Showing papers by "Paula Ghaneh published in 2015"
TL;DR: The authors examine the challenges associated with finding new pancreatic cancer diagnostic biomarkers and explore why translation of biomarker research for patient benefit has thus far failed and what advances may lead to improvements in biomarker detection and implementation.
Abstract: Pancreatic ductal adenocarcinoma is an aggressive malignancy with a 5-year survival rate of approximately 5%. The lack of established strategies for early detection contributes to this poor prognosis. Although several novel candidate biomarkers have been proposed for earlier diagnosis, none have been adopted into routine clinical use. In this review, the authors examine the challenges associated with finding new pancreatic cancer diagnostic biomarkers and explore why translation of biomarker research for patient benefit has thus far failed. The authors also review recent progress and highlight advances in the understanding of the biology of pancreatic cancer that may lead to improvements in biomarker detection and implementation.
43 citations
TL;DR: PET holds the most promise in identifying malignant transformation within an IPMN, and the presence of mural nodule on imaging was the most sensitive whereas raised serum CA19-9 (>37 KU/l) was themost specific feature predictive of malignancy in IPMNs.
Abstract: What Is the Best Way to Identify Malignant Transformation Within Pancreatic IPMN: A Systematic Review and Meta-Analyses
43 citations
TL;DR: This small study of only 43 patients suggested a survival benefit for post-operative chemoradiotherapy combined with follow-on chemotherapy, suggesting that adjuvant chemotherapy (without che Moradiotherapy) prolongs survival.
Abstract: Adjuvant treatment following curative resection for pancreatic cancer is now well established. Historically, the role of adjuvant therapy post resection was uncertain, as was the best form of adjuvant, the choices lying between adjuvant chemotherapy, chemoradiation or a combination of these. The landmark randomized controlled European Study Group for Pancreatic Cancer (ESPAC)-1 trial, provided the strongest evidence for the benefit of adjuvant therapy. ESPAC-1 showed a strong survival advantage for chemotherapy comprising 5-fluorouracil (5-FU) with folinic acid (FA), but no support for the use of chemoradiation. The CONKO-001 trial showed that gemcitabine was also superior to surgery alone. The ESPAC-3 trial showed no superiority for gemcitabine over 5-FU/FA although gemcitabine was less toxic. The effects of adding biological agents or combining agents within regimens are being investigated as well as neo-adjuvant therapies being compared with adjuvant therapy. A network meta-analysis has confirmed reduced survival and increased toxicity with adjuvant chemoradiotherapy. Adjuvant systemic chemotherapy with either gemcitabine or 5-FU/FA following curative resection for pancreatic adenocarcinoma continues as the mainstay of treatment. The five-year survival rates are around 25% with chemotherapy compared to resection alone, with a significant survival benefit also shown for patients with R1 positive resection margins.
36 citations
TL;DR: Although the risk of post-ERCP pancreatitis in individuals with FPC can be reduced by using prophylactic self-expelling stents and diclofenac, it remains too high for routine screening.
Abstract: ObjectivesIndividuals from hereditary pancreatitis (HP) and familial pancreatic cancer (FPC) kindreds are at increased risk of developing pancreatic cancer. Premalignant molecular changes may be detected in pancreatic juice collected by endoscopic retrograde cholangiopancreatography (ERCP). The obje
10 citations
2 citations
01 Jan 2015
TL;DR: The authors examine the challenges associated with finding new pancreatic cancer diagnostic biomarkers and explore why translation of biomarker research for patient benefit has thus far failed.
Abstract: Pancreatic ductal adenocarcinoma is an aggressive malignancy with a 5-year survival rate of approximately 5%. The lack of established strategies for early detection contributes to this poor prognosis. Although several novel candidate biomarkers have been proposed for earlier diagnosis, none have been adopted into routine clinical use. In this review, the authors examine the challenges associated with finding new pancreatic cancer diagnostic biomarkers and explore why translation of biomarker research for patient benefit has thus far failed. The authors also review recent progress and highlight advances in the understanding of the biology of pancreatic cancer that may lead to improvements in biomarker detection and
1 citations
07 Apr 2015