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Pancreatic Neoplasms: HELP
Articles by Daniel G. Haller
Based on 3 articles published since 2009
(Why 3 articles?)

Between 2009 and 2019, D. Haller wrote the following 3 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Review Pancreatic cancer treatment and research: an international expert panel discussion. 2011

Tempero, M A / Berlin, J / Ducreux, M / Haller, D / Harper, P / Khayat, D / Schmoll, H-J / Sobrero, A / Van Cutsem, E. ·Division of Hematology/Oncology, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California 94115, USA. mtempero@medicine.ucsf.edu ·Ann Oncol · Pubmed #21199884.

ABSTRACT: BACKGROUND: Pancreatic cancer has proven extremely challenging to treat. A collaborative effort is needed to advance research and improve treatment. An expert conference was conducted to elicit perspectives regarding the current treatment and future research of pancreatic cancer. METHODS: The conference comprised an international panel of experts representing five European countries and the United States. RESULTS: Adjuvant radiotherapy is used more frequently in the United States than in Europe. In locally advanced disease, there is now more emphasis on early chemotherapy in both Europe and the United States. In metastatic disease, combination chemotherapy is commonly used in Europe and the United States. This varies by country. Advancing pancreatic research will require improving biorepositories and developing a roadmap to prioritize therapeutic targets in different models. Small randomized phase II trials of both non-selected and enriched patient populations will help identify activity of new agents. Phase III trials should only be initiated in appropriate patients based on strong clinical and biological signals. Developing drugs in the adjuvant setting may be preferable to eliminate some of the challenges of drug development in the advanced disease setting. CONCLUSION: Progress in research combined with encouraging improvements from the past offer hope for the future of pancreatic cancer patients.

2 Clinical Trial Phase III, randomized study of gemcitabine and oxaliplatin versus gemcitabine (fixed-dose rate infusion) compared with gemcitabine (30-minute infusion) in patients with pancreatic carcinoma E6201: a trial of the Eastern Cooperative Oncology Group. 2009

Poplin, Elizabeth / Feng, Yang / Berlin, Jordan / Rothenberg, Mace L / Hochster, Howard / Mitchell, Edith / Alberts, Steven / O'Dwyer, Peter / Haller, Daniel / Catalano, Paul / Cella, David / Benson, Al Bowen. ·Cancer Institute of New Jersey,195 Little Albany St, New Brunswick, NJ 08903, USA. poplinea@umdnj.edu ·J Clin Oncol · Pubmed #19581537.

ABSTRACT: PURPOSE: Single-agent gemcitabine (GEM) is standard treatment of metastatic pancreatic cancer. Fixed-dose rate (FDR) GEM and GEM plus oxaliplatin have shown promise in early clinical trials. E6201 was designed to compare overall survival (OS) of standard weekly GEM 1,000 mg/m(2)/30 minutes versus GEM FDR 1,500 mg/m(2)/150 minutes or GEM 1,000 mg/m(2)/100 minutes/day 1 plus oxaliplatin 100 mg/m(2)/day 2 every 14 days (GEMOX). METHODS: This trial included patients with metastatic or locally advanced pancreatic cancer, normal organ function, and performance status of 0 to 2. The study was designed to detect a 33% difference in median survival (hazard ratio [HR] < or = 0.75 for either of the experimental arms) with 81% power while maintaining a significance level of 2.5% in a two-sided test for each of the two primary comparisons. RESULTS: Eight hundred thirty-two patients were enrolled. The median survival and 1-year survival were 4.9 months (95% CI, 4.5 to 5.6) and 16% for GEM, 6.2 months (95% CI, 5.4 to 6.9), and 21% for GEM FDR (HR, 0.83; stratified log-rank P = .04), and 5.7 months (95% CI, 4.9 to 6.5) and 21% for GEMOX (HR, 0.88; stratified log-rank P = .22). Neither of these differences met the prespecified criteria for significance. Survival was 9.2 months for patients with locally advanced disease, and 5.4 months for those with metastatic disease. Grade 3/4 neutropenia and thrombocytopenia were greatest with GEM FDR. GEMOX caused higher rates of nausea, vomiting, and neuropathy. CONCLUSION: Neither GEM FDR nor GEMOX resulted in substantially improved survival or symptom benefit over standard GEM in patients with advanced pancreatic cancer.

3 Article Resection status, age and nodal involvement determine survival among patients receiving adjuvant chemoradiotherapy in pancreatic adenocarcinoma. 2011

Moghanaki, Drew / Mick, Rosemarie / Furth, Emma Elizabeth / Sohal, Davendra / Salmon, Patricia M / Behbahani, Ali / Morgans, Alicia K / Miller, Seth M / Giantonio, Bruce J / Whittington, Richard W / Haller, Daniel G / Rosato, Ernest F / Plastaras, John P. ·Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA. ·JOP · Pubmed #21904068.

ABSTRACT: CONTEXT: Pancreas cancer can potentially be cured by resection, but the role of adjuvant chemotherapy and/or chemoradiation has been controversial. OBJECTIVES: To better define clinicopathological factors that may serve as predictive and/or prognostic variables. PATIENTS: Between 1984 and 2006, we retrospectively analyzed 91 patients with pancreas cancer treated with pancreaticoduodenectomy or total pancreatectomy followed by adjuvant 5-fluorouracil-based chemoradiation at the University of Pennsylvania. Final pathological coding including margin status was confirmed by a pathologist. INTERVENTIONS: Patients were treated with 48.6 to 63.0 Gy, and 96.7% completed their prescribed radiation dose. MAIN OUTCOME MEASURES: The prognostic significance of demographic factors, stage, year of surgery, tumor location, grade, resection status, and number of positive lymph nodes on overall survival were examined. RESULTS: With a median follow-up of 6.5 years, the overall median survival was 2.3 years (95% CI 1.5-3.2 years), and the 5-year overall survival was 28.9%. In multivariate analysis, completeness of resection (P<0.001), fewer number of positive lymph nodes (0 vs. 1-2 vs. 3 or more) (P=0.004), and age less than, or equal to, 60 years (P=0.006) were all independently associated with improved overall survival. The overall survival reported in this study compares favorably with the results of other single-institution studies and with the RTOG 97-04 trial. CONCLUSIONS: Adjuvant 5-FU-based chemoradiation following radical pancreatectomy can be delivered safely and results in comparatively good overall survival. The results of this analysis underscore the importance of resection status, number of involved lymph nodes and patient age as prognostic characteristics. These factors may be considered stratification variables for future post-pancreatectomy adjuvant therapy trials.