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Pancreatic Neoplasms: HELP
Articles from British Columbia
Based on 74 articles published since 2008
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These are the 74 published articles about Pancreatic Neoplasms that originated from British Columbia during 2008-2019.
 
+ Citations + Abstracts
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1 Review A Contemporary Review of the Treatment Landscape and the Role of Predictive and Prognostic Biomarkers in Pancreatic Adenocarcinoma. 2018

Yu, Irene S / Cheung, Winson Y. ·Division of Medical Oncology, Department of Medicine, British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada. · Section of Medical Oncology, Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada. ·Can J Gastroenterol Hepatol · Pubmed #29623263.

ABSTRACT: Pancreatic cancer continues to represent one of the leading causes of cancer-related morbidity and mortality in the developed world. Over the past decade, novel systemic therapy combination regimens have contributed to clinically meaningful and statistically significant improvements in overall survival as compared to conventional monotherapy. However, the prognosis for most patients remains guarded secondary to the advanced stages of disease at presentation. There is growing consensus that outcomes can be further optimized with the use of predictive and prognostic biomarkers whereby the former can be enriching for patients who would benefit from therapies and the latter can inform decision-making regarding the need and timing of advanced care planning. One of the challenges of current biomarkers is the lack of standardization across clinical practices such that comparability between jurisdictions can be difficult or even impossible. This inconsistency can impede widespread implementation of their use. In this review article, we provide a comprehensive overview of the contemporary treatment options for pancreatic cancer and we offer some insights into the existing landscape and future directions of biomarker development for this disease.

2 Review Tumor budding as a standardized parameter in gastrointestinal carcinomas: more than just the colon. 2018

Berg, Kyra B / Schaeffer, David F. ·Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada. kyraberg@alumni.ubc.ca. · Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada. · Division of Anatomical Pathology, Vancouver General Hospital, Vancouver, BC, Canada. ·Mod Pathol · Pubmed #29403085.

ABSTRACT: Tumor budding, defined as single cells or clusters of less than five cells, is thought to be a histomorphologic marker of an aggressive tumor behavior mimicking the embryologic epithelial-mesenchymal transition, and has been well established in the past two decades as a poor prognostic factor in colorectal carcinoma. Slow uptake in routine reporting of this important pathologic prognostic feature was in part due to differing methods of assessment of budding reported in the literature, but has recently been clarified at a consensus conference on tumor budding in colorectal carcinoma. Tumor budding is also increasingly being reported as a useful pathologic prognostic feature in other gastrointestinal carcinomas, including esophageal squamous cell carcinoma and adenocarcinoma, gastric intestinal-type adenocarcinoma, pancreatic ductal adenocarcinoma, and ampullary adenocarcinoma. In this review, we will summarize the studies on tumor budding in gastrointestinal carcinomas, with a focus on the methods of assessment used and the potential clinical applications of the findings.

3 Review Post-gemcitabine therapy for patients with advanced pancreatic cancer - A comparative review of randomized trials evaluating oxaliplatin- and/or irinotecan-containing regimens. 2016

Vogel, Arndt / Ciardiello, Fortunato / Hubner, Richard A / Blanc, Jean-Frédéric / Carrato, Alfredo / Yang, Yoojung / Patel, Dipen A / Ektare, Varun / de Jong, Floris A / Gill, Sharlene. ·Medical School Hannover, Department of Gastroenterology, Hematology and Endocrinology, Carl-Neubergstr. 1, 30659 Hannover, Germany. Electronic address: vogel.arndt@mh-hannover.de. · Dipartimento di Medicina Clinica e Sperimentale "F. Magrassi", Seconda Università degli Studi di Napoli, Via S. Pansini 5, 80131 Napoli, Italy. Electronic address: Fortunato.CIARDIELLO@unina2.it. · Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom. Electronic address: Richard.Hubner@christie.nhs.uk. · Department of Hepato-Gastroenterology and Digestive Oncology, CHU Bordeaux, Hôpital Haut-Lévêque, avenue de Magellan, 33600 Pessac, France. Electronic address: jean-frederic.blanc@chu-bordeaux.fr. · Medical Oncology Department, Ramon y Cajal University Hospital, IRYCIS, Alcala University, Carretera Colmenar Viejo km 9.1, 28034 Madrid, Spain. Electronic address: acarrato@telefonica.net. · Shire, 650 East Kendall Street, Cambridge, MA 02145, United States. Electronic address: Yoojung.yang@baxalta.com. · Pharmerit International, 4350 East West Highway, Suite 430, Bethesda, MD 20814, United States. Electronic address: dpatel@pharmerit.com. · Pharmerit International, 4350 East West Highway, Suite 430, Bethesda, MD 20814, United States. Electronic address: vektare@pharmerit.com. · Shire, Thurgauerstrasse 130, 8152 Glattpark (Opfikon), Zürich, Switzerland. Electronic address: Floris.de.Jong@shire.com. · University of British Columbia, BC Cancer Agency, 600 W. 10th Avenue, Vancouver, BC V5Z 4E6, Canada. Electronic address: sgill@bccancer.bc.ca. ·Cancer Treat Rev · Pubmed #27676174.

ABSTRACT: A systematic review and critical evaluation of randomized trial evidence for oxaliplatin- or irinotecan-containing regimens in patients with advanced pancreatic cancer previously treated with gemcitabine has not yet been published. We conducted a comparative systematic review of randomized trials evaluating oxaliplatin- or irinotecan-based therapies in patients with advanced pancreatic cancer previously treated with gemcitabine to assess trial similarity and the feasibility of performing an indirect treatment comparison (ITC). Studies were identified through PubMed and key oncology conference abstracts. The following trials met our criteria: NAPOLI-1 (nanoliposomal irinotecan [nal-IRI] or nal-IRI+5-fluorouracil [5-FU]/leucovorin [LV] vs 5-FU/LV), CONKO-003 (oxaliplatin+5-FU/LV [OFF] vs 5-FU/LV), PANCREOX (oxaliplatin+5-FU/LV [mFOLFOX6] vs 5-FU/LV), and Yoo et al. (2009) (irinotecan+5-FU/LV [mFOLFIRI3] vs mFOLFOX). Fundamental differences were identified in study design (i.e., number of study sites, number of countries), patient (i.e., locally advanced vs metastatic disease, stratification variables, prior and subsequent treatments) and treatment (i.e., regimens, dose intensity) characteristics, and primary and secondary outcomes (i.e., primary vs secondary outcomes, overall survival [OS], progression-free survival [PFS]) among the 4 included trials. Our comparative review demonstrated significant dissimilarity across trials, which precluded conducting an ITC. In the absence of head-to-head nal-IRI- and/or oxaliplatin-based therapy trials, clinicians are advised to interpret these studies separately within the context of their individual patient population.

