmed #30449404.

ABSTRACT: -- No abstract --

2 Editorial EUS-FNA giving way to fine-needle biopsy: Is it time to retire your old trusted needles? 2018

El Hajj, Ihab I / Al-Haddad, Mohammad. ·Division of Gastroenterology and Hepatology, Section of Interventional Endoscopy, Indiana University School of Medicine, Indianapolis, Indiana, USA. ·Gastrointest Endosc · Pubmed #29759158.

ABSTRACT: -- No abstract --

3 Editorial Concise Commentary: Presurgical Evaluation of IPMNs-Eight Is Enough. 2018

Zyromski, Nicholas J. ·Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. nzyromsk@iupui.edu. ·Dig Dis Sci · Pubmed #29417329.

ABSTRACT: -- No abstract --

4 Editorial Pancreatic cyst ablation: why are we not doing more of these procedures? 2017

DeWitt, John M. ·Department of Gastroenterology and Hepatology, Indiana University Health Medical Center, Indianapolis, Indiana, United States. ·Endoscopy · Pubmed #28850976.

ABSTRACT: -- No abstract --

5 Editorial Sampling para-aortic lymph nodes in pancreatic and biliary cancers with EUS-guided FNA: diagnostic, clinical, and therapeutic implications. 2016

El Hajj, Ihab I / Eloubeidi, Mohamad. ·Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana, USA. · Anniston Digestive Health, Anniston, Alabama, USA. ·Gastrointest Endosc · Pubmed #27530480.

ABSTRACT: -- No abstract --

6 Review Imaging in Autoimmune Pancreatitis and Immunoglobulin G4-Related Disease of the Abdomen. 2018

Sandrasegaran, Kumaresan / Menias, Christine O. ·Department of Radiology, Indiana University School of Medicine, 550 North University Boulevard, UH0279, Indianapolis, IN 46202, USA. Electronic address: ksandras@iupui.edu. · Department of Radiology, Mayo Clinic School of Medicine, Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA. ·Gastroenterol Clin North Am · Pubmed #30115440.

ABSTRACT: Autoimmune pancreatitis (AIP) is steroid-responsive fibroinflammatory disorder of the pancreas. There are 2 distinct subtypes of AIP, types 1 and 2. Type 1 is associated with systemic immunoglobulin (Ig)G4 disease and may affect multiple organs in the body. Type 2 is confined to the pancreas and shows an association with ulcerative colitis. This article describes the imaging findings of AIP and IgG4 disease in the liver, bile ducts, kidneys, and the retroperitoneal regions. The imaging differentiation of AIP from pancreas cancer is discussed.

7 Review The Symptom Experience of Patients With Advanced Pancreatic Cancer: An Integrative Review. 2018

Tang, Chia-Chun / Von Ah, Diane / Fulton, Janet S. ·Author Affiliations: School of Nursing, Indiana University Purdue University at Indianapolis. ·Cancer Nurs · Pubmed #28059839.

ABSTRACT: BACKGROUND: Pancreatic cancer is a devastating disease with limited treatment options. More than 80% of pancreatic cancers are diagnosed in advanced stages and often have debilitating symptoms, making symptom management paramount, yet the symptom experience of patients with advanced pancreatic cancer (APC) is not well understood. OBJECTIVE: The purpose of this integrative review is to synthesize the current evidence regarding the symptom experience of patients with APC. METHOD: An integrative literature review was conducted to identify the patient symptom experience in studies published from 2005 to 2015. RESULTS: Sixteen studies met the inclusion criteria. All studies used a quantitative approach; 44% were quasi-experimental, 31% were descriptive, and 25% were correlational. Physical symptoms, especially pain, were the primary focus in most studies. Fatigue, loss of appetite, and impaired sense of well-being were prevalent and reported by patients to be of high intensity. Few studies examined psychological symptoms in patients with APC, although anxiety and depression were noted. CONCLUSION: Findings suggest that physical and psychological symptoms are prevalent, some with high intensity. Preselection of symptom inventories limits our ability to fully understand the symptom experience of patients with APC. Future qualitative work is needed to provide a more in-depth understanding of symptoms, especially symptom quality and distress level, from patients' perspectives. More studies are needed to explore psychological symptoms and the interaction of physical and psychological symptoms. IMPLICATIONS FOR PRACTICE: Findings help healthcare givers to better understand the symptom experience of their APC patients.

