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Pancreatic Neoplasms: HELP
Articles by Roland Andersson
Based on 65 articles published since 2009
(Why 65 articles?)
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Between 2009 and 2019, R. Andersson wrote the following 65 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Editorial Biomarkers, imaging and multifocality in intraductal papillary mucinous neoplasms: relevant for decision making? 2017

Ansari, Daniel / Aronsson, Linus / Andersson, Roland. ·Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden. ·Future Oncol · Pubmed #28831817.

ABSTRACT: -- No abstract --

2 Editorial Can protein science solve the unmet needs in pancreatic cancer diagnosis and therapy? 2017

Ansari, Daniel / Sambergs, Fredrik / Johansson, Love / Andersson, Roland. ·a Department of Surgery, Clinical Sciences Lund , Lund University, Skåne University Hospital , Lund , Sweden. ·Expert Rev Proteomics · Pubmed #28388239.

ABSTRACT: -- No abstract --

3 Editorial Pancreatic ductal adenocarcinoma: is a cure possible? 2017

Ansari, Daniel / Andersson, Roland. ·Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden. ·Future Oncol · Pubmed #28266248.

ABSTRACT: -- No abstract --

4 Editorial Update on the management of pancreatic cancer: surgery is not enough. 2015

Ansari, Daniel / Gustafsson, Adam / Andersson, Roland. ·Daniel Ansari, Adam Gustafsson, Roland Andersson, Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, SE-221 85 Lund, Sweden. ·World J Gastroenterol · Pubmed #25805920.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) represents the fourth cause of death in cancer and has a 5-year survival of < 5%. Only about 15% of the patients present with a resectable PDAC with potential to undergo "curative" surgery. After surgery, local and systemic recurrence, is though very common. The median survival of resected patients with adjuvant chemotherapy after surgery is only 20-23 mo. This underscores the significant need to improve PDAC management strategies. Increased survival rate is dependent on new breakthroughs in our understanding of not at least tumor biology. The aim of this review is to update and comment on recent knowledge concerning PDAC biology and new diagnostics and treatment modalities. One fundamental approach to improve survival rates is by earlier and improved diagnosis of the disease. In recent years, novel blood-based biomarkers have emerged based on genetic, epigenetic and protein changes in PDAC with very promising results. For biomarkers to enter clinical practice they need to have been developed using adequate control groups and provide high sensitivity and specificity and by this identify patients at risk already in a pre-symptomatic stage. Another way to improve outcomes, is by employing neoadjuvant treatments thereby increasing the number of resectable cases. Novel systemic treatment regimes like FOLFIRINOX and nab-paclitaxel have demonstrated improvements in prolonging survival in advanced cases, but long-term survival is still scarce. The future improved understanding of PDAC biology will inevitably render new treatment options directed against both the cancer cells and the surrounding microenvironment.

5 Editorial Pancreatic cancer: translational research aspects and clinical implications. 2012

Ansari, Daniel / Chen, Bi-Cheng / Dong, Lei / Zhou, Meng-Tao / Andersson, Roland. · ·World J Gastroenterol · Pubmed #22509073.

ABSTRACT: Despite improvements in surgical techniques and adjuvant chemotherapy, the overall mortality rates in pancreatic cancer have generally remained relatively unchanged and the 5-year survival rate is actually below 2%. This paper will address the importance of achieving an early diagnosis and identifying markers for prognosis and response to therapy such as genes, proteins, microRNAs or epigenetic modifications. However, there are still major hurdles when translating investigational biomarkers into routine clinical practice. Furthermore, novel ways of secondary screening in high-risk individuals, such as artificial neural networks and modern imaging, will be discussed. Drug resistance is ubiquitous in pancreatic cancer. Several mechanisms of drug resistance have already been revealed, including human equilibrative nucleoside transporter-1 status, multidrug resistance proteins, aberrant signaling pathways, microRNAs, stromal influence, epithelial-mesenchymal transition-type cells and recently the presence of cancer stem cells/cancer-initiating cells. These factors must be considered when developing more customized types of intervention ("personalized medicine"). In the future, multifunctional nanoparticles that combine a specific targeting agent, an imaging probe, a cell-penetrating agent, a biocompatible polymer and an anti-cancer drug may become valuable for the management of patients with pancreatic cancer.