4 Review The challenge of pancreatic cancer therapy and novel treatment strategy using engineered mesenchymal stem cells. 2014

Moniri, M R / Dai, L-J / Warnock, G L. ·Department of Surgery, University of British Columbia, Vancouver BC, Canada. · 1] Department of Surgery, University of British Columbia, Vancouver BC, Canada [2] Hubei Key Laboratory of Stem Cell Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China. ·Cancer Gene Ther · Pubmed #24384772.

ABSTRACT: Mesenchymal stem cells (MSCs) have attracted significant attention in cancer research as a result of their accessibility, tumor-oriented homing capacity, and the feasibility of auto-transplantation. This review provides a comprehensive overview of current challenges in pancreatic cancer therapy, and we propose a novel strategy for using MSCs as means of delivering anticancer genes to the site of pancreas. We aim to provide a practical platform for the development of MSC-based therapy for pancreatic cancer.

5 Review Endoscopic ultrasound advances, part 1: diagnosis. 2009

Kim, Edward / Telford, Jennifer J. ·Division of Internal Medicine, University of British Columbia, Vancouver, BC, Canada. ·Can J Gastroenterol · Pubmed #19816621.

ABSTRACT: -- No abstract --

6 Review Intraductal papillary mucinous neoplasms and other pancreatic cystic lesions. 2008

Freeman, Hugh-James. ·Department of Medicine, University of British Columbia Hospital, Vancouver V6T 1W5, Canada. hugfree@shaw.ca ·World J Gastroenterol · Pubmed #18494045.

ABSTRACT: Pancreatic cystic neoplasms are being increasingly recognized, even in the absence of symptoms, in large part, due to markedly improved imaging modalities such as magnetic resonance imaging (MRI)/magnetic resonance cholangio pancreatography (MRCP) and computer tomography (CT) scanning. During the past 2 decades, better imaging of these cystic lesions has resulted in definition of different types, including pancreatic intraductal papillary mucinous neoplasms (IPMN). While IPMN represent only a distinct minority of all pancreatic cancers, they appear to be a relatively frequent neoplastic form of pancreatic cystic neoplasm. Moreover, IPMN have a much better outcome and prognosis compared to pancreatic ductal adenocarcinomas. Therefore, recognition of this entity is exceedingly important for the clinician involved in diagnosis and further evaluation of a potentially curable form of pancreatic cancer.

7 Clinical Trial PANCREOX: A Randomized Phase III Study of Fluorouracil/Leucovorin With or Without Oxaliplatin for Second-Line Advanced Pancreatic Cancer in Patients Who Have Received Gemcitabine-Based Chemotherapy. 2016

Gill, Sharlene / Ko, Yoo-Joung / Cripps, Christine / Beaudoin, Annie / Dhesy-Thind, Sukhbinder / Zulfiqar, Muhammad / Zalewski, Pawel / Do, Thuan / Cano, Pablo / Lam, Wendy Yin Han / Dowden, Scot / Grassin, Helene / Stewart, John / Moore, Malcolm. ·Sharlene Gill and Malcolm Moore, BC Cancer Agency, Vancouver · Muhammad Zulfiqar, BC Cancer Agency, Abbotsford · Thuan Do, BC Cancer Agency, Surrey · Wendy Yin Han Lam, Burnaby Hospital Cancer Centre, Burnaby, British Columbia · Yoo-Joung Ko, Sunnybrook Health Sciences Centre · Malcolm Moore, Princess Margaret Hospital, Toronto · Christine Cripps, Ottawa Hospital Cancer Centre, Ottawa · Sukhbinder Dhesy-Thind, Juravinski Cancer Centre, Hamilton · Pawel Zalewski, RSM Durham Regional Cancer Centre, Oshawa · Pablo Cano, Sudbury Regional Hospital, Sudbury, Ontario · Annie Beaudoin, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke · Helene Grassin and John Stewart, Sanofi Canada, Laval, Quebec · and Scot Dowden, Alberta Health Service, Calgary, Alberta, Canada. ·J Clin Oncol · Pubmed #27621395.

ABSTRACT: Purpose The standard of care for second-line therapy in patients with advanced pancreatic cancer after gemcitabine-based therapy is not clearly defined. The CONKO-003 phase III study reported a survival benefit with second-line fluorouracil (FU) and oxaliplatin using the oxaliplatin, folinic acid, and FU (OFF) regimen.

8 Clinical Trial Significance of baseline and change in quality of life scores in predicting clinical outcomes in an international phase III trial of advanced pancreatic cancer: NCIC CTG PA.3. 2016

Vickers, M M / Lee, C / Tu, D / Wheatley-Price, P / Parulekar, W / Brundage, M D / Moore, M J / Au, H / O'Callaghan, C J / Jonker, D J / Ringash, J / Goldstein, D. ·The Ottawa Hospital Cancer Center, Ottawa, ON, Canada. Electronic address: mvickers@toh.ca. · NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, Australia. · NCIC Clinical Trials Group, Queen's University, Kingston, ON, Canada. · The Ottawa Hospital Cancer Center, Ottawa, ON, Canada. · Kingston Cancer Centre, Kingston, ON, Canada. · BC Cancer Agency, Vancouver, BC, Canada. · Princess Margaret Cancer Centre and the University of Toronto, Toronto, ON, Canada. · Prince of Wales Hospital, Randwick, NSW, Australia. ·Pancreatology · Pubmed #27600995.