8 Review Pancreatic acinar cell carcinoma: A review on molecular profiling of patient tumors. 2017

Al-Hader, Ahmad / Al-Rohil, Rami N / Han, Haiyong / Von Hoff, Daniel. ·Division of Hematology/Oncology, Indiana University School of Medicine, Indianapolis, IN 46202-3082, United States. aalhader@iu.edu. · Department of Pathology, Vanderbilt University School of Medicine, Nashville, TN 37232, United States. · Molecular Medicine Division, Translational Genomics Research Institute (TGen), Phoenix, AZ 85004, United States. ·World J Gastroenterol · Pubmed #29259370.

ABSTRACT: Pancreatic carcinomas with acinar differentiation are rare, accounting for 1%-2% of adult pancreatic tumors; they include pancreatic acinar cell carcinoma (PACC), pancreatoblastoma, and carcinomas of mixed differentiation. Patients with PACC have a prognosis better than pancreatic ductal adenocarcinomas but worse than pancreatic neuroendocrine tumors. Reports of overall survival range from 18 to 47 mo. A literature review on PACCs included comprehensive genomic profiling and whole exome sequencing on a series of more than 70 patients as well as other diagnostic studies including immunohistochemistry. Surgical resection of PACC is the preferred treatment for localized and resectable tumors. The efficacy of adjuvant treatment is unclear. Metastatic PACCs are generally not curable and treated with systemic chemotherapy. They are moderately responsive to chemotherapy with different regimens showing various degrees of response in case reports/series. Most of these regimens were developed to treat patients with pancreatic ductal adenocarcinomas or colorectal adenocarcinomas. Review of PACC's molecular profiling showed a number of gene alterations such as:

9 Review Tobacco and alcohol as risk factors for pancreatic cancer. 2017

Korc, Murray / Jeon, Christie Y / Edderkaoui, Mouad / Pandol, Stephen J / Petrov, Maxim S / Anonymous1301033. ·Departments of Medicine, Biochemistry and Molecular Biology, Indiana University School of Medicine, The Melvin and Bren Simon Cancer Center and the Pancreatic Cancer Signature Center, Indianapolis, USA. · Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. · Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA. · Department of Surgery, University of Auckland, Auckland, New Zealand. Electronic address: max.petrov@gmail.com. ·Best Pract Res Clin Gastroenterol · Pubmed #29195672.

ABSTRACT: Pancreatic cancer is projected to become the leading cause of cancer deaths by 2050. The risk for pancreatic cancer may be reduced by up to 27% by modifying lifestyle risk factors, most notably tobacco smoking. Based on analysis of more than 2 million unselected individuals from general population, this article quantified the risk of pancreatic cancer in relation to lifelong tobacco smoking and alcohol consumption status, both alone and in combination. It also provided a state-of-the-art review of animal studies on the effect of tobacco smoke and alcohol on genetically engineered mouse models of pancreatic precursor lesions, as well as the role of immune microenvironment in pancreatic carcinogenesis activated by tobacco and alcohol.

10 Review Impact of Nab-Paclitaxel-based Second-line Chemotherapy in Metastatic Pancreatic Cancer. 2017

Dadi, Neelakanta / Stanley, Melissa / Shahda, Safi / O'Neil, Bert H / Sehdev, Amikar. ·Division of Hematology and Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, U.S.A. · Division of Hematology and Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, U.S.A. asehdev@iupui.edu. · Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, U.S.A. · Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN, U.S.A. ·Anticancer Res · Pubmed #28982867.

