Pancreatic cancer is the 11th most common type of cancer but it is the fourth leading cause of cancer death. The only effective treatment for pancreatic cancer includes surgery. However, only 20% of the patients have surgically treatable disease. Also, the 5-year survival for the surgically treated patients is only 15%.
About 40% of the patients present with advanced disease with distant metastasis, and the remaining 40% present with locally advanced unresectable cancer with the tumor invaded into surrounding major vessels. For those with locally advanced disease, systemic chemotherapy with or without radiotherapy provides palliation of the symptoms but cannot cure the disorder. Systemic chemotherapy is given through peripheral vessels.
The investigators hypothesized that direct injection of the chemotherapeutic drug into the tumor may help to boost the effect of systemic chemotherapy and radiotherapy in those with locally advanced pancreatic cancer.
Compare the effect of G17DT with that of placebo on the survival of subjects with advanced pancreatic cancer.
The purpose of this study is to evaluate the pharmacokinetics (PK) of adjuvant capecitabine in patients who have undergone proximal pancreatico-duodenectomy.
The purpose of this study is to test a double screening strategy for pancreatic cancer, based on a model developed using patient medical records. Investigators would also like to test whether adding specific blood tests, can further help identify people who have a higher risk of pancreatic cancer than the general population, and would benefit from imaging in order to detect cancer early.
This research is being done to learn more about pancreatic cysts. The tests that are currently available are imperfect at determining exactly what type of pancreatic cyst a person has, which cysts contain cancer, or what the risk is of developing cancer in the future. The aim of this study is to use a combination of clinical, imaging, cyst fluid analysis, and molecular markers to try to help develop better tools to answer these questions.
Pancreatic cancer is the eighth most common occurrence in Korea. In the United States, pancreatic cancer is expected to be the number two cause of death from cancer in 2030. The prevalence of pancreatic cancer is also on the rise in Korea. The 5-year survival rate of pancreatic cancer in Korea is 10.8%. According to the 2017 cause of death statistics, pancreatic cancer mortality is ranked fifth. It is known to have the worst prognosis of cancer in the body. The median survival period of unresectable pancreatic cancer is only six months, and resection is the only treatment that can be expected to be completely cured, but only about 10% of cases are possible to be operable at the time of diagnosis.
In the 2000s, the studies began to emerge on diagnosis and treatment of pancreatic cancer with intermediate anatomical and imaging characteristics of resectable and locally advanced pancreatic cancer. Margin negative resection plays an important role in the long-term survival rate in surgical treatment of pancreatic cancer. Prior to 2001, pancreatic cancer with invasion of vein was considered impossible to perform radical resection. However, the studies have been published that a satisfactory long-term survival rate and margin negative resection could be obtained when venous resection was performed along with radical resection. Since the 2006, the National Comprehensive Cancer Network (NCCN) guideline, after performing radical resection among locally advanced pancreatic cancers without remote metastasis, pancreatic cancers with high risk of margin positive resection and treatment failure were classified as ȫorderline resectable". In the borderline resectable pancreatic cancer, neoadjuvant therapy was recommended before surgery. In recent years, the neoadjuvant therapy has been reported to raise the survival rate in resectable pancreatic cancer. Furthermore, a prospective study is in progress to demonstrate the effectiveness of neoadjuvant therapy with FOLFIRINOX in resectable pancreatic cancer. If pancreatic cancer is located in the head of pancreas, jaundice can be occurred often. In the case of preoperative jaundice, the possibility of postoperative complications increases. So biliary drainage is performed before surgery. In biliary drainage, usually the plastic stent was inserted through the endoscope. If the metal stent is inserted in the biliary obstruction, it can cause severe inflammation around the bile duct due to the radial force, and it is difficult to remove in the surgery. However, the meta-analysis comparing the groups of metal and plastic stents in the recent preoperative biliary drainage showed no difference of postoperative complication, and postoperative pancreatic fistula was lower in the group of metal stents (5.1% vs. 11.8% p=0.04). In addition, fewer re-intervention cases before surgery were found in the group of metal stents (3.4% vs.14.8% p < 0.0001).
Not only in the borderline resectable, but also in the resectable pancreatic cancer, neoadjuvant therapy has recently been actively performed in the cases of large tumor size, high CA 19-9, large lymph nodes, severe weight loss, and severe pain. The comparison study of the efficacy between plastic and metal stents in preoperative bile drainage in pancreatic cancer with neoadjuvant therapy has not yet been prospectively performed. However, retrospective studies have shown that metal stents have a lower re-treatment rate than plastic stent (0.24 vs 0.54), and that there is no difference in post-operative complications. Therefore, we planned the study to compare the efficacy and safety between metal and plastic stent in biliary drainage performed in patients undergoing neoadjuvant therapy with pancreatic cancer.
This is a dose-seeking study that will test the safety of increasing doses of Rexin-G, given intravenously, in patients with advanced or metastatic pancreatic cancer who have failed standard chemotherapy. Rexin-G is a tumor-targeted gene therapy vector that contains a "killer" gene that blocks the action of the human cyclin G1 gene. Cyclin G1 is a cell cycle control element that plays an important role in cancer growth. When injected into a vein, the Rexin-GTM vector seeks out and accumulates in cancerous tumors, therefore, increasing the concentration of the drug in the cancerous tumors and not in normal neighbouring organs.
This study will evaluate the effects of the ketogenic diet in patients with metastatic pancreatic cancer while receiving chemotherapy.
The goal of this clinical research study is to learn if treatment with curcumin can help shrink or slow the growth of pancreatic cancers. The effect of curcumin on the way pancreatic cancer cells function and the safety of treatment with curcumin will also be studied.
The purpose of this study is to determine whether duct-to-mucosa is better than invagination in pancreaticojejunostomy after pancreaticoduodenectomy. This single-centre, open, randomized controlled trail is conducted following ISGPF criteria for pancreatic fistula (PF). The duration of the study is supposed to start from Jan 5th 2012 and last to Dec 2014, until 100 or more cases are accessible. Patients diagnosed with pancreatic cancer, peri-ampullar carcinoma or other benign or malignant diseases which need to operate pancreaticoduodenectomy will be included. Main outcomes are pancreatic fistula rate, mortality, morbidity, reoperation and hospital stay. The investigators assumption that duct-to-mucosa is better than invagination.