6 Editorial Proteome-based biomarkers in pancreatic cancer. 2011

Sun, Chen / Rosendahl, Ann H / Ansari, Daniel / Andersson, Roland. · ·World J Gastroenterol · Pubmed #22171124.

ABSTRACT: Pancreatic cancer, as a highly malignant cancer and the fourth cause of cancer-related death in world, is characterized by dismal prognosis, due to rapid disease progression, highly invasive tumour phenotype, and resistance to chemotherapy. Despite significant advances in treatment of the disease during the past decade, the survival rate is little improved. A contributory factor to the poor outcome is the lack of appropriate sensitive and specific biomarkers for early diagnosis. Furthermore, biomarkers for targeting, directing and assessing therapeutic intervention, as well as for detection of residual or recurrent cancer are also needed. Thus, the identification of adequate biomarkers in pancreatic cancer is of extreme importance. Recently, accompanying the development of proteomic technology and devices, more and more potential biomarkers have appeared and are being reported. In this review, we provide an overview of the role of proteome-based biomarkers in pancreatic cancer, including tissue, serum, juice, urine and cell lines. We also discuss the possible mechanism and prospects in the future. That information hopefully might be helpful for further research in the field.

7 Review The Hippo Signaling Pathway in Pancreatic Cancer. 2019

Ansari, Daniel / Ohlsson, Henrik / Althini, Carl / Bauden, Monika / Zhou, Qimin / Hu, Dingyuan / Andersson, Roland. ·Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden. · The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Zhejiang, P.R. China. · Department of Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China. · Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden roland.andersson@med.lu.se. ·Anticancer Res · Pubmed #31262852.

ABSTRACT: Hippo signaling is a key regulator of organ size, tissue hemostasis and regeneration. Dysregulation of the Hippo pathway has been recognized in a variety of human cancers, including pancreatic cancer. YES-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ) are the two major downstream effectors of the Hippo pathway. YAP and TAZ have been found to promote pancreatic tumor development and progression, even in the absence of mutant Kirsten RAS (KRAS). Pancreatic cancer is associated with an abundant stromal reaction leading to tumor growth and immune escape. It has been found that YAP and TAZ modulate behavior of pancreatic stellate cells and recruitment of tumor-associated macrophages and myeloid-derived suppressor cells. Moreover, YAP and TAZ are associated with chemoresistance and poor prognosis in pancreatic cancer. This review dissects the role of Hippo signaling in pancreatic cancer, focusing on molecular mechanisms and prospects for future intervention.

8 Review The Role of PEDF in Pancreatic Cancer. 2019

Ansari, Daniel / Althini, Carl / Ohlsson, Henrik / Bauden, Monika / Andersson, Roland. ·Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Surgery, Lund, Sweden. · Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Surgery, Lund, Sweden. · Lund University, Skane University Hospital, Department of Clinical Sciences Lund, Surgery, Lund, Sweden roland.andersson@med.lu.se. ·Anticancer Res · Pubmed #31262851.

ABSTRACT: Pigment epithelium-derived factor (PEDF) is an important antiangiogenic and antitumorigenic factor in a variety of cancer forms, including pancreatic cancer. PEDF is mainly secreted as a soluble monomeric glycoprotein. In human pancreatic cancer PEDF levels are decreased, both in the tissue and serum. The decrease is associated with increased tumor angiogenesis, fibrosis, inflammation, autophagy, occurrence of liver metastasis and worse prognosis. In murine models, loss of PEDF is sufficient to induce invasive carcinoma and this phenotype is associated with large lesions characterized by poor differentiation. Lentiviral gene transfer of PEDF has resulted in decreased microvessel density and has inhibited tumor growth. Herein we review the multifunctional role of PEDF in pancreatic cancer and its therapeutic potential.

