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Pancreatic Neoplasms: HELP
Articles by Monika K. Krzyzanowska
Based on 7 articles published since 2010
(Why 7 articles?)
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Between 2010 and 2020, M. K. Krzyzanowska wrote the following 7 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Quality of clinical trials in gastroenteropancreatic neuroendocrine tumours. 2012

Walter, Thomas / Krzyzanowska, Monika K. ·Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, ON, Canada. ·Neuroendocrinology · Pubmed #22414794.

ABSTRACT: BACKGROUND: The heterogeneity of neuroendocrine tumours (NETs) makes interpretation of clinical trials in this disease challenging. Our aim was to review the quality of treatment trials in NETs in order to inform the design and reporting of future studies. METHODS: We identified studies by searching MEDLINE. We considered all phase II and III trials of systemic antineoplastic treatments published between 2000 and 2011. Information on trial design, study population, end points, statistical considerations and results was abstracted from each article using a standardized form. RESULTS: Seven phase III and 39 phase II trials were identified. The make-up of the study population was variable: only 24% of trials included patients with one type of tumour (pancreatic NET or carcinoid tumour), 41% included patients with both tumour types, and 35% of trials included other endocrine cancers. Disease progression at baseline was often not reported and was documented for all patients in 22% of the trials. The functional status of the tumour, tumour differentiation, and Ki67 index were reported in 35, 43, and 15% of trials, respectively. The primary end point was clearly defined in 72% of trials. Identifiable statistical design, and predefined sample size were reported in 74 and 61% of trials, respectively. Conflicts of interest and study sponsorship were reported in 46 and 85% of trials. CONCLUSIONS: The quality of the design and reporting of phase II/III NET trials, as described in other cancers, is poor. Future trials should include more homogenous patient populations while adhering to rigorous selection, reporting and interpretation of population and trial parameters.

2 Clinical Trial A phase II study of the HSP90 inhibitor AUY922 in chemotherapy refractory advanced pancreatic cancer. 2016

Renouf, D J / Hedley, D / Krzyzanowska, M K / Schmuck, M / Wang, L / Moore, M J. ·British Columbia Cancer Agency, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z4E6, Canada. drenouf@bccancer.bc.ca. · University Health Network-Princess Margaret Cancer Centre, Toronto, ON, Canada. · British Columbia Cancer Agency, University of British Columbia, 600 West 10th Avenue, Vancouver, BC, V5Z4E6, Canada. ·Cancer Chemother Pharmacol · Pubmed #27422303.

ABSTRACT: OBJECTIVES: AUY922 is a novel heat shock protein inhibitor with preclinical activity in pancreatic cancer. This phase II study evaluated the efficacy of AUY922 in patients with advanced pancreatic cancer previously treated with chemotherapy. METHODS: In this single-arm, Simon two-stage phase II trial, patients with metastatic or locally advanced pancreatic ductal adenocarcinoma who had progressed on at least one line of chemotherapy and were of good performances status (ECOG 0 or 1) were treated with AUY922 at a dose of 70 mg/m(2) IV weekly. The primary endpoint was disease control rate (objective response and stable disease ≥16 weeks). RESULTS: Twelve patients were accrued, all of whom received treatment. At least possibly related ≥grade 3 adverse events included fatigue (8 %) and AST elevation (8 %). Ten patients were evaluable for response with 1 (10 %) having stable disease and 9 (90 %) progressive disease. The median progression-free survival was 1.6 months, and the median overall survival was 2.9 months. CONCLUSIONS: AUY922 was not associated with significant efficacy in previously treated patients with advanced pancreatic cancer.

3 Clinical Trial Induction gemcitabine plus concurrent gemcitabine and radiotherapy for locally advanced unresectable or resected pancreatic cancer. 2014

Youl, M / Hashem, S / Brade, A / Cummings, B / Dawson, L A / Gallinger, S / Hedley, D / Jiang, H / Kim, J / Krzyzanowska, M K / Ringash, J / Wong, R / Brierley, J. ·Department of Radiation Oncology, University Health Network, Princess Margaret Cancer Centre and The University of Toronto, Toronto, Ontario, Canada. · Department of Surgical Oncology, University Health Network, Princess Margaret Cancer Centre and The University of Toronto, Toronto, Ontario, Canada. · Department of Medical Oncology, University Health Network, Princess Margaret Cancer Centre and The University of Toronto, Toronto, Ontario, Canada. · Department of Biostatistics, University Health Network, Princess Margaret Cancer Centre and The University of Toronto, Toronto, Ontario, Canada. · Department of Radiation Oncology, University Health Network, Princess Margaret Cancer Centre and The University of Toronto, Toronto, Ontario, Canada. Electronic address: James.Brierley@rmp.uhn.on.ca. ·Clin Oncol (R Coll Radiol) · Pubmed #24462333.

