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Pancreatic Neoplasms: HELP
Articles by Stephan L. Haas
Based on 4 articles published since 2010
(Why 4 articles?)
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Between 2010 and 2020, S. L. Haas wrote the following 4 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Clinical Trial Cationic liposomal paclitaxel plus gemcitabine or gemcitabine alone in patients with advanced pancreatic cancer: a randomized controlled phase II trial. 2012

Löhr, J M / Haas, S L / Bechstein, W-O / Bodoky, G / Cwiertka, K / Fischbach, W / Fölsch, U R / Jäger, D / Osinsky, D / Prausova, J / Schmidt, W E / Lutz, M P / Anonymous1191075. ·Department of Medicine II, University Hospital Mannheim, Mannheim, Germany. matthias.lohr@ki.se ·Ann Oncol · Pubmed #21896540.

ABSTRACT: BACKGROUND: Paclitaxel embedded in cationic liposomes (EndoTAG™-1; ET) is an innovative agent targeting tumor endothelial cells. This randomized controlled phase II trial evaluated the safety and efficacy of ET in combination with gemcitabine (GEM) in advanced pancreatic cancer (PDAC). PATIENTS AND METHODS: Chemotherapy-naive patients with locally advanced or metastatic disease were randomly assigned to receive weekly GEM 1000 mg/m(2) or GEM plus twice-weekly ET 11, 22 or 44 mg/m(2) for 7 weeks. After a safety run-in of 100 patients, a second cohort continued treatment. End points included overall survival (OS), progression-free survival (PFS), tumor response and safety. RESULTS: Two hundred and twelve patients were randomly allocated to the study and 200 were treated (80% metastatic, 20% locally advanced). Adverse events were manageable and reversible. Transient thrombocytopenia and infusion reactions with chills and pyrexia mostly grade 1 or 2 occurred in the ET groups. Disease control rate after the first treatment cycle was 43% with GEM and 60%, 65% and 52% in the GEM + ET cohorts. Median PFS reached 2.7 compared with 4.1, 4.6 and 4.4 months, respectively. Median OS was 6.8 compared with 8.1, 8.7 and 9.3 months, respectively. CONCLUSIONS: Treatment of advanced PDAC with GEM + ET was generally well tolerated. GEM + ET showed beneficial survival and efficacy. A randomized phase III trial should confirm this positive trend.

2 Article Bioinformatory-assisted analysis of next-generation sequencing data for precision medicine in pancreatic cancer. 2017

Malgerud, Linnéa / Lindberg, Johan / Wirta, Valtteri / Gustafsson-Liljefors, Maria / Karimi, Masoud / Moro, Carlos Fernández / Stecker, Katrin / Picker, Alexander / Huelsewig, Carolin / Stein, Martin / Bohnert, Regina / Del Chiaro, Marco / Haas, Stephan L / Heuchel, Rainer L / Permert, Johan / Maeurer, Markus J / Brock, Stephan / Verbeke, Caroline S / Engstrand, Lars / Jackson, David B / Grönberg, Henrik / Löhr, Johannes Matthias. ·Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden. · Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden. · Department of Medical Epidemiology & Biostatistics (MEB), Karolinska Institutet, Stockholm, Sweden. · Science for Life Laboratory, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden. · Department of Oncology at Radiumhemmet, Karolinska University Hospital, Stockholm, Sweden. · Department of Pathology, Karolinska University Hospital, Stockholm, Sweden. · Molecular Health GmbH, Heidelberg, Germany. · Innovation Office, Karolinska University Hospital, Stockholm, Sweden. · Department of Laboratory Medicine (LABMED), Karolinska Institutet, Stockholm, Sweden. ·Mol Oncol · Pubmed #28675654.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is a tumor with an extremely poor prognosis, predominantly as a result of chemotherapy resistance and numerous somatic mutations. Consequently, PDAC is a prime candidate for the use of sequencing to identify causative mutations, facilitating subsequent administration of targeted therapy. In a feasibility study, we retrospectively assessed the therapeutic recommendations of a novel, evidence-based software that analyzes next-generation sequencing (NGS) data using a large panel of pharmacogenomic biomarkers for efficacy and toxicity. Tissue from 14 patients with PDAC was sequenced using NGS with a 620 gene panel. FASTQ files were fed into treatmentmap. The results were compared with chemotherapy in the patients, including all side effects. No changes in therapy were made. Known driver mutations for PDAC were confirmed (e.g. KRAS, TP53). Software analysis revealed positive biomarkers for predicted effective and ineffective treatments in all patients. At least one biomarker associated with increased toxicity could be detected in all patients. Patients had been receiving one of the currently approved chemotherapy agents. In two patients, toxicity could have been correctly predicted by the software analysis. The results suggest that NGS, in combination with an evidence-based software, could be conducted within a 2-week period, thus being feasible for clinical routine. Therapy recommendations were principally off-label use. Based on the predominant KRAS mutations, other drugs were predicted to be ineffective. The pharmacogenomic biomarkers indicative of increased toxicity could be retrospectively linked to reported negative side effects in the respective patients. Finally, the occurrence of somatic and germline mutations in cancer syndrome-associated genes is noteworthy, despite a high frequency of these particular variants in the background population. These results suggest software-analysis of NGS data provides evidence-based information on effective, ineffective and toxic drugs, potentially forming the basis for precision cancer medicine in PDAC.