9 Review Centrosomal Abnormalities in Pancreatic Cancer: Molecular Mechanisms and Clinical Implications. 2018

Ansari, Daniel / Del Pino Bellido, Carolina / Bauden, Monika / Andersson, Roland. ·Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden. · Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden roland.andersson@med.lu.se. ·Anticancer Res · Pubmed #29491046.

ABSTRACT: The centrosome is the main microtubule-organizing center in human cells. It regulates normal cell-cycle progression and cell division. Aberrations in the number, structure and function of centrosomes have been found to drive genomic instability and tumorigenesis. Pancreatic cancer frequently displays centrosomal aberrations. Supernumerary and abnormal centrosomes are observed in the earliest stages of pancreatic tumor development, and the p53 pathway acts as an initial barrier to the proliferation of cells with extra centrosomes. In this review, we summarize recent advances in the understanding of centrosomal aberrations in pancreatic cancer, focusing on regulatory mechanisms and prospects for future anticancer treatment.

10 Review The role of irreversible electroporation (IRE) for locally advanced pancreatic cancer: a systematic review of safety and efficacy. 2017

Ansari, Daniel / Kristoffersson, Stina / Andersson, Roland / Bergenfeldt, Magnus. ·a Department of Surgery, Clinical Sciences Lund , Lund University, Skåne University Hospital , Lund , Sweden. ·Scand J Gastroenterol · Pubmed #28687047.

ABSTRACT: OBJECTIVES: Irreversible electroporation (IRE) is a new modality for tumor ablation. Electrodes are placed around the tumor, and a pulsed, direct current with a field strength of 2000 V/cm is delivered. The direct current drives cells into apoptosis and cell death without causing significant heating of the tissues, which spares the extracellular matrix and proteins. The purpose of this review was to evaluate current experience of IRE for the ablation of pancreatic cancer. MATERIAL AND METHODS: We searched PubMed for all studies of IRE in human pancreatic cancer in English reporting at least 10 patients. RESULTS: The search yielded 10 studies, comprising a total of 446 patients. Percutaneous IRE was done in 142 patients, while 304 patients were treated during laparotomy. Tumor sizes ranged from median 2.8 to 4.5 cm. Post-procedural complications occurred in 35% of patients, most of them were less severe. Nine patients (2.0%) died after the procedure. The technical success rate was 85-100%. The median recurrence-free survival was 2.7-12.4 months after IRE treatment. The median overall survival was 7-23 months postoperatively. The longest overall survival was noted when IRE was used in conjunction with pancreatic resection. CONCLUSIONS: IRE seems feasible and safe with a low post-procedural mortality. Further efforts are needed to address patient selection and efficacy of IRE, as well as the use of IRE for 'margin accentuation' during surgical resection.

11 Review Does next-generation sequencing of cyst fluid improve management of pancreatic cystic neoplasms? 2017

Aronsson, Linus / Andersson, Roland / Swahn, Fredrik / Ansari, Daniel. ·a Department of Clinical Sciences Lund , Lund University, Skane University Hospital , Lund , Sweden Surgery. ·Scand J Gastroenterol · Pubmed #28678564.

ABSTRACT: Pancreatic cystic lesions represent a heterogeneous group of diseases ranging from benign to malignant lesions. They are increasingly being detected due to the widespread use of cross-sectional imaging. Their management is a challenge because it is often not possible to reliably discriminate between malignant and nonmalignant lesions using current imaging technology. Next-generation sequencing (NGS) has the ability of both whole genome and targeted sequencing at a low cost and from a limited amount of DNA. NGS of cyst fluid aspired by endoscopic ultrasonography-guided fine-needle aspiration provides a valuable tool in biomarker research and may in the future help improve diagnosis and management of pancreatic cystic lesions.