ABSTRACT: BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy with median survival of 20% at 1 year. We conducted a retrospective study to assess the efficacy and tolerability of nab-paclitaxel (NP)-based second-line chemotherapy in metastatic PDAC. PATIENTS AND METHODS: The Indiana University Simon Cancer Center pancreatic cancer program was used to identify patients with metastatic PDAC who received any second-line chemotherapy. Demographic, clinical and outcomes data were collected by manual chart abstraction. Patients were divided into two groups: a NP-based treatment group and a non- NP-based treatment group. Overall (OS) and progression-free (PFS) survival were estimated using Kaplan-Meier method. Cox proportional hazards regression was used for multivariate analyses. RESULTS: A total of 120 patients received second-line chemotherapy. There were 47 (39%) patients in the NP group and 73 (61%) in the non-NP group. As compared to the non-NP group, the NP group showed improved median PFS [2.8 vs. 2.1 months; hazard ratio (HR)=0.62, 95% confidence interval (CI)=0.38-1.02; p=0.06] and median OS (7.5 vs. 4.7 months; HR=0.67, 95% CI=0.45-1.00; p=0.05). Multivariate analyses adjusted for age showed a significantly improved PFS (adjusted HR=0.60, 95% CI=0.36-0.98; p=0.04) and a suggestion of improved OS (adjusted HR=0.67, 95% CI=0.44-1.01, p=0.05) in the NP group as compared to non-NP group. Serious adverse events were seen in 13.3% of patients in the non-NP group and 17.1% patients in the NP group. CONCLUSION: In a single-institution retrospective cohort study, we report a significant improvement in the PFS and suggestion of improvement in the OS with NP-based second-line chemotherapy with an acceptable toxicity rate.

11 Review EUS and related technologies for the diagnosis and treatment of pancreatic disease: research gaps and opportunities-Summary of a National Institute of Diabetes and Digestive and Kidney Diseases workshop. 2017

Lee, Linda S / Andersen, Dana K / Ashida, Reiko / Brugge, William R / Canto, Mimi I / Chang, Kenneth J / Chari, Suresh T / DeWitt, John / Hwang, Joo Ha / Khashab, Mouen A / Kim, Kang / Levy, Michael J / McGrath, Kevin / Park, Walter G / Singhi, Aatur / Stevens, Tyler / Thompson, Christopher C / Topazian, Mark D / Wallace, Michael B / Wani, Sachin / Waxman, Irving / Yadav, Dhiraj / Singh, Vikesh K. ·Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. · Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA. · Departments of Cancer Survey and Gastrointestinal Oncology, Osaka Prefectural Hospital Organization, Osaka International Cancer Institute, Osaka, Japan. · Department of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA. · Division of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. · Comprehensive Digestive Disease Center, Department of Gastroenterology and Hepatology, University of California at Irvine Health, Orange, California, USA. · Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. · Division of Gastroenterology, Indiana University Health Medical Center, Indianapolis, Indiana, USA. · Department of Medicine, University of Washington, Seattle, Washington, USA. · Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. · Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. · Department of Medicine, Stanford University School of Medicine, Stanford, California, USA. · Department of Pathology, University of Pittsburgh Medical Center, Sewickley, Pennsylvania, USA. · Department of Gastroenterology, Cleveland Clinic, Cleveland, Ohio, USA. · Department of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, Florida, USA. · Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. · Department of Medicine, The University of Chicago Comprehensive Cancer Center, University of Chicago School of Medicine, Chicago, Illinois, USA. ·Gastrointest Endosc · Pubmed #28941651.

ABSTRACT: A workshop was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases to address the research gaps and opportunities in pancreatic EUS. The event occurred on July 26, 2017 in 4 sessions: (1) benign pancreatic diseases, (2) high-risk pancreatic diseases, (3) diagnostic and therapeutics, and (4) new technologies. The current state of knowledge was reviewed, with identification of numerous gaps in knowledge and research needs. Common themes included the need for large multicenter consortia of various pancreatic diseases to facilitate meaningful research of these entities; to standardize EUS features of different pancreatic disorders, the technique of sampling pancreatic lesions, and the performance of various therapeutic EUS procedures; and to identify high-risk disease early at the cellular level before macroscopic disease develops. The need for specialized tools and accessories to enable the safe and effective performance of therapeutic EUS procedures also was discussed.