ABSTRACT: BACKGROUND: There is insufficient information regarding the prognostic significance of baseline and change in quality of life (QoL) scores on overall survival (OS) in advanced pancreatic cancer. METHODS: QoL was assessed prospectively using the EORTC QLQ-C30 as part of the PA.3 trial of gemcitabine + erlotinib (G + E) vs. gemcitabine + placebo (G + P). Relevant variables and QoL scores at baseline and change at 8 weeks were analyzed by Cox stepwise regression to determine predictors of OS. RESULTS: 222 of 285 patients (pts) treated with G + E and 220 of 284 pts treated with G + P completed baseline QoL assessments. In a multivariable Cox analysis combining all pts, better QoL physical functioning (PF) score independently predicted longer OS (HR 0.86; CI: 0.80-0.93), as did non-white race (HR 0.64; CI: 0.44-0.95), PS 0-1 (HR 0.65; CI: 0.50-0.85), locally advanced disease (HR 0.55; CI: 0.43-0.71) and G + E (HR 0.78; CI: 0.64-0.96). Improvement in physical function at week 8 also predicted for improved survival (HR 0.89; CI: 0.81-0.97 for 10 point increase in score, p = 0.02). CONCLUSION: In addition to clinical variables, patient reported QoL scores at baseline and change from baseline to week 8 added incremental predictive information regarding survival for advanced pancreatic cancer patients.

9 Clinical Trial A phase II study of the HSP90 inhibitor AUY922 in chemotherapy refractory advanced pancreatic cancer. 2016

Renouf, D J / Hedley, D / Krzyzanowska, M K / Schmuck, M / Wang, L / Moore, M J. ·British Columbia Cancer Agency, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z4E6, Canada. drenouf@bccancer.bc.ca. · University Health Network-Princess Margaret Cancer Centre, Toronto, ON, Canada. · British Columbia Cancer Agency, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z4E6, Canada. ·Cancer Chemother Pharmacol · Pubmed #27422303.

ABSTRACT: OBJECTIVES: AUY922 is a novel heat shock protein inhibitor with preclinical activity in pancreatic cancer. This phase II study evaluated the efficacy of AUY922 in patients with advanced pancreatic cancer previously treated with chemotherapy. METHODS: In this single-arm, Simon two-stage phase II trial, patients with metastatic or locally advanced pancreatic ductal adenocarcinoma who had progressed on at least one line of chemotherapy and were of good performances status (ECOG 0 or 1) were treated with AUY922 at a dose of 70 mg/m(2) IV weekly. The primary endpoint was disease control rate (objective response and stable disease ≥16 weeks). RESULTS: Twelve patients were accrued, all of whom received treatment. At least possibly related ≥grade 3 adverse events included fatigue (8 %) and AST elevation (8 %). Ten patients were evaluable for response with 1 (10 %) having stable disease and 9 (90 %) progressive disease. The median progression-free survival was 1.6 months, and the median overall survival was 2.9 months. CONCLUSIONS: AUY922 was not associated with significant efficacy in previously treated patients with advanced pancreatic cancer.

10 Clinical Trial nab-Paclitaxel Plus Gemcitabine Versus Gemcitabine in Patients with Metastatic Pancreatic Adenocarcinoma: Canadian Subgroup Analysis of the Phase 3 MPACT Trial. 2016

Tehfe, Mustapha / Dowden, Scot / Kennecke, Hagen / El-Maraghi, Robert / Lesperance, Bernard / Couture, Felix / Letourneau, Richard / Liu, Helen / Romano, Alfredo. ·Centre hospitalier de l'université de Montréal (CHUM), Montreal, QC, Canada. mustapha.tehfe.chum@ssss.gouv.qc.ca. · Tom Baker Cancer Centre, Calgary, AB, Canada. · British Columbia Cancer Agency, Vancouver, BC, Canada. · Royal Victoria Regional Health Centre, Barrie, ON, Canada. · Hôpital du Sacré-Coeur de Montreal, Montreal, QC, Canada. · Centre hospitalier universitaire de Québec (CHUQ), Hôtel-Dieu de Quebec, CHUM, Montreal, QC, Canada. · Centre hospitalier de l'université de Montréal (CHUM), Montreal, QC, Canada. · Celgene Corporation, Summit, NJ, USA. ·Adv Ther · Pubmed #27085323.

ABSTRACT: INTRODUCTION: The phase III MPACT trial in patients with metastatic pancreatic cancer (MPC) demonstrated superior efficacy of nab-paclitaxel (nab-P) plus gemcitabine (Gem) compared with Gem monotherapy, including the primary endpoint of overall survival (OS; median 8.7 vs. 6.6 months; hazard ratio [HR] 0.72; P < 0.001). A significant treatment difference favoring nab-P + Gem over Gem was observed for OS in patients treated in North America. The majority of patients were from the US (88%) with only 12% from Canada. Healthcare systems and treatment patterns are different between the 2 countries, and there is limited published information on outcomes of Canadian patients treated with first-line nab-P + Gem. This analysis evaluated efficacy and safety outcomes in Canadian patients in the MPACT trial. METHODS: Treatment-naive patients with MPC (N = 861) received either nab-P 125 mg/m(2) + Gem 1000 mg/m(2) on days 1, 8, and 15 every 4 weeks or Gem 1000 mg/m(2) weekly for the first 7 of 8 weeks (cycle 1) and then on days 1, 8, and 15 every 4 weeks (cycle ≥2). RESULTS: The MPACT trial enrolled 63 patients in Canada. Baseline characteristics were well balanced and comparable with those of the intent-to-treat population. Both OS (median 11.9 vs. 7.1 months; HR 0.76; P = 0.373) and progression-free survival (median 7.2 vs. 5.2 months; HR 0.65; P = 0.224) were numerically longer and overall response rate (27% vs. 17%; P = 0.312) was numerically higher with nab-P + Gem vs. Gem. The most common grade ≥3 adverse events with nab-P + Gem vs. Gem were neutropenia (22% vs. 10%), fatigue (34% vs. 33%), and neuropathy (25% vs. 0%). CONCLUSION: This subanalysis confirmed that nab-P + Gem is an efficacious treatment option and has a manageable safety profile in patients with MPC treated in Canada. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT00844649. FUNDING: Celgene Corporation, Summit, NJ, USA.

