ChemotherapyBorderline resectable pancreatic cancerTumorsOxaliplatinUnderwentOutcomesDiseaseAdenocarcinomaLocally advancedTherapyRadiotherapyGastricUpfront surgeryPostoperativePreoperative ChemoradiotherapySurgeryConcurrentEsophageal cancersSurvival in PatientsDefinitiveClinicalTrialsTumorTreatmentLymph nodeImmuneUnclearDose
Chemotherapy34
- Two recent randomized trials have suggested benefit of neoadjuvant chemoradiotherapy over upfront surgery, both including single-agent chemotherapy regimens. (nih.gov)
- Patients receive 8 cycles of neoadjuvant FOLFIRINOX chemotherapy followed by surgery without adjuvant treatment (arm A), or 3 cycles of neoadjuvant gemcitabine with hypofractionated radiotherapy (36 Gy in 15 fractions) during the second cycle, followed by surgery and 4 cycles of adjuvant gemcitabine (arm B). The primary endpoint is OS by intention-to-treat. (nih.gov)
- In this article, we review the data surrounding the use of chemotherapy (CT) and chemoradiotherapy (CRT) in patients with resectable pancreatic cancer. (cancernetwork.com)
- Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. (helsedirektoratet.no)
- Effect of Neoadjuvant Chemotherapy Followed by Surgical Resection on Survival in Patients With Limited Metastatic Gastric or Gastroesophageal Junction Cancer: The AIO-FLOT3 Trial. (helsedirektoratet.no)
- Current options for resectable esophageal cancer include preoperative cisplatin-based radiotherapy and preoperative or perioperative chemotherapy alone (either 5-fluorouracil/cisplatin, as in the UK Medical Research Council study, [ 1 ] or epirubicin, cisplatin and fluorouracil, as in the MAGIC study [ 2 ] ). (medscape.com)
- This study therefore offers a new option of weekly chemotherapy with concurrent radiotherapy for patients with resectable esophageal (but not gastric) cancers. (medscape.com)
- Preoperative chemoradiotherapy and postoperative chemotherapy with fluorouracil and oxaliplatin versus fluorouracil alone in locally advanced rectal cancer: initial results of the German CAO/ARO/AIO-04 randomised phase 3 trial. (ac.ir)
- The aim of this study is to evaluate whether or not intensified chemotherapy prior to neoadjuvant chemoradiotherapy improves the complete response (CR) rate in these patients. (amsterdamumc.org)
- Exclusion criteria are the presence of a homozygous DPD deficiency, distant metastases, any chemotherapy within the past 6 months, previous radiotherapy within the pelvic area precluding standard chemoradiotherapy, and any contraindication for the planned treatment. (amsterdamumc.org)
- The MEND-IT study aims to evaluate the CR rate after intensified chemotherapy prior to concomitant chemoradiotherapy in a homogeneous group of patients with locally advanced rectal cancer and indisputably unfavourable characteristics, defined as hr-LARC, in order to improve their prognosis. (amsterdamumc.org)
- The benefit of adjuvant chemotherapy following curative-intent surgery in pancreatic ductal adenocarcinoma (PDAC) patients who had received neoadjuvant FOLFIRINOX is unclear. (e-crt.org)
- Among PDAC patients who underwent surgery following neoadjuvant FOLFIRINOX, adjuvant chemotherapy may be associated with improved survival. (e-crt.org)
- Recently, neoadjuvant chemotherapy has been widely used for the management of patients with borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) [ 8 - 13 ]. (e-crt.org)
- There is limited evidence to recommend a specific neoadjuvant chemotherapy regimen because of the lack of prospective comparative trials. (e-crt.org)
- OPDIVO ® (nivolumab), in combination with platinum-doublet chemotherapy, is indicated as neoadjuvant treatment of adult patients with resectable (tumors ≥4 cm or node positive) non-small cell lung cancer (NSCLC). (opdivohcp.com)
- Therefore, both resectable pancreatic cancer and borderline resectable pancreatic cancer are amenable to upfront surgical removal but it is not clear if the patients will benefit more from chemotherapy prior to surgery (neoadjuvant chemotherapy). (bhimar.org)
- Several clinical trials have explored the options of gemcitabine, modified FOLFIRINOX (a combination of chemotherapy drugs), and paclitaxel in the neoadjuvant setting. (bhimar.org)
- Thus, the evidence regarding the use of chemotherapy as the first-line treatment in resectable pancreatic cancer is weak and no clinical decision can be made based on the results of individual clinical trials. (bhimar.org)
