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Pancreatic Neoplasms: HELP
Articles by Mumhammad Wasif Saif
Based on 237 articles published since 2009
(Why 237 articles?)
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Between 2009 and 2019, M. W. Saif wrote the following 237 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10
1 Editorial Pancreatic cancer in 2014. 2014

Kaltsas, Serafim / Syrigos, Konstantinos N / Saif, Muhammad Wasif. ·University of Athens School of Medicine. Athens Greece. wsaif@tuftsmedicalcenter.org. ·JOP · Pubmed #24618423.

ABSTRACT: -- No abstract --

2 Editorial Biomarkers for pancreatic cancer: is it ready for primetime? 2013

Kim, Richard / Mahipal, Amit / Choi, Minsig / Saif, Mohammad Wasif. · ·JOP · Pubmed #23846914.

ABSTRACT: -- No abstract --

3 Editorial Advancements in the management of pancreatic cancer: 2013. 2013

Saif, Muhammad Wasif. · ·JOP · Pubmed #23474549.

ABSTRACT: Pancreatic cancer still remains a significant, unresolved therapeutic challenge and is the most lethal type of gastrointestinal cancer with a 5-year survival rate of 5%. Adjuvant chemotherapy remains to be gemcitabine alone, though fluorouracil offers the same survival and role of radiation remains controversial. Nevertheless, only a few patients survive for at least 5 years after R0 resection and adjuvant therapy. Borderline resectable pancreatic cancer remains an area that requires multi-disciplinary approach. Neo-adjuvant therapy very likely plays a role to downstage to a resectable state in these subgroup patients. There are different treatment approaches to locally advanced pancreatic cancer management, including single or multi-agent chemotherapy, chemotherapy followed by chemoradiation, or immediate concurrent chemoradiation. Most patients need palliative treatment. Once pancreatic cancer becomes metastatic, it is uniformly fatal with an overall survival of generally 6 months from time of diagnosis. Gemcitabine has been the standard since 1997. FOLFIRINOX (5-fluorouracil, oxaliplatin, irinotecan, leucovorin) has already shown superiority over gemcitabine in both progression-free survival and overall survival, but this regimen is suitable only for selected patients in ECOG performance status 0-1. FOLFIRINOX has already trickled down to the clinic in various modifications and in different patient groups, both locally advanced and metastatic. Many targeted agents, including bevacizumab, cetuximab showed negative results, except mild benefit with addition of erlotinib with gemcitabine, which was not considered clinically significant. There is no consensus regarding treatment in the second-line setting. It will be true to say that there was a real medical breakthrough with regards to improving the prognosis of pancreatic cancer as of 2013 with the results of MPACT study. In this study, patients who received nab-paclitaxel plus gemcitabine lived a median of 8.5 months, compared with 6.7 months for those who received gemcitabine alone. At the end of one year, 35% of those getting nab-paclitaxel were alive, compared with 22% of those getting only gemcitabine. After two years, the figures were 9% for those getting nab-paclitaxel and 4% for those who received gemcitabine.

4 Editorial Research in pancreatic cancer: an update after ASCO 2012. 2012

Saif, Muhammad Wasif. · ·JOP · Pubmed #22797382.

ABSTRACT: -- No abstract --

5 Editorial Revising you the staging for pancreatic cancer in 2012. 2012

Saif, Muhammad Wasif. · ·JOP · Pubmed #22406582.

ABSTRACT: -- No abstract --

6 Editorial Pancreatic neoplasm in 2012: an update. Tissue is an issue! 2012

Saif, Muhammad Wasif. · ·JOP · Pubmed #22406581.

ABSTRACT: -- No abstract --

7 Editorial Pancreatic neoplasm in 2011: an update. 2011

Saif, Muhammad Wasif. · ·JOP · Pubmed #21737886.