3 Article Outcome of probe-based confocal laser endomicroscopy (pCLE) during endoscopic retrograde cholangiopancreatography: A single-center prospective study in 45 patients. 2015

Löhr, Johannes-Matthias / Lönnebro, Ragnar / Stigliano, Serena / Haas, Stephan L / Swahn, Fredrik / Enochsson, Lars / Noel, Rozh / Segersvärd, Ralf / Del Chiaro, Marco / Verbeke, Caroline S / Arnelo, Urban. ·Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden. · Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden ; Department of Gastroenterology, La Sapienza University, Rome, Italy. ·United European Gastroenterol J · Pubmed #26668748.

ABSTRACT: BACKGROUND: Diagnosis of pre-malignant and malignant lesions in the bile duct and the pancreas is sometimes cumbersome. This applies in particular to intraductal papillary mucinous neoplasia (IPMN) and bile duct strictures in primary sclerosing cholangitis (PSC). AIMS: To evaluate in a prospective cohort study the sensitivity and specificity of probe-based confocal laser microscopy (pCLE) during endoscopic retrograde cholangiopancreatography (ERCP). METHODS: We performed pCLE together with mother-baby endoscopy (SpyGlass) during 50 ERCP sessions in 45 patients. The Miami and Paris criteria were applied. Clinical diagnosis via imaging was compared to pCLE and the final pathological diagnosis from surgically-resected, biopsy, or cytology specimens. Patients were followed up for at least 1 year. RESULTS: We were able to perform pCLE in all patients. Prior to endoscopy, the diagnosis was benign in 23 patients and undetermined (suspicious) in 16 patients, while six patients had an unequivocal diagnosis of malignancy. Sensitivity was 91% and specificity 52%. The positive (PPV) and negative predictive value (NPV) was 82% and 100%, respectively. Apart from mild post-ERCP pancreatitis in two patients, no complications occurred. CONCLUSIONS: Our study showed that pCLE is a safe, expert endoscopic method with high technical feasibility, high sensitivity and high NPV. It provided diagnostic information that can be helpful for decisions on patient management, especially in the case of IPMN and unclear pancreatic lesions, in individuals whom are at increased risk for pancreatic cancer.

4 Article Short-term Results of a Magnetic Resonance Imaging-Based Swedish Screening Program for Individuals at Risk for Pancreatic Cancer. 2015

Del Chiaro, Marco / Verbeke, Caroline S / Kartalis, Nikolaos / Pozzi Mucelli, Raffaella / Gustafsson, Peter / Hansson, Johan / Haas, Stephan L / Segersvärd, Ralf / Andren-Sandberg, Åke / Löhr, J-Matthias. ·Division of Surgery, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden. · Division of Pathology, Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden. · Division of Radiology, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden. · Department of Clinical Genetics, Karolinska Institute, Stockholm, Sweden. · Department of Onco-Pathology, Karolinska Institute, Stockholm, Sweden. · Department of Medicine, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden. ·JAMA Surg · Pubmed #25853369.

ABSTRACT: IMPORTANCE: Pancreatic cancer is the fourth leading cause of cancer-related death in Western countries. In approximately 10% of all patients with pancreatic cancer, it is possible to define a positive family history for pancreatic cancer or for one of the other related genetic syndromes. A screening program for individuals at risk is recommended; however, surveillance modalities have not been defined yet. OBJECTIVE: To analyze the short-term results of a prospective clinical surveillance program for individuals at risk for pancreatic cancer using a noninvasive magnetic resonance imaging (MRI)-based screening protocol. DESIGN, SETTING AND PARTICIPANTS: A prospective observational study of all patients with a genetic risk for developing pancreatic cancer who were referred to Karolinska University Hospital between January 1, 2010, and January 31, 2013, using an MRI-based surveillance program. All patients were investigated for the most common genetic mutations associated with pancreatic cancer. EXPOSURE: A noninvasive MRI-based screening protocol. MAIN OUTCOMES AND MEASURES: The ability of MRI to identify potential precancerous or early cancers in individuals at risk for pancreatic cancer. RESULTS: Forty patients (24 women and 16 men) were enrolled. The mean age was 49.9 years. The mean length of follow-up was 12.9 months. The numbers of relatives affected by pancreatic cancer were 5 in 2 patients (5%), 4 in 5 patients (12.5%), 3 in 17 patients (42.5%), 2 in 14 patients (35%), and 1 in 2 patients (5%). In 4 patients (10%), a p16 mutation was found; in 3, a BRCA2 mutation (7.5%); and in 1, a BRCA1 mutation (2.5%). In 16 patients (40%), MRI revealed a pancreatic lesion: intraductal papillary mucinous neoplasia (14 patients, 35%) and pancreatic ductal adenocarcinoma (2 patients, 5%). One patient had a synchronous intraductal papillary mucinous neoplasia and pancreatic ductal adenocarcinoma. Five patients (12.5%) required surgery (3 for pancreatic ductal adenocarcinoma and 2 for intraductal papillary mucinous neoplasia), while the remaining 35 are under continued surveillance. CONCLUSIONS AND RELEVANCE: During a median follow-up of approximately 1 year, pancreatic lesions were detected in 40% of the patients, of whom 5 underwent surgery. Although the study time was relatively short, the surveillance program in individuals at risk seems to be effective.