11 Clinical Trial A Novel Biomarker Panel Examining Response to Gemcitabine with or without Erlotinib for Pancreatic Cancer Therapy in NCIC Clinical Trials Group PA.3. 2016

Shultz, David B / Pai, Jonathan / Chiu, Wayland / Ng, Kendall / Hellendag, Madeline G / Heestand, Gregory / Chang, Daniel T / Tu, Dongsheng / Moore, Malcolm J / Parulekar, Wendy R / Koong, Albert C. ·Princess Margaret Cancer Centre, Toronto, Ontario, Canada. · School of Medicine, University of California San Francisco, San Francisco, United States of America. · Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, United States of America. · Kaiser Permanente Medical Center, San Francisco, United States of America. · Moores Cancer Center, University of California San Diego, La Jolla, CA, United States of America. · NCIC Clinical Trials Group, Queen's University, Kingston, Canada. · British Columbia Cancer Agency, Vancouver, British Columbia, CA, United States of America. ·PLoS One · Pubmed #26808546.

ABSTRACT: PURPOSE: NCIC Clinical Trials Group PA.3 was a randomized control trial that demonstrated improved overall survival (OS) in patients receiving erlotinib in addition to gemcitabine for locally advanced or metastatic pancreatic cancer. Prior to therapy, patients had plasma samples drawn for future study. We sought to identify biomarkers within these samples. EXPERIMENTAL DESIGN: Using the proximity ligation assay (PLA), a probe panel was built from commercially available antibodies for 35 key proteins selected from a global genetic analysis of pancreatic cancers, and used to quantify protein levels in 20 uL of patient plasma. To determine if any of these proteins levels independently associated with OS, univariate and mulitbaraible Cox models were used. In addition, we examined the associations between biomarker expression and disease stage at diagnosis using Fisher's exact test. The correlation between Erlotinib sensitivity and each biomarkers was assessed using a test of interaction between treatment and biomarker. RESULTS AND CONCLUSION: Of the 569 eligible patients, 480 had samples available for study. Samples were randomly allocated into training (251) and validation sets (229). Among all patients, elevated levels of interleukin-8 (IL-8), carcinoembryonic antigen (CEA), hypoxia-inducible factor 1-alpha (HIF-1 alpha), and interleukin-6 were independently associated with lower OS, while IL-8, CEA, platelet-derived growth factor receptor alpha and mucin-1 were associated with metastatic disease. Patients with elevated levels of receptor tyrosine-protein kinase erbB-2 (HER2) expression had improved OS when treated with erlotinib compared to placebo. In conclusion, PLA is a powerful tool for identifying biomarkers from archived, small volume serum samples. These data may be useful to stratify patient outcomes regardless of therapeutic intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT00040183.

12 Clinical Trial Positron emission tomography response evaluation from a randomized phase III trial of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone for patients with metastatic adenocarcinoma of the pancreas. 2016

Ramanathan, R K / Goldstein, D / Korn, R L / Arena, F / Moore, M / Siena, S / Teixeira, L / Tabernero, J / Van Laethem, J-L / Liu, H / McGovern, D / Lu, B / Von Hoff, D D. ·Division of Hematology/Oncology, Mayo Clinic, Scottsdale, USA ramanathan.ramesh@mayo.edu. · Department of Medical Oncology, Prince of Wales Hospital, Sydney, Australia. · Diagnostic Radiology, Scottsdale Medical Imaging, Ltd, Scottsdale. · Hematology/Oncology, NYU Langone Arena Oncology, Lake Success, USA. · Provencial Health Services Authority, BC Cancer Agency, Vancouver, Canada. · Falck Division of Oncology, Department of Oncology and Hematology, Niguarda Cancer Center, Ospedale Niguarda Ca' Granda and Università degli Studi di Millano, Milan, Italy. · Department of Medical Oncology, Hôpital Saint-Antoine, Paris, France. · Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain. · University Clinic of Brussels, Hôpital Erasme, Brussels, Belgium. · Biostatistics and Research and Design, Celgene Corporation, Summit. · Clinical Research, Translational Genomics Research Institute and Honor Health, Scottsdale, USA. ·Ann Oncol · Pubmed #26802153.

ABSTRACT: BACKGROUND: In the phase III MPACT trial, nab-paclitaxel plus gemcitabine (nab-P + Gem) demonstrated superior efficacy versus Gem alone for patients with metastatic pancreatic cancer. We sought to examine the feasibility of positron emission tomography (PET) and to compare metabolic response rates and associated correlations with efficacy in the MPACT trial. PATIENTS AND METHODS: Patients with previously untreated metastatic adenocarcinoma of the pancreas were randomized 1:1 to receive nab-P + Gem or Gem alone. Treatment continued until disease progression by RECIST or unacceptable toxicity. RESULTS: PET scans were carried out on the first 257 patients enrolled at PET-equipped centers (PET cohort). Most patients (252 of 257) had ≥2 PET-avid lesions, and median maximum standardized uptake values at baseline were 4.6 and 4.5 in the nab-P + Gem and Gem-alone arms, respectively. In a pooled treatment arm analysis, a metabolic response by PET (best response at any time during study) was associated with longer overall survival (OS) (median 11.3 versus 6.9 months; HR, 0.56; P < 0.001). Efficacy results within each treatment arm appeared better for patients with a metabolic response. The metabolic response rate (best response and week 8 response) was higher for nab-P + Gem (best response: 72% versus 53%, P = 0.002; week 8: 67% versus 51%; P = 0.014). Efficacy in the PET cohort was greater for nab-P + Gem versus Gem alone, including for OS (median 10.5 versus 8.4 months; hazard ratio [HR], 0.71; P = 0.009) and ORR by RECIST (31% versus 11%; P < 0.001). CONCLUSION: Pancreatic lesions were PET avid at baseline, and the rate of metabolic response was significantly higher for nab-P + Gem versus Gem alone at week 8 and for best response during study. Having a metabolic response was associated with longer survival, and more patients experienced a metabolic response than a RECIST-defined response. CLINICALTRIALSGOV: NCT00844649.