ABSTRACT: Pancreatic cancer still is a significant, unresolved therapeutic challenge with nearly similar incidence and mortality rates. It is the most lethal type of digestive cancer with a 5-year survival rate of 5%. Adjuvant chemotherapy remains to be gemcitabine alone or combined with infusional 5-fluorouracil with radiation therapy. Nevertheless, only a few patients survive for at least 5 years after R0 resection and adjuvant therapy. Most patients need palliative treatment. Once pancreatic cancer becomes metastatic, it is uniformly fatal with an overall survival of typically 6 months from diagnosis. Chemotherapy is an important component of palliative care but must be administered as a part of a multidisciplinary approach, including palliation of pain, managing weight loss, and deterioration in functional status. Gemcitabine has been the standard in both locally advanced and metastatic disease. The addition of the tyrosine kinase inhibitor erlotinib prolongs median survival for only 2 weeks. While gemcitabine-based regimens are currently accepted as the standard first-line treatment of patients with locally advanced or metastatic pancreatic adenocarcinoma, there is no consensus regarding treatment in the second-line setting. It will not be untrue to say that there are no real medical breakthroughs with regards to improving the prognosis of pancreatic cancer as of 2011. On the other hand, we have made some progress in patients with advanced pancreatic neuroendocrine tumors. These patients have a 5-year survival that can range from 97% in benign insulinomas to as low as 30% in non-functional metastatic pancreatic neuroendocrine tumors. Treatment options may include surgery, transarterial chemoembolization of liver metastases, and cytotoxic therapy such as streptozotocin, 5-fluorouracil or doxorubicin. Somatostatin analogues, like octreotide, have been proven to prolong progression-free survival in patients with metastatic neuroendocrine tumors of midgut origin. In 2011, two targeted agents, a tyrosine kinase inhibitor sunitinib and mTOR inhibitor everolimus have been approved by FDA for pancreatic neuroendocrine tumors. With these approvals, U.S. physicians can now offer their patients with progressive pancreatic neuroendocrine tumors. Patients with any stage of pancreatic cancer should be considered candidates for clinical trials.

8 Editorial Three-drug combination regimen in pancreatic cancer treatment: are we there yet? 2011

Kang, Soonmo Peter / Saif, Muhammad Wasif. · ·JOP · Pubmed #21386625.

ABSTRACT: -- No abstract --

9 Editorial Rationale for inhibition of the hedgehog pathway paracrine loop in pancreatic adenocarcinoma. 2011

Dimou, Anastasios / Syrigos, Kostas / Saif, Muhammad Wasif. · ·JOP · Pubmed #21206093.

ABSTRACT: The role of hedgehog pathway in the biology of pancreatic adenocarcinoma is an emerging area of investigation and provides a novel field for treatment intervention. Recent studies have shown the activation of the hedgehog pathway in pancreatic cancer. Despite the initial assumption of an autocrine mechanism, it seems that the hedgehog pathway contributes to the molecular conversation between tumor and its microenvironment through a paracrine loop. Furthermore, members of the hedgehog pathway crosstalk with other pathways; they regulate tumor angiogenesis and are associated with cancer stem cells. In addition, there is preclinical evidence about the efficiency of hedgehog inhibitors both in vitro and in vivo and the first clinical trials with those compounds in the treatment of patients with pancreatic adenocarcinoma, are already under way.

10 Editorial Combining epidermal growth factor receptor inhibitors and radiation therapy in pancreatic cancer: small step or giant leap? 2009

Chang, Bryan W / Saif, Muhammad W. · ·JOP · Pubmed #19454812.

ABSTRACT: Targeting the epidermal growth factor receptor (EGFR) with small molecule inhibitors or monoclonal antibodies in combination with chemotherapy and radiation is a theoretically appealing strategy in pancreatic cancer. EGFR inhibitors have shown efficacy as radiosensitizers and activity against metastatic pancreatic cancer when combined with gemcitabine. This paper examines the available clinical data, with a focus on locally advanced, unresectable disease. Further studies with a focus on understanding the basic biology of EGFR inhibition are needed to identify an optimal multi-modality regimen.