12 Review Intraductal papillary mucinous neoplasm of the pancreas - epidemiology, risk factors, diagnosis, and management. 2017

Aronsson, Linus / Andersson, Roland / Ansari, Daniel. ·a Department of Clinical Sciences Lund, Surgery , Lund University, Skane University Hospital , Lund , Sweden. ·Scand J Gastroenterol · Pubmed #28446039.

ABSTRACT: Intraductal papillary mucinous neoplasm (IPMN) is one of the most common cystic neoplasms of the pancreas. It is a heterogeneous disease and can be divided into ductal types and morphological subtypes. The incidence of IPMN is increasing, likely due to the widespread use of cross-sectional imaging and a growing elderly population. IPMN poses an increasing demand on the health care system. Current guidelines provide indications for surgery and recommendations for surveillance, but management of IPMN is still challenging in routine clinical practice. In this article, we review current knowledge about IPMN and provide future directions for improving diagnosis and management.

13 Review Epigenetic alterations as biomarkers in pancreatic ductal adenocarcinoma. 2017

Syren, Pascal / Andersson, Roland / Bauden, Monika / Ansari, Daniel. ·a Department of Surgery , Clinical Sciences Lund, Lund University and Skåne University Hospital , Lund , Sweden. ·Scand J Gastroenterol · Pubmed #28301276.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) prognosis remains very poor and has only marginally improved during the last decades. Epigenetic alterations have been the focus of many recent studies and offer valuable options for PDAC detection, prognosis and treatment. DNA methylation, histone modifications and microRNA (miR) level changes can be used as biomarkers. These alterations occur early in carcinogenesis and may be specific for PDAC. Additionally, epigenetic alterations can be analyzed from cell-free DNA, free-circulating nucleosomes or shed tumor cells in blood. High-throughput methods are available for miR and DNA methylation level detection. In particular, multiple promising miR level changes have been discovered. No single epigenetic biomarker that offers a sufficient specificity has been discovered yet, but patterns containing multiple independent biomarkers exist.

14 Review Pancreatic cancer stroma: controversies and current insights. 2017

Ansari, Daniel / Carvajo, Maria / Bauden, Monika / Andersson, Roland. ·a Department of Surgery , Clinical Sciences Lund, Lund University and Skåne University Hospital , Lund , Sweden. ·Scand J Gastroenterol · Pubmed #28276831.

ABSTRACT: Pancreatic cancer is characterized by a dense stromal response. The stroma includes a heterogeneous mass of cells, including pancreatic stellate cells, fibroblasts, immune cells and nerve cells, as well as extracellular matrix proteins, cytokines and growth factors, which interact with the tumor cells. Previous research has indicated that stromal elements contribute to tumor growth and aggressiveness. However, recent studies suggest that some elements of the stroma may actually restrain the tumor. This review focuses on the complex interactions between the stromal microenvironment and tumor cells, discussing molecular mechanisms and potential future diagnostic and therapeutic approaches by targeting the stroma.

15 Review Immune checkpoint therapy for pancreatic cancer. 2016

Johansson, Henrik / Andersson, Roland / Bauden, Monika / Hammes, Sarah / Holdenrieder, Stefan / Ansari, Daniel. ·Henrik Johansson, Roland Andersson, Monika Bauden, Daniel Ansari, Department of Surgery, Clinical Sciences Lund, Lund University, and Skåne University Hospital, SE-221 85 Lund, Sweden. ·World J Gastroenterol · Pubmed #27920468.