12 Review A Multidisciplinary Approach to Pancreas Cancer in 2016: A Review. 2017

Fogel, Evan L / Shahda, Safi / Sandrasegaran, Kumar / DeWitt, John / Easler, Jeffrey J / Agarwal, David M / Eagleson, Mackenzie / Zyromski, Nicholas J / House, Michael G / Ellsworth, Susannah / El Hajj, Ihab / O'Neil, Bert H / Nakeeb, Attila / Sherman, Stuart. ·Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University Health, Indiana University School of Medicine, University Hospital, Indianapolis, Indiana, USA. · Department of Radiology, Indiana University School of Medicine, Indianapolis, Indiana, USA. · Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA. ·Am J Gastroenterol · Pubmed #28139655.

ABSTRACT: In this article, we review our multidisciplinary approach for patients with pancreatic cancer. Specifically, we review the epidemiology, diagnosis and staging, biliary drainage techniques, selection of patients for surgery, chemotherapy, radiation therapy, and discuss other palliative interventions. The areas of active research investigation and where our knowledge is limited are emphasized.

13 Review Pancreatic cancer: Stroma and its current and emerging targeted therapies. 2017

Kota, Janaiah / Hancock, Julie / Kwon, Jason / Korc, Murray. ·Department of Medical and Molecular Genetics, Indiana University School of Medicine (IUSM), Indianapolis, IN, USA; The Melvin and Bren Simon Cancer Center, IUSM, Indianapolis, IN, USA; Center for Pancreatic Cancer Research, Indiana University and Purdue University-Indianapolis (IUPUI), Indianapolis, IN, USA. Electronic address: jkota@iu.edu. · Department of Medical and Molecular Genetics, Indiana University School of Medicine (IUSM), Indianapolis, IN, USA. · The Melvin and Bren Simon Cancer Center, IUSM, Indianapolis, IN, USA; Center for Pancreatic Cancer Research, Indiana University and Purdue University-Indianapolis (IUPUI), Indianapolis, IN, USA; Department of Biochemistry and Molecular Biology, IUSM, Indianapolis, IN, USA; Department of Medicine, IUSM, Indianapolis, IN, USA. ·Cancer Lett · Pubmed #28093284.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal human malignancies with a 5-year survival rate of 8%. Dense, fibrotic stroma associated with pancreatic tumors is a major obstacle for drug delivery to the tumor bed and plays a crucial role in pancreatic cancer progression. Targeting stroma is considered as a potential therapeutic strategy to improve anti-cancer drug efficacy and patient survival. Although numerous stromal depletion therapies have reached the clinic, they add little to overall survival and are often associated with toxicity. Furthermore, increasing evidence suggests the anti-tumor properties of stroma. Its complete ablation enhanced tumor progression and reduced survival. Consequently, efforts are now focused on developing stromal-targeted therapies that normalize the reactive stroma and avoid the extremes: stromal abundance vs. complete depletion. In this review, we summarized the state of current and emerging anti-stromal targeted therapies, with major emphasis on the role of miRNAs in PDAC stroma and their potential use as novel therapeutic agents to modulate PDAC tumor-stromal interactions.

14 Review Type 3c (pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer. 2016

Hart, Phil A / Bellin, Melena D / Andersen, Dana K / Bradley, David / Cruz-Monserrate, Zobeida / Forsmark, Christopher E / Goodarzi, Mark O / Habtezion, Aida / Korc, Murray / Kudva, Yogish C / Pandol, Stephen J / Yadav, Dhiraj / Chari, Suresh T / Anonymous3191104. ·Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: philip.hart@osumc.edu. · Division of Pediatric Endocrinology and Schulze Diabetes Institute, University of Minnesota Medical Center, Minneapolis, MN, USA. · Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA. · Division of Endocrinology, Diabetes, and Metabolism, The Ohio State University, Wexner Medical Center, Columbus, OH, USA. · Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA. · Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, USA. · Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA, USA. · Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA. · Departments of Medicine, Biochemistry, and Molecular Biology, Indiana University School of Medicine, Indiana University Simon Cancer Center, Indianapolis, IN, USA; Pancreatic Cancer Signature Center, Indiana University Simon Cancer Center, Indianapolis, IN, USA. · Division of Endocrinology and Metabolism, Mayo Clinic, Rochester, MN, USA. · Department of Veterans Affairs, Cedars-Sinai Medical Center, Los Angeles, CA, USA. · Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh and UPMC Medical Center, Pittsburgh, PA, USA; Department of Medicine, University of Pittsburgh and UPMC Medical Center, Pittsburgh, PA, USA. · Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. ·Lancet Gastroenterol Hepatol · Pubmed #28404095.