11 Editorial Role of anticoagulation in the management of pancreatic cancer. 2009

Sohail, Muhammad Adnan / Saif, Muhammad Wasif. · ·JOP · Pubmed #19287098.

ABSTRACT: Pancreatic cancer remains a major clinical challenge. Recent advances in chemotherapeutic and targeted agents have offered a modest survival benefit. One of the major complications of pancreatic cancer is venous thromboembolism. Although it is well-known fact that patients with mucinous carcinoma of the pancreas and gastrointestinal tract pose an increased risk of developing thromboembolic complications, scarce data exists regarding the incidence and pathogenesis of venous thromboembolism in pancreatic cancer patients. The incidence of venous thromboembolism in pancreatic cancer patients ranges from 17% to 57%. Clinical data also suggest that the occurrence of venous thromboembolism may be associated with poorer prognosis in such patients. Recent data suggest that anticoagulant treatments may improve cancer patient survival by decreasing thromboembolic complications as well as by anticancer effects. Thromboembolic disease in pancreatic cancer presents a life-threatening complication and is regarded as paraneoplastic manifestation of the disease. Effective management of this risk factor is very important in the management of pancreatic cancer. Given the lack of extensive data and the clinical relevance of this topic for both physicians and basic research scientists, the authors review the incidence, pathogenesis and clinical implications of venous thromboembolism in pancreatic cancer patients.

12 Review Pharmacokinetics and pharmacodynamics of new drugs for pancreatic cancer. 2019

Sugarman, Ryan / Patel, Rajvi / Sharma, Sandhya / Plenker, Dennis / Tuveson, David / Saif, Muhammad Wasif. ·a Northwell Health Cancer Institute , Donald and Barbara Zucker School of Medicine at Hofstra/Northwell , Lake Success , NY , USA. · b Cold Spring Harbor Laboratory , Cold Spring Harbor , NY , USA. ·Expert Opin Drug Metab Toxicol · Pubmed #31241371.

ABSTRACT:

13 Review Capecitabine for the treatment of pancreatic cancer. 2019

Siddiqui, Nauman S / Godara, Amandeep / Byrne, Margaret M / Saif, Muhammad Wasif. ·a Division of Hematology/Oncology , Tufts Medical Center - Tufts University School of Medicine , Boston , MA , USA. · b Department of Medical Oncology , Northwell Health Cancer Institute , New York , NY , USA. ·Expert Opin Pharmacother · Pubmed #30649964.

ABSTRACT: INTRODUCTION: Capecitabine is an oral prodrug of 5-fluorouracil (5-FU) which is converted to 5FU by a series of reactions catalyzed by different enzymes, the last of the enzymes being thymidine phosphorylase (TP). TP is found to be elevated in tumor cells in comparison to normal cells, which consequently tumor-localizes the production of 5-FU, thereby limiting its systemic toxicity. Today, capecitabine is extensively used for the treatment of many solid malignancies, with a particular focus in breast and gastrointestinal tumors, but also in pancreatic cancer. Areas covered: This review summarizes the pharmacology and the clinical evidence relevant to the use of capecitabine in the treatment of pancreas cancer. The authors provide, furthermore, provide their expert perspectives on its use. Expert opinion: Capecitabine has the advantage over other therapeutics in so much that it has both convenient oral administration and a favorable toxicity profile. Current data has promised the use of capecitabine in all stages of pancreatic cancer. However, predictive markers for outcome and toxicity remain to be validated.

14 Review The safety of lanreotide for neuroendocrine tumor. 2019

Godara, Amandeep / Siddiqui, Nauman S / Byrne, Margaret M / Saif, Muhammad Wasif. ·a Gastrointestinal Oncology Program and Experimental therapeutics, Division of Hematology/Oncology , Tufts Medical Center - Tufts University School of Medicine , Boston , MA , USA. ·Expert Opin Drug Saf · Pubmed #30582380.