ABSTRACT: Novel treatment modalities are necessary for pancreatic cancer. Immunotherapy with immune checkpoint inhibition has shown effect in other solid tumors, and could have a place in pancreatic cancer treatment. Most available clinical studies on immune checkpoint inhibitors for pancreatic cancer are not yet completed and are still recruiting patients. Among the completed trials, there have been findings of a preliminary nature such as delayed disease progression and enhanced overall survival after treatment with immune checkpoint inhibitors in mono- or combination therapy. However, due to small sample sizes, major results are not yet identifiable. The present article provides a clinical overview of immune checkpoint inhibition in pancreatic cancer. PubMed, ClinicalTrials.gov and American Society of Clinical Oncology's meeting abstracts were systematically searched for relevant clinical studies. Four articles, five abstracts and 25 clinical trials were identified and analyzed in detail.

16 Review Paradoxical Role of HMGB1 in Pancreatic Cancer: Tumor Suppressor or Tumor Promoter? 2016

Cebrián, María José García / Bauden, Monika / Andersson, Roland / Holdenrieder, Stefan / Ansari, Daniel. ·Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden. · Institute of Laboratory Medicine, German Heart Center at the Technical University Munich, Munich, Germany. · Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund, Sweden daniel.ansari@med.lu.se. ·Anticancer Res · Pubmed #27630273.

ABSTRACT: Pancreatic cancer has a dismal prognosis and there is an increasing and unmet need to identify better diagnostic and therapeutic targets in order to ameliorate the course of the disease. HMGB1, a nuclear DNA-binding protein that acts as a transcription factor, is currently in the limelight. HMGB1 exhibits a dual role in pancreatic cancer; when intracellular, it acts as an anti-tumor protein stabilizing the genome, whereas extracellular HMGB1 behaves as a pro-tumor protein with cytokine, chemokine and growth factor functions. Although the exact mechanisms of HMGB1 in pancreatic cancer are still to be elucidated, the significance of this protein for processes, such as autophagy, immunogenic cell death, tumor growth, metastasis and resistance to chemotherapy, have become increasingly clear. In this review, we provide a systematic summary and review of the biological and clinical relevance of HMGB1 in pancreatic cancer.

17 Review Re-evaluation of classical prognostic factors in resectable ductal adenocarcinoma of the pancreas. 2016

Åkerberg, Daniel / Ansari, Daniel / Andersson, Roland. ·Daniel Åkerberg, Daniel Ansari, Roland Andersson, Department of Surgery, Clinical Sciences Lund, Lund University, and Skåne University Hospital, SE-221 85 Lund, Sweden. ·World J Gastroenterol · Pubmed #27605878.

ABSTRACT: Pancreatic ductal adenocarcinoma carries a poor prognosis with annual deaths almost matching the reported incidence rates. Surgical resection offers the only potential cure. Yet, even among patients that undergo tumor resection, recurrence rates are high and long-term survival is scarce. Various tumor-related factors have been identified as predictors of survival after potentially curative resection. These factors include tumor size, lymph node disease, tumor grade, vascular invasion, perineural invasion and surgical resection margin. This article will re-evaluate the importance of these factors based on recent publications on the topic, with potential implications for treatment and outcome in patients with pancreatic cancer.

18 Review Pancreatic cancer: yesterday, today and tomorrow. 2016

Ansari, Daniel / Tingstedt, Bobby / Andersson, Bodil / Holmquist, Fredrik / Sturesson, Christian / Williamsson, Caroline / Sasor, Agata / Borg, David / Bauden, Monika / Andersson, Roland. ·Department of Surgery, Clinical Sciences Lund, Lund University & Skåne University Hospital, Lund, Sweden. · Department of Radiology, Clinical Sciences Lund, Lund University & Skåne University Hospital, Lund, Sweden. · Department of Pathology, Skåne University Hospital, Lund, Sweden. · Department of Oncology, Skåne University Hospital, Lund, Sweden. ·Future Oncol · Pubmed #27246628.