- A meta-analysis (review of studies) was performed to provide some clarity about whether chemotherapy before the surgery is advantageous in resectable pancreatic cancer or should the conventional approach of upfront surgery be adopted in patients with localized pancreatic cancer [2]. (bhimar.org)
- Clinical trials testing neoadjuvant chemotherapy or chemotherapy plus radiation have had mixed results. (bhimar.org)
- One study found neoadjuvant chemotherapy plus radiotherapy before surgery improved overall survival to 17.6 months, versus 13.2 months with upfront surgery [3]. (bhimar.org)
- Another trial tested intense chemotherapy called mFFX in neoadjuvant settings [4]. (bhimar.org)
- A meta-analysis combined six clinical trials testing neoadjuvant chemotherapy or chemotherapy plus radiation for resectable pancreatic cancer to find out which first-line treatment holds the most clinical advantage in pancreatic cancer. (bhimar.org)
- However, there is some evidence to suggest a clinical benefit of neoadjuvant chemotherapy in borderline resectable pancreatic cancer, but more research is needed to arrive at a conclusion. (bhimar.org)
- Mismatch repair-deficient tumors do not respond well to chemotherapy applied in the neoadjuvant, adjuvant, or metastatic settings. (cancer.gov)
- Patients received 2 cycles of neoadjuvant chemotherapy with capecitabine and oxaliplatin and were then randomised to one of two concurrent chemotherapy regimens: capecitabine and oxaliplatin or carboplatin and paclitaxel. (biomedcentral.com)
- We aimed to determine the predictive significance of Ki-67 and platelet lymphocyte ratio (PLR) in patients with gastric cancer (GC), who received fluorouracil, leucovorin, oxaliplatin, docetaxel (FLOT) as neoadjuvant chemotherapy (NAC). (jcpsp.pk)
- 1 Since, approximately 2/3 of the patients are in the locally advanced stage at the time of diagnosis, they are generally not suitable for surgical treatment, and neoadjuvant chemotherapy (NAC) is a more suitable treatment option for these patients. (jcpsp.pk)
- Modifying the delivery of systemic chemotherapy to improve patients' survival is another progress in colorectal cancer management, known as total neoadjuvant therapy (TNT). (coloproctol.org)
- Advanced rectal cancers were traditionally treated with neoadjuvant chemoradiation therapy (nCRT) followed by total mesorectal excision (TME) and postoperative adjuvant chemotherapy [ 1 , 2 ]. (coloproctol.org)
- A new treatment strategy named total neoadjuvant therapy (TNT), consists of chemotherapy given before or after the CRT to control micrometastatic disease earlier and improve compliance with chemotherapy. (coloproctol.org)
- Gulam A. Manji, MD, PhD, of Columbia University Medical Center, discusses phase II results on perioperative combination chemotherapy and pembrolizumab in patients with resectable gastric cancer. (ascopost.com)
- Of note is that none of the previously conducted randomized trials of induction chemotherapy used concurrent chemoradiotherapy in the control arm. (jnccn.org)
Borderline resectable pancreatic cancer8
- The PREOPANC-2 trial investigates whether neoadjuvant FOLFIRINOX improves OS compared with neoadjuvant gemcitabine-based chemoradiotherapy and adjuvant gemcitabine in resectable and borderline resectable pancreatic cancer patients. (nih.gov)
- This nationwide multicenter phase III randomized controlled trial includes patients with pathologically confirmed resectable and borderline resectable pancreatic cancer with a WHO performance score of 0 or 1. (nih.gov)
- borderline resectable pancreatic cancer is defined as ≤90 degrees arterial and ≤ 270 degrees venous involvement without occlusion. (nih.gov)
- The PREOPANC-2 trial directly compares two neoadjuvant regimens for patients with resectable and borderline resectable pancreatic cancer. (nih.gov)
- Our study will provide evidence on the neoadjuvant treatment of choice for patients with resectable and borderline resectable pancreatic cancer. (nih.gov)
- Neoadjuvant Chemoradiotherapy Versus upfront Surgery for Resectable and Borderline Resectable Pancreatic Cancer: Long-Term Results of the Dutch Randomized PREOPANC Trial. (wisc.edu)