ABSTRACT: Diabetes mellitus is a group of diseases defined by persistent hyperglycaemia. Type 2 diabetes, the most prevalent form, is characterised initially by impaired insulin sensitivity and subsequently by an inadequate compensatory insulin response. Diabetes can also develop as a direct consequence of other diseases, including diseases of the exocrine pancreas. Historically, diabetes due to diseases of the exocrine pancreas was described as pancreatogenic or pancreatogenous diabetes mellitus, but recent literature refers to it as type 3c diabetes. It is important to note that type 3c diabetes is not a single entity; it occurs because of a variety of exocrine pancreatic diseases with varying mechanisms of hyperglycaemia. The most commonly identified causes of type 3c diabetes are chronic pancreatitis, pancreatic ductal adenocarcinoma, haemochromatosis, cystic fibrosis, and previous pancreatic surgery. In this Review, we discuss the epidemiology, pathogenesis, and clinical relevance of type 3c diabetes secondary to chronic pancreatitis and pancreatic ductal adenocarcinoma, and highlight several important knowledge gaps.

15 Review Management of Mixed-Type Intraductal Papillary Mucinous Neoplasm. 2016

Roch, Alexandra M / Schmidt, Christian Max. ·Department of Surgery, Indiana University School of Medicine, 980 W Walnut Street R3-C541, Indianapolis, IN 46202, USA. · IU Health Pancreatic Cyst and Cancer Early Detection Center, Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, EH 129, Indianapolis, IN 46202, USA. Electronic address: maxschmi@iupui.edu. ·Adv Surg · Pubmed #27520858.

ABSTRACT:

16 Review Pancreatic cancer. 2016

Kleeff, Jorg / Korc, Murray / Apte, Minoti / La Vecchia, Carlo / Johnson, Colin D / Biankin, Andrew V / Neale, Rachel E / Tempero, Margaret / Tuveson, David A / Hruban, Ralph H / Neoptolemos, John P. ·NIHR Pancreas Biomedical Research Unit, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Duncan Building, Daulby Street, Liverpool L69 3GA, UK. · Department of General, Visceral and Pediatric Surgery, University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany. · Departments of Medicine, and Biochemistry and Molecular Biology, Indiana University School of Medicine, the Melvin and Bren Simon Cancer Center, and the Pancreatic Cancer Signature Center, Indianapolis, Indiana, USA. · SWS Clinical School, University of New South Wales, and Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia. · Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. · University Surgical Unit, University Hospital Southampton, Southampton, UK. · Institute of Cancer Sciences, Wolfson Wohl Cancer Research Centre, University of Glasgow, Garscube Estate, Bearsden, Glasgow, Scotland, UK. · QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. · UCSF Pancreas Center, University of California San Francisco - Mission Bay Campus/Mission Hall, San Francisco, California, USA. · Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, New York, USA. · The Sol Goldman Pancreatic Cancer Research Center, Departments of Pathology and Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. ·Nat Rev Dis Primers · Pubmed #27158978.

ABSTRACT: Pancreatic cancer is a major cause of cancer-associated mortality, with a dismal overall prognosis that has remained virtually unchanged for many decades. Currently, prevention or early diagnosis at a curable stage is exceedingly difficult; patients rarely exhibit symptoms and tumours do not display sensitive and specific markers to aid detection. Pancreatic cancers also have few prevalent genetic mutations; the most commonly mutated genes are KRAS, CDKN2A (encoding p16), TP53 and SMAD4 - none of which are currently druggable. Indeed, therapeutic options are limited and progress in drug development is impeded because most pancreatic cancers are complex at the genomic, epigenetic and metabolic levels, with multiple activated pathways and crosstalk evident. Furthermore, the multilayered interplay between neoplastic and stromal cells in the tumour microenvironment challenges medical treatment. Fewer than 20% of patients have surgically resectable disease; however, neoadjuvant therapies might shift tumours towards resectability. Although newer drug combinations and multimodal regimens in this setting, as well as the adjuvant setting, appreciably extend survival, ∼80% of patients will relapse after surgery and ultimately die of their disease. Thus, consideration of quality of life and overall survival is important. In this Primer, we summarize the current understanding of the salient pathophysiological, molecular, translational and clinical aspects of this disease. In addition, we present an outline of potential future directions for pancreatic cancer research and patient management.

