Latest Advances in Pancreatic Neoplasms

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (20 February 2023) | Viewed by 3601

Special Issue Editor


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Guest Editor
Department of Medical Oncology, Kochi Medical School Kohasu, Kochi, Japan
Interests: pancreatic neoplasms; diagnosis; surgery; systemic chemotherapy; molecularly targeted drug; immunotherapy; genomic profile; ctdna; AI (artificial intelligence); multi-omics analysis

Special Issue Information

Dear Colleagues,

Pancreatic cancer is recognized as having one of the poorest prognoses of all cancers. Although it is recognized that the radical cure of pancreatic cancer requires multimodality treatment, combining chemotherapy and radiation, only 15% to 20% of patients are eligible for surgery. Chemotherapy for pancreatic cancer includes combination therapy with cytotoxic agents, while immunotherapy and other therapies are still in development. On the other hand, recent technological innovations have advanced our understanding of the genomic profile of pancreatic cancer, and there are high expectations for the development of new therapies such as molecularly targeted drugs for KRASG12C mutations, early diagnosis using ctDNA, new treatment strategies using AI, and multi-omics analysis. In this Special Issue, we focus on pancreatic cancer, for which the development of new diagnostic and therapeutic strategies is expected to accelerate in the future.

Prof. Dr. Hironaga Satake
Guest Editor

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Keywords

  • pancreatic neoplasms
  • diagnosis
  • surgery
  • systemic chemotherapy
  • molecularly targeted drug
  • immunotherapy
  • genomic profile
  • ctDNA
  • AI (artificial intelligence)
  • multi-omics analysis

Published Papers (2 papers)