- Furthermore, when the cancer cells have only begun to move out of the pancreas, the tumor is called borderline resectable pancreatic cancer. (bhimar.org)
- Determining the first-line treatment for resectable and borderline resectable pancreatic cancer, which is best in terms of overall survival and progression-free survival, is an active area of research. (bhimar.org)
Tumors4
- T4b tumors involving pericardium, pleura, diaphragm are also potentially resectable. (medscape.com)
- For resectable pancreatic body or tail tumors, EUS-FNA should be carefully performed to prevent needle tract seeding and intraoperative as well as postoperative assessment for gastric wall metastasis is mandatory. (biomedcentral.com)
- Currently neoadjuvant therapy seems to have a role in managing marginally resectable tumors and tumors with known lymph node involvement. (stomachguide.net)
- Of the 10-20% of patients who present with resectable tumors, the 5-year surviva rate is still only about 20%, with a median survival of around 23-43 months with adjuvant therapy ( 2 - 4 ). (iiarjournals.org)
Oxaliplatin3
- Potentially, the multi-agent FOLFIRINOX regimen (5-fluorouracil with leucovorin, irinotecan, and oxaliplatin) may further improve outcomes in the neoadjuvant setting for localized pancreatic cancer, but randomized studies are needed. (nih.gov)
- Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. (helsedirektoratet.no)
- All patients will be planned for six two-weekly cycles of FOLFOXIRI (5-fluorouracil, leucovorin, oxaliplatin and irinotecan) prior to chemoradiotherapy (25 × 2 Gy or 28 × 1.8 Gy with concomitant capecitabine). (amsterdamumc.org)
Underwent4
- The study compared the perioperative morbidity and mortality of patients aged 70 years or older with those of patients younger than 70 years who underwent chemoradiotherapy followed by esophagectomy. (medscape.com)
- Patients with resectable disease then underwent minimally invasive esophagectomy (MIE). (hindawi.com)
- Committee of Clinical Research, Japan Pancreas Society: Prognostic importance of peritoneal washing cytology in patients with otherwise resectable pancreatic ductal adenocarcinoma who underwent pancreatectomy: A nationwide, cancer registry-based study from the Japan Pancreas Society. (wakayama-med-2ndsurg.jp)
- This retrospective study included 218 patients with localized non-metastatic PDAC who received neoadjuvant FOLFIRINOX and underwent curative-intent surgery (R0 or R1) between January 2017 and December 2020. (e-crt.org)
Outcomes1
- Multiple studies have evaluated the outcomes of neoadjuvant chemoradiation followed by surgical resection with surgical resection alone (Table 1) . (appliedradiationoncology.com)
Disease9
- The 5-year overall survival of patients with pancreatic cancer is approximately 5%, with potentially resectable disease representing the curable minority. (cancernetwork.com)
- Patients with locally advanced disease (patients with T3 or above and/or N1 disease) require neoadjuvant chemoradiotherapy prior to surgical intervention. (hindawi.com)
- A resection will be performed following radiological confirmation of resectable disease after the completion of chemoradiotherapy. (amsterdamumc.org)
- Only 20% of patients have surgically resectable disease at the time of diagnosis [ 1 - 3 ]. (e-crt.org)
- OPDIVO ® (nivolumab) is indicated for the adjuvant treatment of completely resected esophageal or gastroesophageal junction cancer with residual pathologic disease in adult patients who have received neoadjuvant chemoradiotherapy (CRT). (opdivohcp.com)
- According to the findings of this meta-analysis, neoadjuvant therapy does not improve the clinical outcome including overall survival and disease-free progression in patients with resectable pancreatic cancer. (bhimar.org)
- So, while survival does not improve, neoadjuvant strategies may facilitate resection in this difficult-to-treat disease. (bhimar.org)
- Although patients often present with apparently resectable disease, systemic spread frequently occurs before the development of symptoms and detection of tumor. (elsevierpure.com)
- Its aim was the re-introduction this regimen into the UK in the era of modern RT techniques and post-operative care, after its use was abandoned a decade previously, following concerns over morbidity and mortality [ 9 ], in addition to establishing the optimal neoadjuvant therapy in this disease. (biomedcentral.com)