17 Review ERCP tissue sampling. 2016

Korc, Paul / Sherman, Stuart. ·Indiana University Medical Center, University Hospital, Indianapolis, Indiana, USA; Hoag-USC Digestive Disease Center, Newport Beach, California, USA. · Indiana University Medical Center, University Hospital, Indianapolis, Indiana, USA. ·Gastrointest Endosc · Pubmed #27156656.

ABSTRACT: -- No abstract --

18 Review A systematic review of the role of periadventitial dissection of the superior mesenteric artery in affecting margin status after pancreatoduodenectomy for pancreatic adenocarcinoma. 2016

Butler, James R / Ahmad, Syed A / Katz, Matthew H / Cioffi, Jessica L / Zyromski, Nicholas J. ·Indiana University School of Medicine, Department of Surgery, Indianapolis IN, USA. · The University of Cincinnati Cancer Institute, Cincinnati OH, USA. · Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. · Indiana University School of Medicine, Department of Surgery, Indianapolis IN, USA. Electronic address: nzyromsk@iupui.edu. ·HPB (Oxford) · Pubmed #27037198.

ABSTRACT: BACKGROUND: Resectable pancreatic ductal adenocarcinoma continues to carry a poor prognosis. Of the controllable clinical variables known to affect outcome, margin status is paramount. Though the importance of a R0 resection is generally accepted, not all margins are easily managed. The superior mesenteric artery [SMA] in particular is the most challenging to clear. The aim of this study was to systematically review the literature with specific focus on the role of a SMA periadventitial dissection during PD and it's effect on margin status in pancreatic adenocarcinoma. STUDY DESIGN: The MEDLINE, EMBASE and Cochrane databases were searched for abstracts that addressed the effect of margin status on survival and recurrence following pancreaticoduodenectomy [PD]. Quantitative analysis was performed. RESULTS: The overall incidence of a R1 resection ranged from 16% to 79%. The margin that was most often positive following PD was the SMA margin, which was positive in 15-45% of resected specimens. Most studies suggested that a positive margin was associated with decreased survival. No consistent definition of R0 resection was observed. CONCLUSIONS: Margin positivity in resectable pancreatic adenocarcinoma is associated with poor survival. Inability to clear the SMA margin is the most common cause of incomplete resection. More complete and consistently reported data are needed to evaluate the potential effect of periadventitial SMA dissection on margin status, local recurrence, or survival.

19 Review Role of Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Clinical Assessment of Pancreatic Neoplasms. 2016

Varadarajulu, Shyam / Bang, Ji Young. ·Center for Interventional Endoscopy, Florida Hospital, 601 East Rollins Street, Orlando, FL 32803, USA. Electronic address: svaradarajulu@yahoo.com. · Division of Gastroenterology-Hepatology, Indiana University, 702 Rotary Circle, Suite 225, Indianapolis, IN 46202, USA. ·Surg Oncol Clin N Am · Pubmed #27013363.

ABSTRACT: Accurate diagnosis and staging of pancreatic neoplasms is essential for surgical planning and identification of locally advanced and metastatic disease that is incurable by surgery. The ability to position the endoscopic ultrasonography (EUS) transducer close to the pancreas combined with the use of fine-needle aspiration enables the accurate diagnosis of pancreatic cysts and solid masses. EUS is also increasingly being used to procure core tissue for molecular analysis that facilitates personalized treatment of pancreatic cancer. Various therapeutic interventions can be undertaken under EUS guidance. This article focuses on the applications of EUS and endoscopic retrograde cholangiopancreatography in pancreatic neoplasms.

20 Review Overview of pre-clinical and clinical studies targeting angiogenesis in pancreatic ductal adenocarcinoma. 2016

Craven, Kelly E / Gore, Jesse / Korc, Murray. ·Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA. · Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Pancreatic Cancer Signature Center, Indiana University Simon Cancer Center, Indianapolis, IN 46202, USA. · Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Pancreatic Cancer Signature Center, Indiana University Simon Cancer Center, Indianapolis, IN 46202, USA. Electronic address: mkorc@iu.edu. ·Cancer Lett · Pubmed #26723874.