ABSTRACT: AIMS: To determine the efficacy of induction gemcitabine followed by biweekly gemcitabine concurrent with radiotherapy for locally advanced pancreatic cancer. MATERIALS AND METHODS: Between March 2001 and August 2009, 90 patients with unresectable (78) or resected (12) pancreatic cancer were treated with a standard treatment policy of induction gemcitabine (seven doses of weekly gemcitabine at 1000 mg/m(2)) followed by concurrent radiotherapy (52.5 Gy) and biweekly gemcitabine (40 mg/m(2)). RESULTS: After induction gemcitabine, 17.8% of patients did not proceed to chemoradiotherapy, due to either disease progression, performance status deterioration or gemcitabine toxicity. Of the patients who received chemoradiotherapy, 68.9% completed the course of 52.5 Gy, whereas 79.7% received more than 45 Gy. Chemoradiotherapy was stopped early due to treatment toxicity in 22.9% of patients. On intention to treat analysis, the median overall survival was 12.7 months in the locally advanced group and 18.2 months in the resected group. On multivariate analysis for the unresectable patients, a larger gross tumour volume was a significant poor prognostic factor for overall survival and local progression-free survival. CONCLUSION: This large series confirms, in a standard practice setting, similar efficacy and tolerability of treatment as previously reported in our phase I-II study. The benefit to patients with a gross tumour volume >48 cm(3) may be limited.

4 Clinical Trial A phase II study of the halichondrin B analog eribulin mesylate in gemcitabine refractory advanced pancreatic cancer. 2012

Renouf, Daniel J / Tang, Patricia A / Major, Pierre / Krzyzanowska, Monika K / Dhesy-Thind, Bindi / Goffin, John R / Hedley, David / Wang, Lisa / Doyle, L / Moore, Malcolm J. ·University Health Network-Princess Margaret Hospital, Toronto, ON, Canada. ·Invest New Drugs · Pubmed #21526355.

ABSTRACT: BACKGROUND: Eribulin mesylate is a halichondrin B analog that inhibits microtubule dynamics. Pre-clinical studies have suggested anti-tumor activity in pancreatic cancer. This phase II study of eribulin in patients with advanced pancreatic cancer previously treated with gemcitabine was conducted by the Princess Margaret Hospital Phase II consortium. PATIENTS AND METHODS: Eligibility criteria included locally advanced or metastatic pancreatic adenocarcinoma and previous treatment with gemcitabine. The study was a single arm phase II trial using a Simon 2-stage design. The primary endpoint was response rate, secondary endpoints included time to progression and overall survival. RESULTS: Fifteen patients were enrolled, 14 received treatment, and 12 were evaluable for response. The median age was 61, and the majority of patients were ECOG performance status 1. Grade 3 or greater adverse events included neutropenia (29%), fatigue (14%), peripheral neuropathy (7%) and thrombosis (7%). There were no complete or partial responses and therefore the study was closed after the first stage. The best response was stable disease in 5/12 (42%) of patients. Of these five patients, three had stable disease for 9 months or greater. Median time to progression was 1.4 months, and median overall survival was 6.1 months. CONCLUSION: Eribulin was well tolerated but did not result in any objective responses in gemcitabine refractory pancreatic cancer. However, several patients had prolonged stable disease, suggesting that further studies of eribulin in pancreatic cancer may be warranted.

5 Article Pancreatic Neuroendocrine Tumor Producing Insulin and Vasopressin. 2018

Alshaikh, Omalkhaire M / Yoon, Ju-Yoon / Chan, Bryan A / Krzyzanowska, Monika K / Butany, Jagdish / Asa, Sylvia L / Ezzat, Shereen. ·Department of Internal Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia. · Department of Medicine, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Room 7-327, Toronto, ON, M5G 2M9, Canada. · Department of Pathology, University Health Network, University of Toronto, Toronto, ON, Canada. · Department of Medicine, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Room 7-327, Toronto, ON, M5G 2M9, Canada. shereen.ezzat@utoronto.ca. ·Endocr Pathol · Pubmed #28718084.