ABSTRACT: INTRODUCTION: Lanreotide autogel is a synthetic somatostatin analogue which has been FDA and EMA approved for unresectable, well to moderately differentiated, locally advanced or metastatic gastroenteropancreatic neuroendocrine tumor. Its action is mediated by its affinity to somatostatin receptors, especially sst2 and sst5 receptors. Its longer half-life offers the convenience of 4-week dosing over the need for frequent injections of short-acting somatostatin analogues. Areas covered: Lanreotide ATG offers progression-free survival benefit in locally advanced or metastatic neuroendocrine tumor (NET) compared to placebo, reflecting a strong antiproliferative signal. As lanreotide is commonly used for management of NET, it is imperative to recognize and appropriately manage any drug-related toxicities. In this review, we will provide an overview of the toxicity with lanreotide and its management. Expert opinion: Lanreotide is highly effective in managing carcinoid symptoms and has a robust anti-tumor effect in NET. Overall, it is well tolerated with low rates of treatment discontinuation due to toxicity. It's toxicity profile is mostly predictable, and patients should be informed of the transient nature of some of the upfront toxicities.

15 Review An update on the management of pancreatic neuroendocrine tumors. 2018

Gao, Limin / Natov, Nikola S / Daly, Kevin P / Masud, Faisal / Chaudhry, Sadia / Sterling, Mark J / Saif, Muhammad W. ·Division of Hematology and Oncology, GI Oncology Program and Experimental Therapeutics. · Division of Gastroenterology, Tufts University School of Medicine, Boston, Massachusetts, USA. · Department of Radiology. · King Edward Medical University, Lahore. · Foundation University Medical College, Rawalpindi, Pakistan. ·Anticancer Drugs · Pubmed #29782352.

ABSTRACT: Pancreatic neuroendocrine tumors (PNETs) are a rare and heterogeneous group of neoplasia and differ in their clinical presentation, behavior, and prognosis based on both histological features and cancer stage at the time of diagnosis. Although small-sized tumors can be surgically resected, locally advanced and metastatic tumors confer a poor prognosis. In addition, only limited treatment options are available to the latter group of patients with PNETs, such as hormonal analogs, cytotoxic agents, and targeted therapy. In selected patients, liver-directed therapies are also used. As expected, clinicians taking care of these patients are challenged to develop an effective and comprehensive treatment strategy for their patients amid a wide variety of treatment modalities. Targeted therapy for PNETs is limited to sunitinib and everolimus. Presently, a number of clinical studies are ongoing to assess the efficacy of newer targeted agents alone and in combination with previous agents for the treatment of advanced PNETs. The authors reviewed the current treatment and also discussed the emerging agents and emphasized the need to identify biomarkers.

16 Review T cell optimization for the treatment of pancreatic cancer. 2017

Liu, Fang / Saif, Muhammad Wasif. ·a GI Oncology Program and Experimental Therapeutics , Tufts University School of Medicine , Boston , MA , USA. · b PGY-2, Internal Medicine Residency Program at Metrowest Medical Center , Framingham , MA , USA. ·Expert Opin Biol Ther · Pubmed #28835191.

ABSTRACT: INTRODUCTION: Pancreatic cancer remains a deadly disease despite advances in surgery, chemotherapy, and radiation therapy. Treatment failure is likely due to intense chemoresistance and immunosuppression. Therefore, new treatment paradigms are urgently needed. Immunotherapy, particularly adoptive T cell transfer, is a highly-personalized therapy that involves the isolation and ex vivo expansion of tumor-specific T cells before administration to cancer-bearing hosts. Areas covered: This review summarizes different strategies of adoptive T cell therapy and their application in pancreatic cancer treatment. It also highlights recent advances and gives discussion on the future directions in T cell-based immunotherapy for pancreatic cancer. Expert opinion: Pancreatic ductal adenocarcinoma is extremely challenging to treat, in part, due to intense desmoplastic reaction and immunosuppression. The recent progress in cancer immunotherapy triggers a hope to use immunotherapeutic modality to treat pancreatic cancer. Immunotherapy is generally well tolerated, and has the potential to function as a monotherapy or in synergistic combination with conventional chemotherapy. We must make efforts to optimize the immunotherapeutic regimen and to select patients to treat based on their biological profile. To accomplish this goal, an intense collaboration is needed to bridge between bench and bedside.