ABSTRACT: The importance of angiogenesis in pancreatic ductal adenocarcinoma (PDAC) and its therapeutic potential have been explored in both pre-clinical and clinical studies. Human PDACs overexpress a number of angiogenic factors and their cognate high-affinity receptors, and anti-angiogenic agents reduce tumor volume, metastasis, and microvessel density (MVD), and improve survival in subcutaneous and orthotopic pre-clinical models. Nonetheless, clinical trials using anti-angiogenic therapy have been overwhelmingly unsuccessful. This review will focus on these pre-clinical and clinical studies, the potential reasons for failure in the clinical setting, and ways these shortcomings could be addressed in future investigations of angiogenic mechanisms in PDAC.

21 Review Recapitulation of complex transport and action of drugs at the tumor microenvironment using tumor-microenvironment-on-chip. 2016

Han, Bumsoo / Qu, Chunjing / Park, Kinam / Konieczny, Stephen F / Korc, Murray. ·School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA. Electronic address: bumsoo@purdue.edu. · Department of Biological Science, Purdue University, West Lafayette, IN, USA. · Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Birck Nanotechnology Center, Purdue University, West Lafayette, IN, USA. · Departments of Medicine, Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Pancreatic Cancer Signature Center, Indiana University Simon Cancer Center, Indianapolis, IN 46202, USA. ·Cancer Lett · Pubmed #26688098.

ABSTRACT: Targeted delivery aims to selectively distribute drugs to targeted tumor tissues but not to healthy tissues. This can address many clinical challenges by maximizing the efficacy but minimizing the toxicity of anti-cancer drugs. However, a complex tumor microenvironment poses various barriers hindering the transport of drugs and drug delivery systems. New tumor models that allow for the systematic study of these complex environments are highly desired to provide reliable test beds to develop drug delivery systems for targeted delivery. Recently, research efforts have yielded new in vitro tumor models, the so called tumor-microenvironment-on-chip, that recapitulate certain characteristics of the tumor microenvironment. These new models show benefits over other conventional tumor models, and have the potential to accelerate drug discovery and enable precision medicine. However, further research is warranted to overcome their limitations and to properly interpret the data obtained from these models. In this article, key features of the in vivo tumor microenvironment that are relevant to drug transport processes for targeted delivery were discussed, and the current status and challenges for developing in vitro transport model systems were reviewed.

22 Review A meta-analysis comparing ProCore and standard fine-needle aspiration needles for endoscopic ultrasound-guided tissue acquisition. 2016

Bang, Ji Young / Hawes, Robert / Varadarajulu, Shyam. ·Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana, United States. · Center for Interventional Endoscopy, Florida Hospital, Orlando, Florida, United States. ·Endoscopy · Pubmed #26561917.

ABSTRACT: BACKGROUND AND STUDY AIMS: To overcome the limitations associated with cytology, a uniquely designed needle (ProCore) was introduced in an effort to obtain a core of tissue under endoscopic ultrasound (EUS) guidance. However, studies comparing the sample quality between ProCore and standard-design fine-needle aspiration (FNA) needles have yielded varying results. A systematic review and meta-analysis was therefore conducted to compare the performance of the ProCore and standard FNA needles when performing EUS-guided tissue acquisition. PATIENTS AND METHODS: MEDLINE and EMBASE were searched to identify all published manuscripts that compared the ProCore needle with standard FNA needles. Noncomparative and technical feasibility studies were excluded. The main outcome measures were diagnostic adequacy, diagnostic accuracy, acquisition of histological core tissue, and mean number of passes required to achieve a diagnosis when sampling solid lesions. RESULTS: Nine studies (total 576 patients) met the inclusion criteria. There was no significant difference in diagnostic adequacy (75.2 % vs. 89.0 %, odds ratio [OR] 0.39, P = 0.23), diagnostic accuracy (85.8 % vs. 86.2 %, OR 0.88, P = 0.53) or rate of histological core specimen acquisition (77.7 % vs. 76.5 %, OR 0.94, P = 0.85) between the ProCore and standard FNA needles, respectively. The mean number of passes required for diagnosis, however, was significantly lower when using the ProCore needle (standardized mean difference - 1.2, P < 0.001). CONCLUSIONS: Current data do not demonstrate a significant difference between the ProCore and standard FNA needles for sample adequacy, diagnostic accuracy or acquisition of a core specimen. However, the ProCore needle establishes the diagnosis with fewer passes.

