Incidence and risk factors for abdominal occult metastatic disease in patients with pancreatic adenocarcinoma

2018 ◽  
Vol 118 (8) ◽  
pp. 1277-1284 ◽  
Author(s):  
Georgios Gemenetzis ◽  
Vincent P. Groot ◽  
Alex B. Blair ◽  
Ding Ding ◽  
Sameer S. Thakker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Adenocarcinoma ◽  
Metastatic Disease ◽  
Occult Metastatic Disease

scholarly journals Serial monitoring of circulating tumor DNA in patients with primary breast cancer for detection of occult metastatic disease

2015 ◽  
Vol 7 (8) ◽  
pp. 1034-1047 ◽  
Author(s):  
Eleonor Olsson ◽  
Christof Winter ◽  
Anthony George ◽  
Yilun Chen ◽  
Jillian Howlin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Primary Breast Cancer ◽  
Circulating Tumor Dna ◽  
Occult Metastatic Disease ◽  
Tumor Dna

scholarly journals Outcomes of Patients with Initially Locally Advanced Pancreatic Adenocarcinoma who did not Benefit from Resection: A Prospective Cohort Study

2020 ◽  
Author(s):  
Jonathan Garnier ◽  
Jacques Ewald ◽  
Ugo Marchese ◽  
Marine Gilabert ◽  
Simon Launay ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Pancreatic Adenocarcinoma ◽  
Metastatic Disease ◽  
Performance Status ◽  
Locally Advanced ◽  
Wilcoxon Test ◽  
Stepwise Logistic Regression ◽  
Short Term Treatment ◽  
Locally Advanced Pancreatic Adenocarcinoma ◽  
Advanced Pancreatic Adenocarcinoma

Abstract Background: The current study aimed to evaluate the outcomes of patients with unresectable non-metastatic locally advanced pancreatic adenocarcinoma (LAPA) who did not benefit from resection considering the treatment strategy in the clinical settings. Methods: Between 2010 and 2017, a total of 234 patients underwent induction chemotherapy for LAPA that could not be treated with surgery. After oncologic restaging, continuous chemotherapy or chemoradiation (CRT) was decided for patients without metastatic disease. The Kaplan–Meier method was used to determine overall survival (OS), and the Wilcoxon test to compare survival curves. Multivariate analysis was performed using the stepwise logistic regression method. Results: FOLFIRINOX was the most common induction regimen (168 patients, 72%), with a median of 6 chemotherapy cycles and resulted in higher OS, compared to gemcitabine (19 vs. 16 months, hazard ratio (HR)=1.2, 95% confidence interval: 0.86–1.6, P =.03). However, no difference was observed after adjusting for age (≤75 years) and performance status score (0–1). At restaging, 187 patients (80%) had non-metastatic disease: CRT was administered to 126 patients (67%) while chemotherapy was continued in 61 (33%). Patients who received CRT had characteristics comparable to those who continued with chemotherapy, with similar OS. They also had longer progression-free survival (median 13.3 vs. 9.6 months, HR=1.38, 95% confidence interval: 1–1.9, P <.01) and limited short-term treatment-related toxicity. Conclusions: The median survival of patients who could not undergo surgery was 19 months. Hence, CRT should not be eliminated as a treatment option and may be useful as a part of optimised sequential chemotherapy for both local and metastatic disease.

The genomic profile of pancreatic adenocarcinoma and its relationship to metastatic disease

2016 ◽  
Vol 101 (2) ◽  
pp. 172-175
Author(s):  
K.J. Pierce ◽  
F.B. de Abreu ◽  
J.D. Peterson ◽  
A.A. Suriawinata ◽  
G.J. Tsongalis ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Metastatic Disease ◽  
Genomic Profile

Investigate the efficacy of immunotherapy for treatment of pancreatic adenocarcinoma (PDAC) with mismatch repair deficiency (dMMR).

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 415-415
Author(s):  
Arish Noor ◽  
Luis E. Aguirre ◽  
Kirsten Blue ◽  
Trenton Avriett ◽  
Estrella M. Carballido ◽  
...  
Keyword(s):  
Pancreatic Adenocarcinoma ◽  
Metastatic Disease ◽  
Checkpoint Inhibitors ◽  
Objective Response ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Complete Response ◽  
Median Number ◽  
Cancer Center ◽  
Duration Of Response

415 Background: Immune checkpoint inhibitors (ICI) have been approved in solid tumors with dMMR. However, only limited data are available for PDAC with dMMR given the rarity of dMMR in PDAC. We evaluated efficacy of ICIs in PDAC with dMMR. Methods: Retrospective clinical and pathologic data were collected for patients (pts) with pancreatic adenocarcinoma from May 2017 to June 2020 at Moffitt cancer center. Results: We identified 10 pts with dMMR PDAC. The median age was 64.5 years (range: 42-86) and 4 pts were male. 4 pts had resectable disease, 3 had locally advanced and 3 had metastatic disease at initial diagnosis. MSH6 deficiency (def) was found in 2 cases, PMS2 def in 2, MLH/PMS2 def in 5, and MSH2/MSH6 in 1. 7 pts were treated with ICIs. 3 pts had locally advanced and 4 had metastatic disease when they started ICIs. 5 received Pembrolizumab (pem), 1 received ipilimumab/ nivolumab (ipi/nivo), and 1 received pem then ipi/nivo after progressive disease (PD) on pem. The median number of prior lines of chemotherapy was 1 (range 0-2). 6 pts were evaluable, and 1 had rapid disease progression after 1 dose of pem. Among 6 evaluable pts, 3 had an objective response (1: complete response and 2: partial response), and 2 had stable disease (SD). Median progression-free survival was 8.2 mo, and median overall survival was not reached with median follow-up (FU) of 6.8 mo. The median duration of response was not reached with a median FU of 22.6 mo. The pt with CR remained disease-free for up to 22 months. The pt whose treatment was switched to ipi/nivo after PD on pem achieved SD > 4mo on ipi/nivo. While on immunotherapy, one patient with ipi/nivo developed immunotherapy associated rash requiring systemic steroids, and another on pem developed hypothyroidism requiring levothyroxine. Conclusions: This series suggest ICIs can provide durable clinical efficacy in pts with dMMR PDAC.

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