Adenocarcinoma1
- Neoadjuvant and/or adjuvant treatment has led to an improved survival in patients with resectable gastroesophageal adenocarcinoma (GEAC). (esmo.org)
Locally advanced5
- Neoadjuvant treatment for locally advanced esophageal cancer is the standard of care [ 1 , 2 ]. (hindawi.com)
- This is a review of morbidity and mortality for first 51 MIE procedures for locally advanced esophageal cancer, that were resectable, on post neoadjuvant computerized tomography (CT) of chest and abdomen. (hindawi.com)
- Neoadjuvant chemoradiotherapy is recommended to locally advanced rectal cancer, especially for the lower and middle ones. (ac.ir)
- In this review, we examine the role of trimodality therapy in the management of locally advanced esophageal cancer, focusing on controversies surrounding the optimal total neoadjuvant RT dose employed. (appliedradiationoncology.com)
- Finally, neoadjuvant therapy consisting of Capecitabine plus radiation therapy, for locally advanced rectal cancer was analysed. (wjgnet.com)
Therapy10
- Neoadjuvant chemoradiotherapy appears to be associated with better survival than local therapy or surgery alone. (medscape.com)
- Likewise, centralization and application of national guidelines, widespread use of neoadjuvant therapy, and the stage migration phenomenon are serious concerns to be discussed. (frontiersin.org)
- CROSS: New Standard for Esophageal Neoadjuvant Therapy? (medscape.com)
- 001). A pathological complete response was achieved in 29% of patients after neoadjuvant therapy. (medscape.com)
- Is neoadjuvant therapy beneficial in pancreatic cancer? (bhimar.org)
- More data is needed to optimize neoadjuvant therapy for borderline pancreatic cancer. (bhimar.org)
- Preliminary results suggest that neoadjuvant therapy with paclitaxel-based combinations (including 5-fluorouracil and cisplatin) and radiation is highly active, with variable toxicity. (elsevierpure.com)
- In the study, patients will be randomized to receive either neoadjuvant chemoradiotherapy (standard of care) or neoadjuvant chemo-proton-therapy (intervention). (nanovi.com)
- The primary study endpoint is the incidence of pulmonary complications during and following neoadjuvant chemoradiotherapy or neoadjuvant chemo-proton-therapy - and surgery. (nanovi.com)
- These dramatic changes reflected the results of 2 prospective randomized clinical trials, i.e., the RAPIDO (Rectal Cancer and Preoperative Induction Therapy Followed by Dedicated Operation) trial [ 8 ] and PRODIGE (Partenariat de Recherche en Oncologie Digestive) 23 trial [ 9 ] in 2021. (coloproctol.org)
Radiotherapy4
- The investigators randomly assigned patients with resectable cancers to undergo surgery alone or receive weekly carboplatin (area under the curve, 2) and paclitaxel (50 mg/m 2 ) for 5 weeks and concurrent radiotherapy, followed by surgery. (medscape.com)
- Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. (ac.ir)
- Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer: 12-year follow-up of the multicentre, randomised controlled TME trial. (ac.ir)
- Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial. (ac.ir)
Gastric1
- Robotic total gastrectomy with Roux-en-Y reconstruction for gastric cancer (with video). (wakayama-med-2ndsurg.jp)
Upfront surgery1
- It found no survival benefit from neoadjuvant treatment compared to upfront surgery for resectable pancreatic cancer. (bhimar.org)
Postoperative1
- Preoperative chemoradiotherapy versus postoperative chemoradiotherapy for stage II-III resectable rectal cancer: a meta-analysis of randomized controlled trials. (ac.ir)
Preoperative Chemoradiotherapy1
- Four randomized phase III trials compared preoperative chemoradiotherapy plus surgery with surgery alone. (elsevierpure.com)
Surgery6
- A study by Fogh et al of induction chemoradiotherapy followed by surgery, a strategy that is widely used in treating esophageal cancer, found that perioperative morbidity and mortality with this approach was not significantly different in patients aged 70 years or older compared with younger patients. (medscape.com)
- A study by Fogh et al examined the use of induction chemoradiotherapy followed by surgery a strategy that is widely used in treating esophageal cancer. (medscape.com)
