Adenocarcinoma pancreas

Spratlin, J., Sangha, R., Glubrecht, D., Dabbagh, L., Young, J.D., Dumontet, C., Cass, C., Lai, R., and Mackey, J.R. (2004) The absence of human equilibrative nucleoside transporter 1 is associated with reduced survival in patients with gemcitabine-treated pancreas adenocarcinoma. Clinical Cancer Research, 10 (20), 6956-6961. 

Cytokeratin 17 (CK17) Squamous cell carcinoma, basal cell carcinoma, transitional cell carcinoma, bile duct and pancreas adenocarcinoma Carcinoma of breast lung, ovary and thyroid, mesothelioma Myoepithelial and basal cells, hair shaft epithelium... 

Pancreatic cancer is the fourth to fifth leading cause of cancer-related deaths in the Western world. The prognosis for patients with pancreatic cancer is bleak, with an overall 5-year survival rate of <5%. According to the histopathologic classification, there are wide varieties of mahgnant tumors that arise from the exocrine pancreas, adenocarcinoma being by far the most com-... 

Most adenocarcinomas of the pancreas occur in the 101 head of the gland, which is in close proximity to bile. 

Safran H, Akerman P, Cioffi W, et al. Paclitaxel and concurrent radiation therapy for locally advanced adenocarcinomas of the pancreas, stomach, and gastroesophagealjunction. Semin Radiat Oncol 1999 9(2 Suppl 1) 53—57. 

Nitecki SS, et al. Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving Ann Surg 1995 221(l) 59-66. 

Sohn TA, et al. Resected adenocarcinoma of the pancreas-616 patients results, outcomes, and prognostic indicators. J Gastrointest Surg 2000 4(6) 567-579. 

Spitz FR, et al. Preoperative and postoperative chemoradiation strategies in patients treated with pancreaticoduodenectomy for adenocarcinoma of the pancreas. J Clin Oncol 1997 15(3) 928-937. 

Hoffman JP, et al. Phase II trial of preoperative radiation therapy and chemotherapy for patients with localized, resectable adenocarcinoma of the pancreas an Eastern Cooperative Oncology Group Study. J Clin Oncol 1998 16(1) 317—323. 

Miller AR, et al. Neoadjuvant chemoradiation for adenocarcinoma of the pancreas. Surg Oncol Clin NAm 1998 7(1) 183-197. 

Gemcitabine is intracellularly activated by nucleoside kinases to diphosphate and triphosphate nucleosides. Gemcitabine diphosphate inhibits DNA synthesis by inhibiting ribonucleotide reductase while gemcitabine triphosphate competes with deoxycytidine triphosphate for incorporation into DNA. Gemcitabine is used for the treatment of non-small cell lung carcinoma and of adenocarcinoma of the pancreas. It has to be administred intravenously and is eliminated by metabolism with an elimination half-life of approximately 50 minutes. Its spectrum of adverse effects is comparable to that of 5-FU. 

A patient of yours has been receiving 5-fluorouracil as palliative therapy for adenocarcinoma of the pancreas. You suspect that the patient has become resistant to the treatment. You want to understand the most likely cause of the resistance before you select another agent. Which of the following is the most likely cause ... 

Fluorouracil is used in several combination regimens in the treatment of breast cancer. It also has palliative activity in gastrointestinal adenocarcinomas, including those originating in the stomach, pancreas, liver, colon, and rectum. Other tumors in which some antitumor effects have been reported include carcinomas of the ovary, cervix, oropharynx, bladder, and prostate. Topical 5-fluorouracil cream has been useful in the treatment of premalignant keratoses of the skin and superficial basal cell carcinomas, but it should not be used in invasive skin cancer. 

Ollayos, C. W., Riordan, P., and Rushin, J. M. 1994. Estrogen receptor detection in paraffin sections of adenocarcinomas of the colon, pancreas and lung. Arch. Pathol. Lab. Med. 118 630-632. 

Rosty C, Christa L, Kuzdzal S, Baldwin WM, Zahurak ML, Carnot F, Chan DW, Canto M, Lillemoe KD, Cameron JL, Yeo CJ, Hruban RH, Goggins M. Identification of hepatocarcinoma-intestine-pancreas/pancreatitis-associated protein I as a biomarker for pancreatic ductal adenocarcinoma by protein biochip technology. Cancer Res 2002 62 1868-1875. 

Gemcitabine [gem SITE ah bean] is an analog of the nucleoside deoxycytidine its chemical structure is 2 2 -difluorodeoxycytidine (dFdC). Its use is indicated in the first-line treatment of locally advanced or metastatic adenocarcinoma of the pancreas. It has also shown some activity against other tumors. 

Honore B, Baandrup U, Nielsen S et al. Endonuclcin is a cell cycle regulated WD-rcpcat protein that is up-regulated in adenocarcinoma of the pancreas. Oncogene 2002 21(7) 1123-29. 

In gemcitiihine, fluorine atonts replace the hydroxyl group and the hydrogen atom at the 2 position of cytidine."" After its anabolism to diphosphate and triphosphate metabolites, gemcituhine inhibits ribonucleotide mducta.se and competes with 2 -deoxycytidine triphosphate for incorporation into DN A. These effects pnxluce cell-cyclc-specific cytotoxicity. Gemcitabine has become a first-line treatment for liK ally advanced and metastatic adenocarcinoma of the pancreas. 

Gemcitabinc is a lirst-linc treatment for locally advanced or metastatic adenocarcinoma of the pancreas. It is also u.sed in combination with cisplutin for ITrst-line irealmcnl of inoperable locally advanced or metastatic non-small cell lung cancer. Tlic limiting toxicity is myclosuppres.sion. This toxicity requires a complete blotxl count before each do.se. Other adverse effects include fever, rash, teratogenicity, and mild renal toxicity. ... 

Rosty, C. Christa, L. Kuzdzal, S. Baldwin, W.M. Zahurak, M.L. Carnot, R Chan, D.W. Canto, M. Lillemoe, K.D. Cameron, J.L. Yeo, C.J. Hruban, R.H. Goggins, M. Identification of Hepatocarcinoma-Intestine-Pancreas/Pancreatitis-Associated Protein I as a Biomarker for Pancreatic Ductal Adenocarcinoma by Protein Biochip Technology, Cancer Res 62(6), 1868-1875 (2002). 

CK7 (-I-) adenocarcinomas of breast, lung, ovary, endometrium, and pancreas mesothelioma, urothelial carcinomas, thymic carcinomas and fibrolamellar variant of hepatocellular carcinomas. 

Primary adenocarcinomas of the lung are typically CK7-F, CK20-, and CEA-f, whereas colorectal carcinomas are CK7-, CK20-F, and CEA-i- ductal and lobular breast carcinomas are CK7-f, CK20-, and often CEA-I- and ovarian carcinomas are CK7-I-, CK20 , and CEA-.121,125-129,224-227 Neoplasms that typically are strongly positive for most CEA antibodies include adenocarcinomas of the lung, colon, stomach, biliary tree, pancreas, urinary bladder, endocervix, paranasal... 

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