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Chemo before surgery benefits some pancreatic cancer patients
Patients with pancreatic cancer who received chemotherapy both before and after surgery experienced longer survival rates than would be expected from surgery followed by chemotherapy, according to a new study from researchers at Yale Cancer Center (YCC) and Yale School of Medicine. The study, published 20 June, in JAMA Oncology,
included patients with pancreatic ductal adenocarcinoma (PDAC), which accounts for 90% of pancreatic cancers. An aggressive cancer with a high mortality rate, PDAC is predicted to become the second leading cause of cancer-related deaths in the US by 2030. The findings, say the researchers, are encouraging for the 15 to 20% of pancreatic cancer patients whose tumours are operable. The single-arm Phase II trial evaluated a modified form of the chemotherapy treatment FOLFIRINOX (a combination treatment consisting of leucovorin calcium, fluorouracil, irinotecan hydrochloride, and oxaliplatin approved in 2011 as a first-line treatment for patients with metastatic pancreatic cancer). Patients in the trial received six cycles of the modified FOLFIRINOX before surgery, followed by an additional six cycles of the chemotherapy treatment after surgery. The modified regimen consisted of slightly lower doses of FOLFIRINOX to improve tolerability, which was previously shown in a 2016 publication not to impact outcomes negatively. Of the 46 patients who started the modified treatment, 37 completed all six cycles of chemotherapy before surgery and
FREE webinar on key trends in TDM for IBD management
CSJ and BIOHIT HealthCare recently hosted a webinar on the current and future trends in inflammatory bowel disease (IBD) therapeutic drug monitoring (TDM). The BIOHIT team were joined by Rachel Nice,
Section Lead for R&D and Specialist Services at Exeter Clinical Laboratory, and Rebecca Smith, Gastroenterology Specialist Registrar, both from the Royal Devon University Healthcare NHS Foundation Trust. The management of IBD is rapidly evolving,
27 had successful tumour removal operations. For all enrolled patients, the 12-month progression- free survival rate — meaning the disease did not worsen — was 67%, indicating significant progress in controlling the disease. Furthermore, 59% of all patients lived at least two years after completing the full chemotherapy treatment plan and surgery. The study was the first of its kind for patients
with PDAC when senior author and YCC member Dr. Jill Lacy started it in 2014. The study goal had been a 12-month progression-free survival rate of at least 50% of patients. The study used advanced techniques to monitor the progress of treatment, including analysing circulating tumour DNA (ctDNA) and using the cancer biomarker keratin 17 to help predict outcomes. For example, patients with detectable ctDNA four weeks post-surgery had significantly worse progression-free survival than those who had no detectable ctDNA.
driven by recent studies and advances, including the personalised anti-TNF therapy in Crohn’s disease study (PANTS). In this webinar, the expert speakers explored various topics surrounding TDM, including our current understanding, the development of immunogenicity and importance of early optimisation, as well as how we can use TDM most effectively to enable subcutaneous drug delivery and manage biologics treatment in the first year of therapy. They also delved into applications beyond anti-TNF therapies, and discussed how this approach could be used alongside pharmaco-multiomics in the future. Over 160 clinicians pre-registered, but the webinar is now available to view for those who were unable to attend. Register at:
https://tinyurl.com/5cxctw66
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