23 Review Hematologic malignancies of the pancreas. 2015

Sandrasegaran, Kumar / Tomasian, Anderanik / Elsayes, Khaled M / Nageswaran, Harris / Shaaban, Akram / Shanbhogue, Alampady / Menias, Christine O. ·Indiana University School of Medicine, 550 N University Blvd, UH 0279, Indianapolis, IN, 46202, USA, ksandras@iupui.edu. ·Abdom Imaging · Pubmed #25120155.

ABSTRACT: Hematologic malignancies are relatively uncommon neoplasms of abdominal soft tissue. This article discusses the clinical and imaging features of pancreatic lymphoma, pancreatic extraosseous multiple myeloma, granulocytic sarcoma (chloroma), posttransplant lymphoproliferative disorder, and Castleman disease. The combination of imaging findings and the appropriate clinical presentation should allow the radiologist to raise a provisional diagnosis of hematologic malignancy.

24 Review Critical role of NF-κB in pancreatic cancer. 2014

Prabhu, Lakshmi / Mundade, Rasika / Korc, Murray / Loehrer, Patrick J / Lu, Tao. ·Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN USA. · Department of Medicine, Indiana University School of Medicine, Indianapolis, IN USA. Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN USA. · Division of Hematology and Oncology, Indiana Cancer Pavilion, Indianapolis, IN USA. · Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN USA. Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN USA. Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN USA. ·Oncotarget · Pubmed #25473891.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers, and in spite of intense efforts there are limited therapeutic options for patients with PDAC. PDACs harbor a high frequency of Kras mutations and other driver mutations that lead to altered signaling pathways and contribute to therapeutic resistance. Importantly, constitutive activation of nuclear factor κB (NF-κB) is frequently observed in PDAC. An increasing body of evidence suggests that both classical and non-classical NF-κB pathways play a crucial role in PDAC development and progression. In this review, we update the most recent advances regarding different aspects of NF-κB involvement in PDAC development and progression, emphasizing its potential as a therapeutic target and the need to discover pathway-specific cytosolic NF-κB regulators which could be used to design novel therapeutic strategies for PDAC.

25 Review Applications of endoscopic ultrasound in pancreatic cancer. 2014

Luz, Leticia Perondi / Al-Haddad, Mohammad Ali / Sey, Michael Sai Lai / DeWitt, John M. ·Leticia Perondi Luz, Mohammad Ali Al-Haddad, Michael Sai Lai Sey, John M DeWitt, Division of Gastroenterology and Hepatology, Indiana University, Medical Center, Roudebush VA Medical Center, Indianapolis, IN 46202, United States. ·World J Gastroenterol · Pubmed #24976719.

ABSTRACT: Since the introduction of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA), EUS has assumed a growing role in the diagnosis and management of pancreatic ductal adenocarcinoma (PDAC). The objective of this review is to discuss the various applications of EUS and EUS-FNA in PDAC. Initially, its use for detection, diagnosis and staging will be described. EUS and EUS-FNA are highly accurate modalities for detection and diagnosis of PDAC, this high accuracy, however, is decreased in specific situations particularly in the presence of chronic pancreatitis. Novel techniques such as contrast-enhanced EUS, elastography and analysis of DNA markers such as k-ras mutation analysis in FNA samples are in progress and might improve the accuracy of EUS in the detection of PDAC in this setting and will be addressed. EUS and EUS-FNA have recently evolved from a diagnostic to a therapeutic technique in the management of PDAC. Significant developments in therapeutic EUS have occurred including advances in celiac plexus interventions with direct injection of ganglia and improved pain control, EUS-guided fiducial and brachytherapy seed placement, fine-needle injection of intra-tumoral agents and advances in EUS-guided biliary drainage. The future role of EUS and EUS in management of PDAC is still emerging.

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