13 Clinical Trial A phase II study of erlotinib in gemcitabine refractory advanced pancreatic cancer. 2014

Renouf, D J / Tang, P A / Hedley, D / Chen, E / Kamel-Reid, S / Tsao, M S / Tran-Thanh, D / Gill, S / Dhani, N / Au, H J / Wang, L / Moore, M J. ·British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada. Electronic address: drenouf@bccancer.bc.ca. · Tom Baker Cancer Centre, Calgary, AB, Canada. · University Health Network-Princess Margaret Cancer Centre, Toronto, ON, Canada. · British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada. · Cross Cancer Institute, Edmonton, AB, Canada. ·Eur J Cancer · Pubmed #24857345.

ABSTRACT: BACKGROUND: Erlotinib induced skin toxicity has been associated with clinical benefit in several tumour types. This phase II study evaluated the efficacy of erlotinib, dose escalated to rash, in patients with advanced pancreatic cancer previously treated with gemcitabine. METHODS: Erlotinib was given at an initial dose of 150 mg/day, and the dose was escalated by 50mg every 2 weeks (to a maximum of 300 mg/day) until >grade 1 rash or other dose limiting toxicities occurred. Erlotinib pharmacokinetics were performed, and baseline tumour tissue was collected for mutational analysis and epidermal growth factor receptor (EGFR) expression. The primary end-point was the disease control rate (objective response and stable disease >8 weeks). RESULTS: Fifty-one patients were accrued, and 49 received treatment. Dose-escalation to 200-300 mg of erlotinib was possible in 9/49 (18%) patients. The most common ⩾ grade 3 adverse events included fatigue (6%), rash (4%) and diarrhoea (4%). Thirty-seven patients were evaluable for response, and the best response was stable disease in 12 patients (32% (95% confidence interval (CI) 17-47%)). Disease control was observed in nine patients (24% (95% CI: 10-38%)). Median survival was 3.8 months, and 6 month overall survival rate was 32% (95% CI 19-47%). Mutational analysis and EGFR expression were performed on 29 patients, with 93% having KRAS mutations, none having EGFR mutations, and 86% expressing EGFR. Neither KRAS mutational status nor EGFR expression was associated with survival. CONCLUSIONS: Erlotinib dose escalated to rash was well tolerated but not associated with significant efficacy in non-selected patients with advanced pancreatic cancer.

14 Clinical Trial Single-fraction stereotactic body radiation therapy and sequential gemcitabine for the treatment of locally advanced pancreatic cancer. 2011

Schellenberg, Devin / Kim, Jeff / Christman-Skieller, Claudia / Chun, Carlene L / Columbo, Laurie Ann / Ford, James M / Fisher, George A / Kunz, Pamela L / Van Dam, Jacques / Quon, Andrew / Desser, Terry S / Norton, Jeffrey / Hsu, Annie / Maxim, Peter G / Xing, Lei / Goodman, Karyn A / Chang, Daniel T / Koong, Albert C. ·Department of Radiation Oncology, BC Cancer Agency, Surrey, British Columbia, Canada. ·Int J Radiat Oncol Biol Phys · Pubmed #21549517.

ABSTRACT: PURPOSE: This Phase II trial evaluated the toxicity, local control, and overall survival in patients treated with sequential gemcitabine and linear accelerator-based single-fraction stereotactic body radiotherapy (SBRT). METHODS AND MATERIALS: Twenty patients with locally advanced, nonmetastatic pancreatic adenocarcinoma were enrolled on this prospective single-institution, institutional review board-approved study. Gemcitabine was administered on Days 1, 8, and 15, and SBRT on Day 29. Gemcitabine was restarted on Day 43 and continued for 3-5 cycles. SBRT of 25 Gy in a single fraction was delivered to the internal target volume with a 2- 3-mm margin using a nine-field intensity-modulated radiotherapy technique. Respiratory gating was used to account for breathing motion. Follow-up evaluations occurred at 4-6 weeks, 10-12 weeks, and every 3 months after SBRT. RESULTS: All patients completed SBRT and a median of five cycles of chemotherapy. Follow-up for the 2 remaining alive patients was 25.1 and 36.4 months. No acute Grade 3 or greater nonhematologic toxicity was observed. Late Grade 3 or greater toxicities occurred in 1 patient (5%) and consisted of a duodenal perforation (G4). Three patients (15%) developed ulcers (G2) that were medically managed. Overall, median survival was 11.8 months, with 1-year survival of 50% and 2-year survival of 20%. Using serial computed tomography, the freedom from local progression was 94% at 1 year. CONCLUSION: Linear accelerator-delivered SBRT with sequential gemcitabine resulted in excellent local control of locally advanced pancreatic cancer. Future studies will address strategies for reducing long-term duodenal toxicity associated with SBRT.

15 Clinical Trial Phase II study of calcitriol-enhanced docetaxel in patients with previously untreated metastatic or locally advanced pancreatic cancer. 2009

Blanke, C D / Beer, T M / Todd, K / Mori, M / Stone, M / Lopez, C. ·British Columbia Cancer Agency and University of British Columbia, BC, Canada. cblanke@bccancer.bc.ca ·Invest New Drugs · Pubmed #18843448.

ABSTRACT: PURPOSE: To determine the safety and efficacy of weekly high-dose oral calcitriol and docetaxel, given to patients with non-resectable, incurable pancreatic cancer. PATIENTS AND METHODS: Twenty-five patients were enrolled onto this phase II study. Patients were treated with oral calcitriol 0.5 microg/kg on day 1, followed by docetaxel 36 mg/m(2) IV on day 2, administered weekly for three consecutive weeks, followed by 1 week without treatment. Patients followed a low-calcium diet and increased their hydration. The primary end-point of the trial was time-to-progression. RESULTS: Three of 25 patients attained a partial response (12%, 95% CI 3 to 31) and seven (28%) achieved stable disease. Median time-to-progression was 15 weeks, and median overall survival was 24 weeks. Toxicities observed (hyperglycemia, fatigue) were mostly attributable to the docetaxel or its pre-treatment. CONCLUSIONS: This regimen of high-dose calcitriol with docetaxel may have activity in incurable pancreatic cancer, with a modest increase in TTP when compared to historical findings using single-agent docetaxel. However, results do not appear superior to those seen with gemcitabine, with or without erlotinib.