- This trial confirms that preoperative chemoradiation for resectable esophageal cancer is safe and, compared with surgery alone, is associated with pathological complete responses, higher rates of R0 resection, and prolonged survival. (medscape.com)
- At an early stage, when the cancer cells have not left the primary site of origin, the tumor mass can be resected using conventional surgery and it is said to be resectable. (bhimar.org)
- 14 When comparing definitive CRT to neoadjuvant CRT followed by surgery, there was no difference in long-term recurrence or mortality (HR = 0.88). (appliedradiationoncology.com)
- 9 Similarly, the European Organization for Research and Treatment of Cancer (EORTC) trial 8 randomized SCC patients to surgery alone or neoadjuvant CRT consisting of two 1-week courses of RT, separated by a 2-week break, to a total dose of 37 Gy in 10 fractions with concurrent cisplatin. (appliedradiationoncology.com)
Concurrent6
- Of the 63 patients reviewed, 61 patients (97%) completed concurrent chemoradiotherapy. (iiarjournals.org)
- Otherwise, adverse reactions during concurrent chemoradiotherapy were well-tolerated and the majority were Common Terminology Criteria for Adverse Events grades 1 and 2. (iiarjournals.org)
- The FFCD 9102 trial randomized 444 patients with resectable esophageal cancer (majority squamous histology) to induction CRT consisting of either 46 Gy in 23 fractions with concurrent cisplatin and 5-FU or split course 30 Gy in 10 fractions RT given over 4 weeks (5 days on, 10 days off, 5 days on). (appliedradiationoncology.com)
- In these patients, the conventional long-course concurrent chemoradiotherapy is not suitable because of the risk of progression of the metastatic lesions. (kjco.org)
- Locoregional control has dramatically improved with concurrent chemoradiotherapy. (jnccn.org)
- A number of randomized trials are planned or currently ongoing to investigate concurrent chemoradiotherapy with or without induction. (jnccn.org)
Esophageal cancers2
- Stage I, II, and III esophageal cancers are all potentially resectable. (medscape.com)
- All patients undergoing MIE at Shaukat khanum Memorial Cancer Hospital, for resectable esophageal cancers between January 2011 and May 2013, were reviewed. (hindawi.com)
Survival in Patients1
- Aim: Neoadjuvant chemoradiotherapy may improve survival in patients with advanced cholangiocarcinoma. (bvsalud.org)
Definitive1
- Two randomized trials have compared the use of definitive CRT to neoadjuvant CRT followed by surgical resection. (appliedradiationoncology.com)
Clinical1
- The primary endpoint is the CR rate, described as a pathological CR or a sustained clinical CR one year after chemoradiotherapy. (amsterdamumc.org)
Trials1
- Further therapeutic advances and prospective trials are needed to better define the optimal role of adjuvant and neoadjuvant treatment in patients with resectable pancreatic cancer. (cancernetwork.com)
Tumor1
- Response to neoadjuvant chemoradiotherapy and histological type of tumor were the two prognostic factors. (ac.ir)
Treatment1
- 4,5] Despite the use of neoadjuvant and adjuvant therapies, little progress has been made in the last three decades, and the search for more efficacious treatment continues. (cancernetwork.com)
Lymph node2
- Herein, we examined the expression of LAG-3 in tumour-infiltrating immune cells (TIC) in chemoradiotherapy-naïve GEAC and paired lymph node metastases, with particular reference to its relationship with PD-1 and PD-L1 expression, mismatch repair (MMR) status, and survival. (esmo.org)
- Immunohistochemical LAG-3 expression was analysed in tissue microarrays with 165 primary tumours and 72 paired lymph node metastases from a retrospective consecutive cohort of patients with chemoradiotherapy-naïve resected GEAC. (esmo.org)
Immune1
- This study was the first prospective data set to show what many have suspected-that neoadjuvant immune checkpoint blockade would lead to a. (ascopost.com)
Unclear1
- So the effectiveness and best neoadjuvant regimen is still unclear. (bhimar.org)
Dose2
- This Phase I study aimed to determine the recommended dose of neoadjuvant chemoradiotherapy and decide whether to move to a Phase II study. (bvsalud.org)
- Conclusion: We determined the recommended dose of neoadjuvant chemoradiotherapy for resectable cholangiocarcinoma. (bvsalud.org)