ABSTRACT: Pancreatic cancer is one of our most lethal malignancies. Despite substantial improvements in the survival rates for other major cancer forms, pancreatic cancer survival rates have remained relatively unchanged since the 1960s. Pancreatic cancer is usually detected at an advanced stage and most treatment regimens are ineffective, contributing to the poor overall prognosis. Herein, we review the current understanding of pancreatic cancer, focusing on central aspects of disease management from radiology, surgery and pathology to oncology.

19 Review Multifocal intraductal tubulopapillary neoplasm of the pancreas with total pancreatectomy: report of a case and review of literature. 2015

Kölby, David / Thilén, Johan / Andersson, Roland / Sasor, Agata / Ansari, Daniel. ·Department of Surgery, Clinical Sciences Lund, Lund University, Skåne University Hospital Lund, Sweden. · Department of Pathology, Clinical Sciences Lund, Lund University, Skåne University Hospital Lund, Sweden. ·Int J Clin Exp Pathol · Pubmed #26464736.

ABSTRACT: Intraductal neoplasms of the pancreas are classified as intraductal tubulopapillary neoplasms (ITPNs) and intraductal papillary mucinous neoplasm (IPMNs) in the current WHO classification. ITPN is a rare tumor and there are only a few cases of ITPN reported in the literature. We present the case of an otherwise healthy 42-year-old male, who presented with upper abdominal pain. He was subsequently diagnosed with multifocal ITPN and underwent total pancreatectomy. The pathological report showed invasive growth. The postoperative course was uneventful and the patient received 6 months of adjuvant chemotherapy with gemcitabine-capecitabine. The patient is still alive 19 months after the procedure with no signs of recurrence. Literature review revealed only 30 individual cases of ITPN in the pancreas including our reported case. Mean age was 61 years (16 males/14 females; ratio 1.14:1). Mean tumor size was 3 cm. Immunohistochemical staining was positive for CK-7 in 100% of the patients, CK-19 in 95% and for MUC-1 in 88%. Trypsin was negative in all cases. β-catenin was negative in 94% and MUC-2 was negative in 96% of the cases. BRAF, KRAS, TP53 and PIK3CA mutations were infrequently seen. Invasive growth was present in 54% of the cases. Tumor size and Ki-67 index showed a statistically significant association with invasive growth. Survival rate could not be determined, due to short follow-up, and further research is needed to establish prognostic factors for disease recurrence and survival.

20 Review SPARC: A Potential Prognostic and Therapeutic Target in Pancreatic Cancer. 2015

Vaz, Juan / Ansari, Daniel / Sasor, Agata / Andersson, Roland. ·From the Departments of *Surgery and †Pathology, Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden. ·Pancreas · Pubmed #26335014.

ABSTRACT: Pancreatic cancer is a complex and heterogeneous disease that often lacks disease-specific symptoms in early stages. The malignancy is currently the fourth leading cause of cancer-related death in Western countries. In advanced stages, the overall 5-year survival is less than 1% to 2%. Most available treatments lack convincing cost-efficiency determinations and are generally not associated with relevant success rates. Targeting stromal components and stromal depletion is currently becoming an area of extensive research in pancreatic cancer. In this context, a glycoprotein, SPARC (secreted protein acidic and rich in cysteine) appears to play a central role. Still, the role of SPARC in carcinogenesis is controversial because conflicting results have been reported, and the pathways involved in SPARC signaling are not well established. Nonetheless, SPARC is highly expressed in the tumor stroma, principally in peritumoral fibroblasts, and the overexpression of SPARC in this compartment is associated with poorer prognosis. Interestingly, it has been suggested that SPARC present in the tumor stroma could sequester albumin-bound paclitaxel, enhancing the delivery of paclitaxel into the tumor microenvironment. In the present review, we summarize the known associations between SPARC and pancreatic cancer. Moreover, present and future therapies comprising SPARC-targeting are discussed.

21 Review Radioimmunotherapy--a potential novel tool for pancreatic cancer therapy? 2015

Sahlin, Marie / Bauden, Monika Posaric / Andersson, Roland / Ansari, Daniel. ·Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, 221 85, Lund, Sweden. ·Tumour Biol · Pubmed #25926382.