16 Article Effects of adding an albumin binder chain on [ 2018

Rousseau, Etienne / Lau, Joseph / Zhang, Zhengxing / Uribe, Carlos F / Kuo, Hsiou-Ting / Zhang, Chengcheng / Zeisler, Jutta / Colpo, Nadine / Lin, Kuo-Shyan / Bénard, François. ·Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC V5Z 1L3, Canada; Département de Médecine Nucléaire et Radiobiologie, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada. · Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC V5Z 1L3, Canada. · Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC V5Z 1L3, Canada; Department of Radiology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada. Electronic address: klin@bccrc.ca. · Department of Molecular Oncology, BC Cancer Research Centre, Vancouver, BC V5Z 1L3, Canada; Department of Radiology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada. Electronic address: fbenard@bccrc.ca. ·Nucl Med Biol · Pubmed #30170196.

ABSTRACT: INTRODUCTION: [ METHODS: DOTATATE and its derivatives with an albumin-binder motif (GluAB-DOTATATE and AspAB-DOTATATE) were prepared by solid-phase peptide synthesis. Binding affinities of the Lu-labeled peptides for human somatostatin receptor 2 (SSTR2) were measured with membrane competition binding assays. Compounds were radiolabeled with [ RESULTS: GluAB-DOTATATE and AspAB-DOTATATE were synthesized in 18.8% and 14.3% yields, while Lu-GluAB-DOTATATE and Lu-AspAB-DOTATATE were obtained in 86.5% and 50.0% yields, respectively. The compounds exhibited nanomolar binding affinity (K CONCLUSION: The addition of albumin binder motifs to [

17 Article The VAR2CSA malaria protein efficiently retrieves circulating tumor cells in an EpCAM-independent manner. 2018

Agerbæk, Mette Ø / Bang-Christensen, Sara R / Yang, Ming-Hsin / Clausen, Thomas M / Pereira, Marina A / Sharma, Shreya / Ditlev, Sisse B / Nielsen, Morten A / Choudhary, Swati / Gustavsson, Tobias / Sorensen, Poul H / Meyer, Tim / Propper, David / Shamash, Jonathan / Theander, Thor G / Aicher, Alexandra / Daugaard, Mads / Heeschen, Christopher / Salanti, Ali. ·Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, 2200, Copenhagen, Denmark. · Vancouver Prostate Centre, Vancouver, BC, V6H 3Z6, Canada. · Department of Urologic Sciences, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada. · Stem Cells in Cancer & Ageing, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, United Kingdom. · Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 11490, Taipei, Taiwan. · Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, V5Z 1L3, Canada. · UCL Cancer Institute, University College London, London, WC1E 6BT, United Kingdom. · Department of Medical Oncology, Barts Health NHS, London, EC1A 7BE, United Kingdom. · Stem Cells in Cancer & Ageing, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, United Kingdom. c.heeschen@unsw.edu.au. · School of Medical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia. c.heeschen@unsw.edu.au. · Centre for Medical Parasitology at Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, 2200, Copenhagen, Denmark. salanti@sund.ku.dk. ·Nat Commun · Pubmed #30115931.

ABSTRACT: Isolation of metastatic circulating tumor cells (CTCs) from cancer patients is of high value for disease monitoring and molecular characterization. Despite the development of many new CTC isolation platforms in the last decade, their isolation and detection has remained a challenge due to the lack of specific and sensitive markers. In this feasibility study, we present a method for CTC isolation based on the specific binding of the malaria rVAR2 protein to oncofetal chondroitin sulfate (ofCS). We show that rVAR2 efficiently captures CTCs from hepatic, lung, pancreatic, and prostate carcinoma patients with minimal contamination of peripheral blood mononuclear cells. Expression of ofCS is present on epithelial and mesenchymal cancer cells and is equally preserved during epithelial-mesenchymal transition of cancer cells. In 25 stage I-IV prostate cancer patient samples, CTC enumeration significantly correlates with disease stage. Lastly, rVAR2 targets a larger and more diverse population of CTCs compared to anti-EpCAM strategies.

18 Article Improved survival with higher doses of octreotide long-acting release in gastroenteropancreatic neuroendocrine tumors. 2018

Lau, Sally C / Abdel-Rahman, Omar / Cheung, Winson Y. ·Department of Medical Oncology, BC Cancer, 600 West 10th Avenue, Vancouver, BC, V5Z4E6, Canada. · Department of Oncology, Tom Baker Cancer Centre, University of Calgary, 1331 29 St NW, Calgary, AB, T2N 4N2, Canada. · Department of Oncology, Tom Baker Cancer Centre, University of Calgary, 1331 29 St NW, Calgary, AB, T2N 4N2, Canada. winson.cheung@ahs.ca. ·Med Oncol · Pubmed #30078166.

ABSTRACT: Gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) represent a heterogeneous group of tumors that is associated with an indolent course. Octreotide has a positive effect on disease stabilization in well-differentiated midgut NETs, but a meaningful survival analysis was not possible due to insufficient events. Higher doses of octreotide long-acting release (LAR) are often used in clinical practice for control of carcinoid symptoms and our objective was to determine if dose of octreotide correlates with survival. We reviewed all patients with advanced GEP NETs who initiated treatment with octreotide LAR between 2000 and 2013 in a large, representative Canadian province. We compared overall survival in patients who received low (< 30 mg) compared to high (≥ 30 mg) doses of octreotide. A total of 170 patients were identified. Baseline characteristics in the low- and high-dose groups were similar: median age 62/63 years, 50/58% were male, 46/48% originated from the small bowel, and 74/66% had liver metastases at diagnosis. The median time from diagnosis to treatment initiation was 5.5 and 6.0 months. Octreotide LAR was initiated with the intent of symptom management (71%), disease stabilization (23%), or biomarker control (6%). Median overall survival (OS) was better in the high-dose group, 66 months compared to 22 months (multivariate HR 0.5, p < 0.01). Age ≥ 65 (HR 1.9, p < 0.01), ECOG ≥ 2 (HR 2.7, p < 0.01), and pancreatic NETs (HR 1.7, p = 0.03) were all predictors of worse survival. Our findings suggest that octreotide may confer survival benefits in GEP NETs. Further prospective studies are warranted to validate the impact of high-dose octreotide on outcomes.

