View clinical trials related to Pancreatic Neoplasms.
Filter by:The PREOPANC-3 study is a randomized, multicenter, phase 3 trial. Patients with resectable pancreatic cancer will be randomly assigned (1:1) to 8 cycles of neoadjuvant mFOLFIRINOX followed by surgery and 4 cycles of adjuvant mFOLFIRINOX (arm 1) or to upfront surgery followed by 12 cycles of adjuvant mFOLFIRINOX (arm 2). The primary objective of the trial is to determine whether perioperative mFOLFIRINOX improves overall survival compared with adjuvant mFOLFIRINOX in patients with resectable pancreatic cancer.
This study is a prospective phase II, single arm mono-institutional study conducted in Queen Mary Hospital (Hong Kong) assessing the efficacy and safety of TAS 102 in advanced or metastatic pancreatic cancer patients.
This prospective randomized controlled study is aimed to determine the advantages of thoracic epidural analgesia for open upper abdominal surgery in combination with multimodal analgesia compared with no thoracic epidural analgesia on postoperative pain control. The primary outcome is total opioid consumption in postoperative 72 hours. Secondary outcomes are the success of continuous epidural analgesia or complications of this technique, pain intensity, morbidity and mortality compare to no continuous epidural analgesia.
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 "borderline 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.
Patients with digestive tract malignancy often experience severe and unremitting abdominal pain that negatively affects physical, emotional, and social function, as well as health related quality of life (HRQOL). Therapeutic virtual reality (VR) has emerged as a promising and evidence-based treatment modality for cancer pain. Users of VR wear a pair of goggles with a close-proximity screen in front of the eyes that creates a sensation of being transported into lifelike, three-dimensional worlds. To date, VR has been limited to short-term clinical trials for cancer pain. Moreover, limited research exists on theory-based VR modalities beyond mere distraction, such as VR that employs acceptance and commitment therapy (ACT) with components of biofeedback and mindfulness. To bridge these gaps, this study seeks to: (1) assess the impact of immersive VR on patient-reported outcomes (PROs), including pain, activity metrics, and opioid use among patients with visceral pain from a digestive tract malignancy; (2) assess differences in PROs, activity metrics, and opioid use between skills-based VR therapy vs. distraction VR therapy; and (3) determine patient-level predictors of VR treatment response in visceral cancer pain. To address these aims, the study will measure PROs and opioid use in 360 patients randomized among 3 groups and follow them for 60 days after enrollment: (1) an enhanced VR group receiving skills-based VR; (2) a distraction-based VR group receiving patient-selected VR videos; and (3) a VR sham control group using a VR headset with 2-D content. The results will inform best practices for the implementation of VR for visceral cancer pain management and guide selection of patient-tailored experiences.
This clinical trial studies the effectiveness of a web-based cancer education tool called Helping Oncology Patients Explore Genomics (HOPE-Genomics) in improving patient knowledge of personal genomic testing results and cancer and genomics in general. HOPE-Genomics is a web-based education tool that teaches cancer/leukemia patients, and patients who may be at high-risk for developing cancer, about genomic testing and provide patients with information about their own genomic test results. The HOPE-Genomics tool may improve patient's genomic knowledge and quality of patient-centered care. In addition, it may also improve education and care quality for future patients.
This is a first-in-human, Phase 1/2 open-label, multicenter, dose-escalation, safety, pharmacokinetics (PK), and biomarker study of CBX-12 in subjects with advanced or metastatic refractory solid tumors.
There is a high rate of R1 resection following patients undergoing pancreaticoduodenectomy for pancreatic cancer. The most commonly positive margin is the SMA. Peri-adventitial dissection has been proposed as an effective method of achieving R0 margins. There is lack of standardisation of the proposed technique and no grade 1 evidence to support routine use of this technique. The goal of this randomised controlled trial is to investigate the role of routine peri-adventitial dissection on the SMA margin status.
To evaluate the efficacy of Tislelizumab combined with Nab-paclitaxel and Gemcitabine in the treatment of recurrent pancreatic cancer
This clinical quality improvement study reviews and develops a clinical operations workflow to identify cancer patients who meet criteria for genetic counseling and testing. This study may improve utilization of genetic counseling and testing amongst community-based oncology providers caring for cancer patients in a rural and underserved area.