ABSTRACT: Pancreatic cancer is one of the most severe cancers and is predicted to rise up to the number two cancer killer by 2030. The ineffective treatment options available and that the cancer is silent until very late in its course are the main reasons for the poor outcome of the disease. Surgery is the only curative option but only available for 10-15 % of the patients, but even then many relapse due to metastases. Many new treatments are under way, and one of the promising ones is radioimmunotherapy (RIT). This review includes clinical trials with RIT in pancreatic cancer as well as a review of adverse events observed during treatment of other solid tumors. Additionally, preclinical studies are reviewed with emphasis on effect, adverse events, the tumor targeting as well as isotope function. Four clinical trials with pancreatic cancer have been conducted with positive results, and one phase III trial is underway. The use of RIT in patients with solid tumors has proven to be well tolerated, and the adverse effects are almost exclusively hematological. Multiple targets and isotopes have been evaluated preclinically, alone, or in combination with existing drug options. Smaller tumors have in several studies completely regressed, while larger ones have stabilized or progressed more slowly. Pancreatic cancer is one of the solid tumors where RIT have reached the longest. The tumor heterogeneity will most likely leave room for more than one treatment option, and several aspiring therapies are under way. RIT may become part of multimodality tumor-directed therapy for pancreatic cancer.

22 Review hENT1 expression is predictive of gemcitabine outcome in pancreatic cancer: a systematic review. 2014

Nordh, Stina / Ansari, Daniel / Andersson, Roland. ·Stina Nordh, Daniel Ansari, Roland Andersson, Department of Surgery, Clinical Sciences Lund, Lund University and Skåne University Hospital, SE-221 85 Lund, Sweden. ·World J Gastroenterol · Pubmed #25024604.

ABSTRACT: High human equilibrative nucleoside transporter 1 (hENT1)-expression has shown a survival benefit in pancreatic cancer patients treated with gemcitabine in several studies. The aim of this systematic review was to summarize the results and try to assess the predictive value of hENT1 for determining gemcitabine outcome in pancreatic cancer. Relevant articles were obtained from PubMed, Embase and Cochrane databases. Studies evaluating hENT1-expression in pancreatic tumor cells from patients treated with gemcitabine were selected. Outcome measures were overall survival, disease-free survival (DFS), toxicity and response rate. The database searches identified 10 studies that met the eligibility criteria, and a total of 855 patients were included. Nine of 10 studies showed a statistically significant longer overall survival in univariate analyses in patients with high hENT1-expression compared to those with low expression. In the 7 studies that reported DFS as an outcome measure, 6 had statistically longer DFS in the high hENT1 groups. Both toxicity and response rate were reported in only 2 articles and it was therefore hard to draw any major conclusions. This review provides evidence that hENT1 is a predictive marker for pancreatic cancer patients treated with gemcitabine. Some limitations of the review have to be taken into consideration, the majority of the included studies had a retrospective design, and there was no standardized scoring protocol for hENT1-expression.