19 Article A population-based analysis of urban-rural disparities in advanced pancreatic cancer management and outcomes. 2018

Canale, Thomas D / Cho, HyoKeun / Cheung, Winson Y. ·University of British Columbia, Vancouver, BC, Canada. · BC Cancer Agency, Vancouver, BC, Canada. winson.cheung@ahs.ca. · University of Calgary, 1331 29 ST NW, Calgary, AB, T2N 4N2, Canada. winson.cheung@ahs.ca. ·Med Oncol · Pubmed #29974267.

ABSTRACT: Given the significant morbidity burden associated with advanced pancreatic cancer (APC), its management is complex and frequently requires multidisciplinary care. Because of potential geographical barriers to healthcare access, we aimed to determine the effect of rurality on management and outcomes of APC patients. Patients diagnosed with APC from 2008 to 2015 and received Gemcitabine (Gem), Gemcitabine plus nab-Paclitaxel (Gem/Nab), or FOLFIRINOX at any 1 of 6 British Columbia cancer centers across the province were reviewed. Using postal codes, the Google Maps Distance Matrix determined the distance from each patient's residence to the closest cancer center. Rural and urban status were defined as patients living ≥ 100 and < 100 km from the closest treatment site, respectively. Univariate and Cox regression analyses were applied to examine whether rurality resulted in variations in management and outcomes. In total, we identified 659 patients: median age 68 years, 54.3% men, and 76.6% metastatic disease. For treatment, 67.7, 9.2, and 23.0% received Gem, Gem/Nab, and FOLFIRINOX, respectively. However, there were no differences in baseline clinical characteristics between rural and urban patients (all p > 0.05). Also, there were no significant variations in treatment patterns. For example, time from diagnosis to oncology appointment and time from appointment to treatment were 31.5 and 29.5 days for rural patients and 28.6 and 40.1 days for urban patients, respectively (all p > 0.05). Use of Gem/Nab (10.1% vs 9.1%) and FOLFIRINOX (21.0% vs 23.5%) were similar regardless of rurality. In multivariate Cox regression, risk of death was similar between rural and urban groups (HR 0.864, 95% CI 0.619-1.206, p = 0.09). Our findings suggest that there is no correlation between rurality and outcomes in APC. The strategic and geographic allocation of cancer care delivery across the province of British Columbia may serve as a model for other jurisdictions that experience disparities in the outcomes of cancers that often require complex multidisciplinary care.

20 Article A Comparison of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Fine-Needle Biopsy in the Diagnosis of Solid Pancreatic Lesions. 2018

Ayres, Lachlan R / Kmiotek, Elizabeth K / Lam, Eric / Telford, Jennifer J. ·Poole Hospital NHS Foundation Trust, Poole, UK. · Jagiellonian University Medical College, Krakow, Poland. · Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada. ·Can J Gastroenterol Hepatol · Pubmed #29850451.

ABSTRACT: Background and Aims: Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) is the method of choice for sampling pancreatic lesions. This study compares the diagnostic accuracy and safety of FNB using a novel core needle to FNA in solid pancreatic lesions. Methods: A retrospective review of patients in whom EUS FNA or FNB was performed for solid pancreatic lesions was conducted. Diagnostic performance was calculated based upon a dual classification system: classification 1, only malignant pathology considered a true positive, versus classification 2, atypical, suspicious, and malignant pathology considered a true positive. Results: 43 patients underwent FNB compared with 51 FNA. Using classification 1, sensitivity was 74.0% versus 80.0%, specificity 100% versus 100%, and diagnostic accuracy 77.0% versus 80.0% for FNB versus FNA, respectively (all Conclusion: FNA and FNB have comparable sensitivity and diagnostic accuracy. FNB required fewer passes.

21 Article Discussion of "Modified Appleby procedure for locally advanced pancreatic cancer". 2018

Buczkowski, Andrzej K. ·University of British Columbia, Canada. Electronic address: andrzejbc@yahoo.ca. ·Am J Surg · Pubmed #29615191.

ABSTRACT: -- No abstract --

22 Article Loss of Pten and Activation of Kras Synergistically Induce Formation of Intraductal Papillary Mucinous Neoplasia From Pancreatic Ductal Cells in Mice. 2018

Kopp, Janel L / Dubois, Claire L / Schaeffer, David F / Samani, Atefeh / Taghizadeh, Farnaz / Cowan, Robert W / Rhim, Andrew D / Stiles, Bangyan L / Valasek, Mark / Sander, Maike. ·Departments of Pediatrics and Cellular and Molecular Medicine, University of California-San Diego, La Jolla, California; Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada. · Departments of Pediatrics and Cellular and Molecular Medicine, University of California-San Diego, La Jolla, California. · Department of Pathology and Laboratory and Medicine, University of British Columbia, Vancouver, British Columbia, Canada. · Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, British Columbia, Canada. · Ahmed Center for Pancreatic Cancer Research and Department of Gastroenterology, Hepatology and Nutrition, University of Texas M.D. Anderson Cancer Center, Houston, Texas. · Department of Pharmaceutical Sciences, School of Pharmacy, Keck School of Medicine, University of Southern California, and the Norris Comprehensive Cancer Center, Los Angeles, California. · Department of Pathology, University of California-San Diego, La Jolla, California. · Departments of Pediatrics and Cellular and Molecular Medicine, University of California-San Diego, La Jolla, California. Electronic address: masander@ucsd.edu. ·Gastroenterology · Pubmed #29273451.

ABSTRACT: BACKGROUND & AIMS: Intraductal papillary mucinous neoplasias (IPMNs) are precancerous cystic lesions that can develop into pancreatic ductal adenocarcinomas (PDACs). These large macroscopic lesions are frequently detected during medical imaging, but it is unclear how they form or progress to PDAC. We aimed to identify cells that form IPMNs and mutations that promote IPMN development and progression. METHODS: We generated mice with disruption of Pten specifically in ductal cells (Sox9CreER RESULTS: Mice with ductal cell-specific disruption of Pten but not control mice developed sporadic, macroscopic, intraductal papillary lesions with histologic and molecular features of human IPMNs. Pten CONCLUSIONS: In analyses of mice with ductal cell-specific disruption of Pten, with or without activated Kras, we found evidence for a ductal cell origin of IPMNs. We also showed that PTEN loss and activated Kras have synergistic effects in promoting development of IPMN and progression to PDAC.

