Active clinical trials for "Pancreatic Neoplasms"

Pancreaticoduodenectomy (PD), more commonly known as Whipple's surgery is the mainstay treatment for pancreatic head and periampullary cancer. Factors contributing to PD outcomes are broadly categorized to disease-related, patient-related and operative factors. Whereas an inexhaustible list of study exists on looking at reducing PD complication rates with respect to the above-mentioned factors, it was only recently that more attention has been given to the impact of perioperative and intraoperative fluid regimes on PD outcomes. This study takes interest in the impact of intraoperative fluid regimes on PD outcomes. The objective of this investigation is to compare the outcomes with the use of intraoperative intravenous human albumin versus standard intraoperative fluid regimes.

To learn if piflufolastat F18 can be used in imaging scans for patients with breast cancer, HCC, or pancreatic cancer

The aim of the study is to examine the incremental value of using magnetic resonance imaging (MRI) in addition to computed tomography (CT) in the diagnostic workup of pancreatic cancer patients.

In this prospective study new diagnostic tools are to be explored for the patients with borderline resectable and locally advanced pancreatic ductal adenocarcinoma (BR or LAPDA) who undergo neoadjuvant chemotherapy with FOLFIRINOX. The diagnostic work-up and therapy for the study population shall not differ from the gold standard during the study, only extra diagnostic tools will be added and their value is to be analysed post hoc. The 5-year survival rate of pancreatic cancer is 9%, but it can be drastically improved if surgery is possible. With its increasing incidence and dismal prognosis, pancreatic cancer is becoming a global oncologic problem where major breakthroughs are still required to improve outcomes. Patients with BR or LAPDA usually undergo neoadjuvant treatment with FOLFIRINOX chemotherapy, with ulterior referral for surgery in case of response. In these situations, surgical resectability is difficult to predict based on CT because of tumoural desmoplastic reaction, which blurs the tumoural contact with the blood vessels without a clear morphologic change. Consequently, patients without tumoural progression on CT and with a decreased tumour marker (CA 19-9) are considered for surgical exploration, in order not to deny the possibility of a curative path to anyone. However, the unspecific value of CA 19-9 and unreliable spatial changes on CT, do not allow an accurate stratification of the patients. Other diagnostic strategies are necessary for a better prediction of resectability in order to avoid negative laparotomies while not denying a possible curative approach when deemed possible. In this project the investigator will apply diffusion weighted magnetic resonance imaging (DW-MRI) as it has been proven to be useful in the evaluation of tumour response beyond morphologic parameters, with detection of functional tumoural changes, differences in vascularisation or fibrosis without a modification of shape. The statistical evaluation of visual information with radiomics optimises the analysis of data which can be compared in time (before and after chemotherapy) as well as with the operative findings (resectable or unresectable tumour). The investigator will focus on patients with BR and LAPDA and evaluate if a combination of clinical and genetic factors can predict successful surgical resection of tumors. Hereto DW-MRI imaging will be complemented with the evolution of the number of circulating tumour cells (CTC's) in blood samples of patients. Furthermore, the investigator aims to validate in the prospective patient cohort, the predictive value of recently published SNPs (single nucleotide polymorphisms) in genes that regulate cancer progression, invasion, and metastasis and of which some alleles were shown to be associated with an increased risk for tumour-associated death compared with those with protective genotypes.

The purpose of this research is to investigate the activity and safety of the combination of gemcitabine plus nab-paclitaxel and sintilimab as neoadjuvant therapy in treating patients with resectable and borderline resectable pancreatic cancer. The drugs involved in this study are: Sintilimab Nab-paclitaxel Gemcitabine

This randomized, controlled clinical trial compares the perioperative treatment with acetylsalicylic acid (aspirin) in patients with cancer of the pancreatic head. The main question it aims to answer is: Do patients treated perioperatively with aspirin develop less metastasis after curative resection of pancreatic head tumors? Participants will be asked to : take a daily aspirin tablet starting 1-4 weeks before surgery until 6 months after surgery participate in regular follow-up visits (every three months in the first year after surgery, every six months in years 2 and 3 after surgery).

The purpose of this phase I clinical study was to evaluate the safety and tolerability of JS107 monotherapy and combination with Toripalimab in patients with Advanced pancreatic cancer.

Pancreatic cancer is a very aggressive disease and its prognosis is poor. Large proportion of patients diagnosed with pancreatic cancer is already in metastatic or locally advanced phases. Although there have been huge improvements in survival for many other cancers over the last few decades, the same isn't true for pancreatic cancer. Median 5-year survival rate for pancreatic cancer is around 10% and there are limited number of treatments approved for pancreatic cancer. There is no definite consensus on the best second-line chemotherapy for patients with metastatic pancreatic cancer who have progressed after first-line chemotherapy. The randomized phase III study, NAPOLI-1 trial has revealed that liposomal irinotecan (nal-IRI) plus fluorouracil/leucovorin (FL) regimen could be an acceptable treatment option in patients with metastatic pancreatic cancer who had been previously treated with gemcitabine-based chemotherapy. In this study, The investigators will evaluate how the treatment landscape has been changed since the appearance of nal-IRI in Korea. By retrospectively comparing treatment efficacy and safety outcomes before (cohort 1; without nal-IRI/FL) and after the launch of nal-IRI (cohort 2; with nal-IRI/FL), investigators will identify the degree of improvement in treatment outcome brought about by nal-IRI and will confirm whether the nal-IRI could be applied as an effective treatment option in patients with metastatic pancreatic cancer who failed first-line chemotherapy.

This phase IV trial evaluates how well giving standard of care (SOC) peptide receptor radionuclide therapy (PRRT) after SOC surgical removal of as much tumor as possible (debulking surgery) works in treating patients with grade 1 or 2, somatostatin receptor (SSTR) positive, gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that have spread from where they first started (primary site) to the liver (hepatic metastasis). Lutetium Lu 177 dotatate is a radioactive drug that uses targeted radiation to kill tumor cells. Lutetium Lu 177 dotatate includes a radioactive form (an isotope) of the element called lutetium. This radioactive isotope (Lu-177) is attached to a molecule called dotatate. On the surface of GEP-NET tumor cells, a receptor called a somatostatin receptor binds to dotatate. When this binding occurs, the lutetium Lu 177 dotatate drug then enters somatostatin receptor-positive tumor cells, and radiation emitted by Lu-177 helps kill the cells. Giving lutetium Lu 177 dotatate after surgical debulking may better treat patients with grade 1/2 GEP-NETs

The aim of this study is to evaluate the impact of concomitant main pancreatic duct repair or reconstruction during minimally invasive pancreatic tumor enucleation on long-term patient prognosis and quality of life.