17 Review Second line treatment options for pancreatic cancer. 2017

Passero, Frank C / Saif, Muhammad Wasif. ·a GI Oncology and Experimental Therapeutics , Tufts Medical Center , Boston , MA , USA. ·Expert Opin Pharmacother · Pubmed #28820270.

ABSTRACT: INTRODUCTION: Patients with advanced pancreatic cancer (APC) refractory to first-line therapy have a dismal prognosis and limited therapeutic options, with only one option consisting of nanoliposomal irinotecan in combination with fluorouracil and folinic acid which was approved by FDA based upon results of the phase III NAPOLI-1 study. Areas covered: We performed a literature search for relevant published clinical trials, abstracts of trials in progress and ongoing or planned trials for the second line treatment of APC using Pubmed.com, ClinicalTrials.gov and American Society of Clinical Oncology (ASCO) abstract search as sources. We present an in-depth analysis of the phase I-III clinical trials determining the role and efficacy of second-line treatment in patients with APC. We also describe ongoing studies and rationale for future investigation. Expert opinion: Despite advances in first-line therapy such as gemcitabine/nab-paclitaxel and FOLFIRINOX in APC, median overall survival remains less than 12 months, highlighting the need to develop second-line therapies. In order to establish much needed effective second-line treatment options, we need cooperative efforts among institutions and community practices in enrolling these refractory patients in clinical trials. It should be emphasized that in addition to chemotherapy options, all patients should have the opportunity to consult with nutritionist, social worker and palliative care health providers to assist with goals of care, symptom management and end of life discussions.

18 Review New therapeutic directions for advanced pancreatic cancer: cell cycle inhibitors, stromal modifiers and conjugated therapies. 2017

Matera, Robert / Saif, Muhammad Wasif. ·a Department of Hematology and Oncology , Tufts University School of Medicine , Boston , MA , USA. ·Expert Opin Emerg Drugs · Pubmed #28783977.

ABSTRACT: INTRODUCTION: Pancreatic adenocarcinoma is a devastating malignancy with an extremely poor prognosis. These tumors progress rapidly and somewhat silently with few specific symptoms and are relatively resistant to chemotherapeutic agents. Many agents, including cell cycle inhibitors, are under development for the treatment of this cancer for which there are disappointingly few treatment options. Areas covered: Here we outline the existing approved treatments for advanced pancreatic disease and discuss a range of novel therapies currently under development including cell cycle inhibitors, stromal modifiers and conjugated therapies. We also describe the current state of the pancreatic cancer therapeutics market both past and future. Expert opinion: Despite the recent explosion of novel therapies with an array of unique targets, the core treatment of pancreatic cancer still with traditional cytotoxic agents with a few exceptions. However, as these novel treatments move through the pipeline, we are hopeful that there will soon be a number of effective options for patients with advanced pancreatic cancer.

19 Review The safety and efficacy of Onivyde (irinotecan liposome injection) for the treatment of metastatic pancreatic cancer following gemcitabine-based therapy. 2016

Passero, Frank C / Grapsa, Dimitra / Syrigos, Kostas N / Saif, Muhammad Wasif. ·a Division of Hematology/Oncology and Experimental Therapeutics , Tufts Medical Center , Boston , MA , USA. · b Oncology Unit GPP , Sotiria General Hospital , Athens , Greece. ·Expert Rev Anticancer Ther · Pubmed #27219482.

