التفاصيل البيبلوغرافية
| العنوان: |
Duodenal ischemia and upper GI bleeding are dose-limiting toxicities of 24-h continuous intra-arterial pancreatic perfusion of gemcitabine following vascular isolation of the pancreatic head: early results from the Regional Chemotherapy in Locally Advanced Pancreatic Cancer (RECLAP) study |
| المؤلفون: |
Beane, Joal D, Griffin, Kayla F, Levy, Elliot B, Pandalai, Prakash, Wood, Bradford, Abi-Jaoudeh, Nadine, Beresnev, Tatiana, Shutack, Yvonne, Webb, Carole C, Avital, Itzhak, Rudloff, Udo |
| المصدر: |
Investigational New Drugs, vol 33, iss 1 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2015 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Cancer, Clinical Trials and Supportive Activities, Orphan Drug, Clinical Research, Digestive Diseases, Pancreatic Cancer, Rare Diseases, Patient Safety, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Aged, Antimetabolites, Antineoplastic, Carcinoma, Pancreatic Ductal, Catheterization, Deoxycytidine, Duodenal Diseases, Duodenum, Female, Gastrointestinal Hemorrhage, Humans, Ischemia, Male, Maximum Tolerated Dose, Middle Aged, Pancreas |
| جغرافية الموضوع: |
109 - 118 |
| الوصف: |
BackgroundRegional chemotherapy is used successfully in the treatment of both primary and secondary malignancies, in particular of the peritoneal surface and the liver, and is currently explored as an attractive approach for patients with locally advanced pancreatic ductal adenocarcinoma. To establish the feasibility and toxicity of regional intra-arterial gemcitabine delivered as a 24-h continuous infusion to the pancreas as a novel treatment option for patients with locally advanced PDAC a phase I clinical trial was conducted.MethodsBetween April 2011 and September 2013 six patients with biopsy confirmed, borderline or unresectable pancreatic adenocarcinoma, and having received at least one line of systemic chemotherapy, underwent vascular redistribution of the inflow to the head of the pancreas by arterial coil embolization followed by perfusion catheter placement within the splenic artery. Patients were treated with increasing doses of gemcitabine administered by continuous splenic arterial infusion over 24 h with inter-patient and intra-patient dose escalation scheme. The primary endpoint was toxicity of the intra-arterial gemcitabine regimen and to establish the maximum tolerated dose.ResultsCatheter placement and gemcitabine infusion was successful in all patients enrolled to date (n = 6). Four out of six patients experienced catheter tip migration requiring replacement or revision. Patients received a median of four doses of 24-h gemcitabine infusion. Two patients developed grade 3 and 4 duodenal ischemia and upper gastrointestinal bleeding. Median overall survival was 15.3 months and median time to progression was 3 months. Three patients (50 %, n = 3/6) progressed systemically. Two patients had stable disease >4 months following treatment and underwent pancreaticoduodenectomy.ConclusionsWhile technically feasible to treat locally advanced pancreatic ductal adenocarcinoma, prolonged regional pancreatic perfusion with gemcitabine following pancreatic arterial redistribution carries a high risk for ... |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt2bw9h8qf; https://escholarship.org/uc/item/2bw9h8qfTest |
| الإتاحة: |
https://escholarship.org/uc/item/2bw9h8qfTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.53E6FBF |
| قاعدة البيانات: |
BASE |