23 Article Molecular characterization of metastatic pancreatic neuroendocrine tumors (PNETs) using whole-genome and transcriptome sequencing. 2018

Wong, Hui-Li / Yang, Kevin C / Shen, Yaoqing / Zhao, Eric Y / Loree, Jonathan M / Kennecke, Hagen F / Kalloger, Steve E / Karasinska, Joanna M / Lim, Howard J / Mungall, Andrew J / Feng, Xiaolan / Davies, Janine M / Schrader, Kasmintan / Zhou, Chen / Karsan, Aly / Jones, Steven J M / Laskin, Janessa / Marra, Marco A / Schaeffer, David F / Gorski, Sharon M / Renouf, Daniel J. ·Division of Medical Oncology, BC Cancer Agency, Vancouver, British Columbia V5Z 4E6, Canada. · Pancreas Centre BC, Vancouver, British Columbia V5Z 4E6, Canada. · Department of Molecular Biology and Biochemistry, Simon Fraser University, Vancouver, British Columbia V5A 1S6, Canada. · Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4S6, Canada. · Division of Anatomical Pathology, Vancouver General Hospital, Vancouver, British Columbia V5Z 1M9, Canada. · Vancouver Island Centre, British Columbia Cancer Agency, Vancouver, British Columbia V8R 6V5, Canada. · Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada. ·Cold Spring Harb Mol Case Stud · Pubmed #29092957.

ABSTRACT: Pancreatic neuroendocrine tumors (PNETs) are a genomically and clinically heterogeneous group of pancreatic neoplasms often diagnosed with distant metastases. Recurrent somatic mutations, chromosomal aberrations, and gene expression signatures in PNETs have been described, but the clinical significance of these molecular changes is still poorly understood, and the clinical outcomes of PNET patients remain highly variable. To help identify the molecular factors that contribute to PNET progression and metastasis, and as part of an ongoing clinical trial at the BC Cancer Agency (clinicaltrials.gov ID: NCT02155621), the genomic and transcriptomic profiles of liver metastases from five patients (four PNETs and one neuroendocrine carcinoma) were analyzed. In four of the five cases, we identified biallelic loss of

24 Article Primary Care Versus Oncology-Based Surveillance Following Adjuvant Chemotherapy in Resected Pancreatic Cancer. 2018

Samawi, Haider H / Yin, Yaling / Lim, Howard J / Cheung, Winson Y. ·Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada. · Section of Medical Oncology, Tom Baker Cancer Centre, 1331 29 St NW, Calgary, AB, T2N 4N2, Canada. winson.cheung@ahs.ca. ·J Gastrointest Cancer · Pubmed #28674913.

ABSTRACT: INTRODUCTION: High level evidence to guide surveillance following curative intent treatment for pancreatic cancer is lacking and this has likely resulted in wide variations in practice. We aim to describe patterns of surveillance and evaluate their impact on outcomes. METHODS: A total of 147 adult patients who received at least one cycle of adjuvant gemcitabine or 5-fluorouracil-based chemotherapy at any one of five British Columbia Cancer Agency centers between 2001 and 2015 were included. Surveillance strategies were classified into two categories: discharged to primary care physicians (PCPs) or follow-up at cancer centers (CC) that included regular clinical assessments, laboratory testing, and/or diagnostic imaging. RESULTS: Median age at diagnosis was 64 (range 38-85) years and 48% were men. More patients were followed by CC than by PCPs (66 vs. 44%). Among the measured prognostic factors, only patients with advanced tumor stage (T3/4) were more likely to be followed by cancer specialists (78 vs. 62%, P = 0.03), while other patient and disease characteristics were balanced between the two groups. In the entire cohort, 100 (68%) patients had a documented recurrence. Patients followed by CC were more likely to receive palliative chemotherapy at recurrence than those followed by PCPs (58 vs. 34%, respectively, P = 0.03). The median overall survival (OS) was 2.82 (95% CI 2.17-3.32) years in the CC group and 3.35 (95% CI 2.85-5.06) years in the PCP group while the median relapse-free survival (RFS) was 1.4 (95% CI 1.37-1.77) and 2.4 (95% CI 2.07-4.59) years, respectively. On multivariate analysis, there was no significant difference in OS between CC and PCP-based surveillance (HR 1.23; 95% CI 0.74-2.04, P = 0.40); however, RFS favored the PCP group (HR 1.62; 95% CI 1.01-2.56, P = 0.04, for the CC group). CONCLUSION: In this population-based analysis, surveillance tests and imaging performed by CC detected recurrences earlier when compared to follow-up by PCPs, but this did not result in OS differences. Patients with more advanced tumors were more likely to be seen at CC. PCPs may play a larger role in the follow-up care of selected low risk patients with resected pancreatic cancer.

25 Article Risk factors, biomarker and imaging techniques used for pancreatic cancer screening. 2017

Thomas, Cyrus. ·Life Sciences Centre, University of British Columbia, Vancouver, Canada. cyrus.thomas@alumni.ubc.ca. ·Chin Clin Oncol · Pubmed #29307201.

ABSTRACT: Pancreatic cancer (PC) is one of the most lethal epithelial malignancies. There have been many attempts aimed at improving survival rates; however, the fatality of PC has been attributed to its few, nonspecific and diverse symptoms that delay diagnosis, rapid metastatic progression and overall treatment resistance. The aggressive nature of PC has stimulated interest in detecting smaller asymptomatic cancers or precursor lesions that are more likely to be curable. This review discusses potential risk factors including lifestyle and genetic variables that are believed to be the most important in contributing to the development of PC. In addition, we focus our review on emerging literature to compare and contrast current screening strategies including biomarkers and imaging modalities with regards to detecting early PC. It is hoped that in the future, biomarker development will be supported by novel techniques in medical imaging that are currently being developed and tested to ultimately lead to earlier detection and increased cure for this fatal disease.

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