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Research

10 pages, 1129 KiB  
Article
A Retrospective Study Investigating the Safety and Efficacy of Nanoliposomal Irinotecan in Elderly Patients with Unresectable Pancreatic Cancer
by Tatsuki Ikoma, Toshihiko Matsumoto, Shogen Boku, Tomoyo Yasuda, Masataka Masuda, Takashi Ito, Koh Nakamaru, So Yamaki, Shinji Nakayama, Daisuke Hashimoto, Tomohisa Yamamoto, Nobuhiro Shibata, Tsukasa Ikeura, Makoto Naganuma, Sohei Satoi and Takayasu Kurata
J. Clin. Med. 2023, 12(10), 3477; https://doi.org/10.3390/jcm12103477 - 15 May 2023
Cited by 1 | Viewed by 1656
Abstract
Although nanoliposomal irinotecan combined with 5-fluorouracil and leucovorin (nal-IRI+5-FU/LV) has been used to treat first-line resistant unresectable pancreatic cancer, the efficacy and safety data among the elderly remain limited. We retrospectively analyzed clinical outcomes among elderly patients. Patients treated with nal-IRI+5-FU/LV were assigned [...] Read more.
Although nanoliposomal irinotecan combined with 5-fluorouracil and leucovorin (nal-IRI+5-FU/LV) has been used to treat first-line resistant unresectable pancreatic cancer, the efficacy and safety data among the elderly remain limited. We retrospectively analyzed clinical outcomes among elderly patients. Patients treated with nal-IRI+5-FU/LV were assigned to the elderly (≥75 years) and non-elderly (<75 years) groups. Herein, 85 patients received nal-IRI+5-FU/LV, with 32 assigned to the elderly group. Patient characteristics in the elderly and non-elderly groups were as follows: age: 78.5 (75–88)/71 (48–74), male: 17/32 (53%/60%), performance status (ECOG) 0:9/20 (28%/38%), nal-IRI+5-FU/LV in second line: 23/24 (72%/45%), respectively. A significantly high number of elderly patients exhibited aggravated kidney and hepatic functions. Median overall survival (OS) and progression-free survival (PFS) in the elderly group vs. non-elderly group were 9.4 months vs. 9.9 months (hazard ratio (HR) 1.51, 95% confidence interval (CI) 0.85–2.67, p = 0.16) and 3.4 months vs. 3.7 months (HR 1.41, 95% CI 0.86–2.32, p = 0.17). Both groups exhibited a similar incidence of efficacy and adverse events. There were no significant differences in OS and PFS between groups. We analyzed the C-reactive protein/albumin ratio (CAR) and neutrophil/lymphocyte ratio (NLR) as indicators that could determine eligibility for nal-IRI+5-FU/LV. The median CAR and NLR scores in the ineligible group were 1.17 and 4.23 (p < 0.001 and p = 0.018, respectively). Elderly patients with worse CAR and NLR score could be deemed ineligible for nal-IRI+5-FU/LV. Full article
(This article belongs to the Special Issue Latest Advances in Pancreatic Neoplasms)
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15 pages, 1327 KiB  
Article
Correlation of UGT1A1 Gene Polymorphisms or Prior Irinotecan Treatment and Treatment Outcomes of Nanoliposomal-Irinotecan plus 5-Fluorouracil/Leucovorin for Pancreatic Ductal Adenocarcinoma: A Multicenter, Retrospective Cohort Study (HGCSG2101)
by Kazuaki Harada, Takahiro Yamamura, Osamu Muto, Michio Nakamura, Susumu Sogabe, Kentaro Sawada, Shintaro Nakano, Masataka Yagisawa, Tetsuhito Muranaka, Masayoshi Dazai, Miki Tateyama, Yoshimitsu Kobayashi, Sosuke Kato, Kazuteru Hatanaka, Yasuyuki Kawamoto, Satoshi Yuki, Yuh Sakata, Naoya Sakamoto and Yoshito Komatsu
J. Clin. Med. 2023, 12(4), 1596; https://doi.org/10.3390/jcm12041596 - 17 Feb 2023
Cited by 1 | Viewed by 1531
Abstract
The effects of UGT1A1 gene polymorphisms or prior irinotecan treatment on treatment outcomes of nanoliposomal-irinotecan plus 5-fluorouracil/leucovorin (nal-IRI+5-FU/LV) in patients with unresectable pancreatic ductal adenocarcinoma (PDAC) are not established. This multicenter, retrospective cohort study compared treatment outcomes in patients with UGT1A1*1/*1 and those [...] Read more.
The effects of UGT1A1 gene polymorphisms or prior irinotecan treatment on treatment outcomes of nanoliposomal-irinotecan plus 5-fluorouracil/leucovorin (nal-IRI+5-FU/LV) in patients with unresectable pancreatic ductal adenocarcinoma (PDAC) are not established. This multicenter, retrospective cohort study compared treatment outcomes in patients with UGT1A1*1/*1 and those with UGT1A1*1/*6 or *1/*28 genotypes. We also analyzed the impact of prior irinotecan treatment on survival outcomes in 54 patients treated with nal-IRI+5-FU/LV. Comparable effectiveness was found regardless of the UGT1A1 genotypes. While no significant differences were found, grade ≥3 neutropenia and febrile neutropenia were more frequent in patients with UGT1A1*1/*6 or *1/*28 than in those with UGT1A1*1/*1 genotypes (grade ≥3 neutropenia, 50.0% vs. 30.8%, p = 0.24; febrile neutropenia, 9.1% vs. 0.0%, p = 0.20, respectively). No significant difference in progression-free survival (PFS) and overall survival (OS) was observed between irinotecan-naïve-patients and other patients. However, irinotecan-resistant patients showed significantly shorter PFS (hazard ratio (HR) 2.83, p = 0.017) and OS (HR 2.58, p = 0.033) than other patients. Our study indicated that patients with UGT1A1*1/*6 or *1/*28 may be prone to neutropenia, though further study is needed. The survival benefit of nal-IRI+5-FU/LV could be maintained in patients without disease progression after irinotecan therapy. Full article
(This article belongs to the Special Issue Latest Advances in Pancreatic Neoplasms)
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