ABSTRACT: The objective of the study is to report a rare case of pancreatic neuroendocrine tumor (pNET) producing insulin and vasopressin. We describe the clinical presentation and management of a metastatic pNET with refractory hypoglycemia and progressive severe hyponatremia. A 52-year-old patient had abdominal pain leading to the diagnosis of a tumor that was initially presumed to be splenic in origin. Investigations ultimately identified a pancreatic mass that on biopsy proved to be a pNET. Eventually, he developed extensive liver metastases, and with tumor progression, he manifested hypoglycemia and severe hyponatremia. He was managed with multiple therapies including somatostatin analogue, peptide-receptor-radionuclide-therapy (PRRT), diazoxide, and everolimus; none of these therapeutic modalities was successful in controlling functional and structural progression of the tumor. Ultimately, the pNET proved fatal and autopsy confirmed widely metastatic disease that stained strongly and diffusely for vasopressin, a feature not seen in the previous liver biopsy. This case illustrates the challenges of diagnosis and management of aggressive insulin-producing pNETs and highlights the potential concomitant ectopic production of vasopressin leading to refractory hyponatremia.

6 Article Palliative care and the aggressiveness of end-of-life care in patients with advanced pancreatic cancer. 2015

Jang, Raymond W / Krzyzanowska, Monika K / Zimmermann, Camilla / Taback, Nathan / Alibhai, Shabbir M H. ·Division of Medical Oncology and Hematology (RWJ, MKK) and Department of Psychosocial Oncology and Palliative Care (CZ), Princess Margaret Cancer Centre/University Health Network, Toronto, Canada (RWJ, MKK) · Department of Medicine (RWJ, MKK, CZ, SMHA), Institute of Medical Sciences (MKK, CZ, SMHA), Division of Biostatistics, Dalla Lana School of Public Health (NT), and Institute of Health Policy, Management, and Evaluation (MKK, SMHA), University of Toronto, Toronto, Canada · Institute for Clinical Evaluative Sciences, Toronto, Canada (MKK). ·J Natl Cancer Inst · Pubmed #25609233.

ABSTRACT: BACKGROUND: We examined the impact of palliative care (PC) on aggressiveness of end-of-life care for patients with advanced pancreatic cancer. Measures of aggressive care included chemotherapy within 14 days of death; and at least one intensive care unit (ICU) admission, more than one emergency department (ED) visit, and more than one hospitalization, all within 30 days of death. METHODS: A retrospective population-based cohort study using administrative data was conducted in patients with advanced pancreatic cancer from 2005 to 2010 in Ontario, Canada. Multivariable logistic regression was performed with the above measures of aggressive care as the outcomes of interest and PC as the main exposure, adjusting for covariables. Secondary analyses examined intensity of PC as the main exposure defined in two ways: 1) absolute number of PC visits before the outcome of interest (0, 1, 2, 3+ visits) and 2) monthly rate of PC visits. RESULTS: The cohort included 5381 patients (median survival 75 days); 2816 (52.3%) had received a PC consultation. PC consultation was associated with decreased use of chemotherapy near death (odds ratio [OR] = 0.34, 95% confidence interval [CI] = 0.25 to 0.46); lower risk of ICU admission: OR = 0.12, 95% CI = 0.08 to 0.18; multiple ED visits: OR = 0.19, 95% CI = 0.16 to 0.23; multiple hospitalizations near death: OR = 0.24, 95% CI = 0.19 to 0.31). A per-unit increase in the monthly rate of PC visits was associated with lower odds of aggressive care for all four outcomes. CONCLUSION: PC consultation and a higher intensity of PC were associated with less aggressive care near death in patients with advanced pancreatic cancer.

7 Article Nocardia brain abscess in a patient treated with everolimus for a metastatic insulinoma. 2013

Walter, Thomas / Zadeh, Gelareh / Hawryluk, Gregory / Krzyzanowska, Monika K. ·Department of Medical Oncology & Hematology, Princess Margaret Hospital, University of Toronto, Toronto, Canada. thomas.walter@chu-lyon.fr ·J Clin Oncol · Pubmed #23182991.

ABSTRACT: -- No abstract --