This is a prospective study addressing the challenge of predicting disease progression and/or recurrence in patients diagnosed with metastatic colorectal, pancreatobiliary, or esophagogastric cancer that are receiving anti-cancer therapy.
This study will evaluate the efficacy and safety of adjuvant therapy with liposomal irinotecan in combination with oxaliplatin, and S-1 compared with capecitabine combined with capecitabine in participants with pancreatic ductal adenocarcinoma after radical surgery.
A multi-center Phase 1b/2 study testing the combination of AMG 820 and pembrolizumab in subjects with select advanced solid tumors.
The purpose of this study is to confirm safety and immunological responses of Preoperative intratumor dendritic cells injection immunotherapy using immature dendritic cells with S pyogenes Preparation (OK-432) for patients with resectable pancreatic cancer for pancreatic cancer patients.
This phase II study investigates the efficacy of IORT for patients with borderline resectable pancreatic cancer. The purpose of the study is to investigate whether the addition of IORT, after FOLOFIRINOX-base chemotherapy, and SBRT, increases the 3-year survival rate. A total of 101 patients will be enrolled, and these patients will receive IORT of 10 to 20 Gy, according to the resection status (to the tumor bed after resection, or to the tumor in situ in case of non-resection).
The purpose of the study is to collect pancreatic tissue, blood and urine from adults to study pancreatic abnormalities.
Malnutrition is a common challenge in patients with pancreatic cancer undergoing cephalic pancreaticoduodenectomy (CPD), impacting postoperative recovery and overall prognosis. Nutritional support plays a crucial role in optimising metabolic, inflammatory, and digestive outcomes. This randomised, double-blind, crossover clinical trial aims to evaluate the effects of Peptamen 1.6, a hydrolysed whey protein-based enteral formula, compared to Resource HP/HC, a high-protein and high-calorie polymeric formula, in malnourished or at-risk patients with pancreatic cancer undergoing PD.
The study comprises both in vivo and in vitro analyses. The in vivo component will assess the impact of Peptamen 1.6 on digestive tolerance, amino acid absorption, nutritional status, metabolic profile, inflammatory markers, and gut microbiota composition. The in vitro component will utilise human intestinal organoid models to explore how enteral nutrition formulations influence intestinal permeability and metabolism, with a focus on microbiota interactions.
Primary outcomes include improvements in metabolic status, assessed through serum biomarkers (albumin, immune markers, intestinal permeability, and myosin profile), inflammatory status via peripheral blood mononuclear cells (PBMCs), and microbiota shifts in faecal samples. Additionally, adherence to treatment, digestive tolerance, and changes in body composition will be monitored using bioelectrical impedance, dynamometry, and functional mobility tests.
By elucidating the mechanisms through which different enteral nutrition strategies influence clinical, physiological, and molecular parameters, this study aims to enhance personalised nutritional interventions for patients with pancreatic cancer. The findings could contribute to optimising nutritional support strategies, ultimately improving patient outcomes following CPD.
The purpose of this study is to evaluate the role of routine Staging Laparoscopy in patients with potentially resectable pancreatobiliary cancer.
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.
FOLFIRINOX regimen was recently presented at an international oncology meeting and represents a new standard regimen in the treatment of metastatic pancreatic cancer. FOLFIRINOX is one of the high response rate treatment regimen , the investigators considered as a promising treatment as neoadjuvant chemotherapy . On the other hand , incidences of grade 3 or 4 neutropenia , febrile neutropenia and diarrhea were significantly higher in the FOLFIRINOX group compared with gemcitabine group. Therefore, it was decided to consider the balance of safety and efficacy as a preoperative chemotherapy, the investigators use the FIRINOX regimen by eliminating LV and bolus 5-FU, and irinotecan reduced to 150mg/m2 of 180mg/m2 from FOLFIRINOX regimen
