AI Article Synopsis
- Non-randomized studies suggest that multi-agent gemcitabine-based therapies (GEM-NAT) may improve overall survival (OS) in patients with borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC), though optimal treatment sequencing is still being explored.
- A meta-analysis of individual participant data involving 271 patients showed that the median OS for those who received GEM-NAT followed by surgery was significantly longer (27.8 months) compared to those who didn't have surgery (15.4 months) or had upfront surgery (13.0 months).
- The study indicates that GEM-NAT can enhance survival rates and R0 (complete) resection rates in BR-PDAC patients, but further validation through
Article Abstract
Non-randomized studies have investigated multi-agent gemcitabine-based neo-adjuvant therapies (GEM-NAT) in borderline resectable pancreatic ductal adenocarcinoma (BR-PDAC). Treatment sequencing and specific elements of neoadjuvant treatment are still under investigation. The present meta-analysis aims to assess the effectiveness of GEM-NAT on overall survival (OS) in BR-PDAC. A meta-analysis of individual participant data (IPD) on GEM-NAT for BR-PDAC were performed. The primary outcome was OS after treatment with GEM-based chemotherapy. In the Individual Patient Data analysis data were reappraised and confirmed as BR-PDAC on provided radiological data. Six studies investigating GEM-NAT were included in the IPD metanalysis. The IPD metanalysis was conducted on 271 patients who received GEM-NAT. Pooled median patient-level OS was 22.2 months (95%CI 19.1-25.2). R0 rates ranged between 81 and 95% ( = 0%, = 0.64), respectively. Median OS was 27.8 months (95%CI 23.9-31.6) in the patients who received NAT-GEM followed by resection compared to 15.4 months (95%CI 12.3-18.4) for NAT-GEM without resection and 13.0 months (95%CI 7.4-18.5) in the group of patients who received upfront surgery ( < 0.0001). R0 rates ranged between 81 and 95% ( = 0%, = 0.64), respectively. Overall survival in the R0 group was 29.3 months (95% CI 24.3-34.2) vs. 16.2 months (95% CI 7·9-24.5) in the R1 group ( = 0·001). The present study is the first meta-analysis combining IPD from a number of international centers with BR-PDAC in a cohort that underwent multi-agent gemcitabine neoadjuvant therapy (GEM-NAT) before surgery. GEM-NAT followed by surgical resection improve survival and R0 resection in BR-PDAC. Also, GEM-NAT may result in a good palliative option in non-resected patients because of progressive disease after neoadjuvant treatment. Results from randomized controlled trials (RCTs) are awaited to validate these findings.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7431761 | PMC |
| http://dx.doi.org/10.3389/fonc.2020.01112 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Assessing healthcare cost changes associated with transitioning away from cigarette smoking using healthcare claims data: an exploratory study among adult male patients with COPD.
Harm Reduct J
December 2024
Merative LP, 75 Binney St. 4th Floor, Cambridge, MA, 02142, USA.
Background: The assessment of potential health effects of switching from cigarette smoking to non-combustible tobacco products has important implications for public health and regulatory decisions. Robust epidemiological evidence requires long-term follow-up of a large number of individuals. Real-world evidence derived from health records has the potential to help fill the gap in the interim.
View Article and Find Full Text PDFPredictors of limited forearm rotation following conservative treatment of distal radius fractures: a retrospective comparative study.
BMC Musculoskelet Disord
December 2024
The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P.R. China.
Background: Limitations in forearm rotation resulting from distal radius fracture are often neglected in clinical practice. We aimed to explore possible influencing factors of forearm rotation limitation following conservative treatment of these fractures.
Methods: A series of patients with distal radius fractures who underwent conservative treatment in the Third Hospital of Hebei Medical University were retrospectively enrolled.
Completeness of repeated patient-reported outcome measures in adult rehabilitation: a randomized controlled trial in a diverse clinical population.
BMC Health Serv Res
December 2024
Health Services Research and Innovation Unit, and Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
Background: Data collection through patient-reported outcome measures (PROMs) is essential for the purpose of rehabilitation research and registries. Existing problems with incomplete PROM data may relate to the patient burden and data set length. This study aimed to analyse response patterns and degree of data completeness in systematic outcome assessments conducted within a clinical study in a multidisciplinary rehabilitation setting, comparing completeness of a brief and a longer set of PROMs.
View Article and Find Full Text PDFComparing supraclavicular surgery with radiotherapy versus radiotherapy alone in breast cancer patients with ipsilateral supraclavicular lymph node metastasis: a two-center retrospective cohort study.
BMC Cancer
December 2024
Department of Radiation Oncology, Cancer Center, West China Hospital, No. 37, Guoxue Alley, Chengdu, 610041, China.
Background: This study aimed to assess combined supraclavicular lymph node dissection (SLND) and radiotherapy (RT) versus standalone radiotherapy for efficacy in newly diagnosed breast cancer patients with ipsilateral supraclavicular lymph node metastasis (ISLNM).
Methods: Totally 143 ISLNM patients treated between 2014 and 2021 in two medical institutions were examined retrospectively. Patients were divided into two groups to undergo combined SLND and radiotherapy (surgery + RT, n = 73) or radiotherapy alone (RT, n = 70).
Meta-analysis of the efficacy and safety of vamorolone in Duchenne muscular dystrophy.
Neurol Sci
December 2024
Dresden International University, Division of Medicine, Dresden, Germany.
Background: Duchenne muscular dystrophy (DMD) is a severe neuromuscular disorder, often leading to wheelchair dependence by age 13 with limited treatment options, largely relying on glucocorticosteroids. We assessed the efficacy and safety of vamorolone, a modified synthetic corticosteroid, for DMD.
Methods: We performed a systematic review and meta-analysis using seven databases including prospective studies comparing vamorolone with glucocorticosteroids or placebo in DMD patients.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!