23 Review Intervention on toll-like receptors in pancreatic cancer. 2014

Vaz, Juan / Andersson, Roland. ·Juan Vaz, Roland Andersson, Department of Surgery, Clinical Sciences Lund, Skåne University Hospital Lund, Lund University, SE-221 85 Lund, Sweden. ·World J Gastroenterol · Pubmed #24914341.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDA) is a devastating disease with pronounced morbidity and a high mortality rate. Currently available treatments lack convincing cost-efficiency determinations and are in most cases not associated with relevant success rate. Experimental stimulation of the immune system in murine PDA models has revealed some promising results. Toll-like receptors (TLRs) are pillars of the immune system that have been linked to several forms of malignancy, including lung, breast and colon cancer. In humans, TLRs are expressed in the pancreatic cancer tissue and in several cancer cell lines, whereas they are not expressed in the normal pancreas. In the present review, we explore the current knowledge concerning the role of different TLRs associated to PDA. Even if almost all known TLRs are expressed in the pancreatic cancer microenvironment, there are only five TLRs suggested as possible therapeutic targets. Most data points at TLR2 and TLR9 as effective tumor markers and agonists could potentially be used as e.g. future adjuvant therapies. The elucidation of the role of TLR3 in PDA is only in its initial phase. The inhibition/blockage of TLR4-related pathways has shown some promising effects, but there are still many steps left before TLR4 inhibitors can be considered as possible therapeutic agents. Finally, TLR7 antagonists seem to be potential candidates for therapy. Independent of their potential in immunotherapies, all existing data indicate that TLRs are strongly involved in the pathophysiology and development of PDA.

24 Review The role of quantitative mass spectrometry in the discovery of pancreatic cancer biomarkers for translational science. 2014

Ansari, Daniel / Aronsson, Linus / Sasor, Agata / Welinder, Charlotte / Rezeli, Melinda / Marko-Varga, György / Andersson, Roland. ·Department of Surgery, Clinical Sciences Lund, Lund University, and Skåne University Hospital, SE-221 85 Lund, Sweden. roland.andersson@med.lu.se. ·J Transl Med · Pubmed #24708694.

ABSTRACT: In the post-genomic era, it has become evident that genetic changes alone are not sufficient to understand most disease processes including pancreatic cancer. Genome sequencing has revealed a complex set of genetic alterations in pancreatic cancer such as point mutations, chromosomal losses, gene amplifications and telomere shortening that drive cancerous growth through specific signaling pathways. Proteome-based approaches are important complements to genomic data and provide crucial information of the target driver molecules and their post-translational modifications. By applying quantitative mass spectrometry, this is an alternative way to identify biomarkers for early diagnosis and personalized medicine. We review the current quantitative mass spectrometric technologies and analyses that have been developed and applied in the last decade in the context of pancreatic cancer. Examples of candidate biomarkers that have been identified from these pancreas studies include among others, asporin, CD9, CXC chemokine ligand 7, fibronectin 1, galectin-1, gelsolin, intercellular adhesion molecule 1, insulin-like growth factor binding protein 2, metalloproteinase inhibitor 1, stromal cell derived factor 4, and transforming growth factor beta-induced protein. Many of these proteins are involved in various steps in pancreatic tumor progression including cell proliferation, adhesion, migration, invasion, metastasis, immune response and angiogenesis. These new protein candidates may provide essential information for the development of protein diagnostics and targeted therapies. We further argue that new strategies must be advanced and established for the integration of proteomic, transcriptomic and genomic data, in order to enhance biomarker translation. Large scale studies with meta data processing will pave the way for novel and unexpected correlations within pancreatic cancer, that will benefit the patient, with targeted treatment.

25 Review Positron emission tomography in malignancies of the liver, pancreas and biliary tract - indications and potential pitfalls. 2013

Ansari, Daniel / Keussen, Inger / Andersson, Roland. ·Department of Surgery, Clinical Sciences Lund, Lund University, Lund, Sweden. ·Scand J Gastroenterol · Pubmed #23148675.

ABSTRACT: Abstract Malignancies of the hepato-pancreatico-biliary (HPB) system are relatively common and generally characterized by a dismal prognosis. Positron emission tomography (PET) is a functional imaging technique that has emerged as an important modality in oncological decision-making. The principal radiopharmaceutical in PET imaging is the glucose analog (18)F-fluorodeoxyglucose, which is able to detect altered glucose metabolism in malignant tissue. PET is typically used in conjunction with computed tomography (CT), and previous studies have supported several uses of PET/CT in HPB malignancies, including staging, differential diagnostics and monitoring of treatment response and progress of disease. A review of PET/CT in the context of HPB malignancies will be presented, including indications and potential pitfalls.

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