ABSTRACT: INTRODUCTION: Patients with advanced and metastatic pancreatic cancer refractory to gemcitabine based therapy have a dismal prognosis and limited therapeutic options. Recently, the FDA approved nanoliposomal irinotecan combined with fluorouracil/folinic acid for such patients based upon results of the NAPOLI-1 study which showed this regimen compared to fluorouracil/folinic acid significantly prolonged progression free survival (3.1 vs. 1.5 months) and overall survival (6.2 vs. 4.1 months). AREAS COVERED: The pharmacokinetic and pharmacogenetic characteristics of this novel formulation of irinotecan, its safety profile, and use in a clinical context for patients with pancreatic cancer are reviewed. Expert commentary: Nanoliposomal irinotecan, in combination with 5-FU/folinic acid, represents an important step forward in improving second line treatment options in patients with progression of metastatic pancreatic cancer. Furthermore, the novel drug formulation offers pharmacokinetic advantages which serve as a basis for further clinical testing in a various pancreatic cancer settings and other malignancies.

20 Review Immunotherapy for pancreatic cancer. 2016

Kotteas, Elias / Saif, Muhammad Wasif / Syrigos, Konstantinos. ·Oncology Unit, 3rd Department of Internal Medicine, Sotiria General Hospital, Athens University School of Medicine, 152 Mesogeion Avenue, Athens, Greece. ilkotteas@hotmail.com. · Section of GI and Experimental Therapeutics, Tufts University School of Medicine, Boston, MA, USA. · Oncology Unit, 3rd Department of Internal Medicine, Sotiria General Hospital, Athens University School of Medicine, 152 Mesogeion Avenue, Athens, Greece. · Yale School of Medicine, New Haven, CT, USA. ·J Cancer Res Clin Oncol · Pubmed #26843405.

ABSTRACT: INTRODUCTION: Pancreatic cancer is among the most lethal malignancies resistant to conventional therapies. The vast majority of patients is diagnosed with advanced/metastatic disease and consequently has grim prognosis. Despite the available options with nab-paclitaxel and gemcitabine or 5-fluorouracil/leucovorin/oxaliplatin, chemotherapy offers a modest survival benefit. Targeted therapy in combination with chemotherapy has not shown significant improvement in treatment outcomes. The urgent need for new therapies has turned the spotlights on immunotherapy. Immunotherapy in pancreatic cancer recruits and activates T cells which recognize tumor-specific antigens. RESULTS: Preclinical models have demonstrated that chemotherapy or targeted therapy works synergistically with immunotherapy. A growing body of evidence has already been gathered regarding the efficacy of checkpoint inhibitors, vaccines, adoptive T cell therapy, monoclonal antibodies, and cytokines in patients with pancreatic cancer. CONCLUSIONS: Many ongoing trials are aiming to identify treatments which could combine efficacy with limited toxicity. In this article, we review the available data concerning multiple aspects of immunotherapy in pancreatic cancer.

21 Review Metformin and pancreatic cancer: Is there a role? 2016

De Souza, Andre / Khawaja, Khadija Irfan / Masud, Faisal / Saif, Muhammad Wasif. ·Section of GI Cancers and Experimental Therapeutics, Department of Hematology and Oncology, Tufts University School of Medicine and Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA. · Department of Endocrinology and Metabolism, Services Institute of Medical Sciences, Lahore, Pakistan. · King Edward Medical University, Lahore, Pakistan. · Section of GI Cancers and Experimental Therapeutics, Department of Hematology and Oncology, Tufts University School of Medicine and Tufts Cancer Center, Tufts Medical Center, 800 Washington Street, Boston, MA, 02111, USA. wsaif@tuftsmedicalcenter.org. ·Cancer Chemother Pharmacol · Pubmed #26740120.

ABSTRACT: Pancreatic cancer is the fourth leading cause of cancer-related deaths in the USA, with a 5-year survival rate of 6 %. Anti-hyperglycemic treatments for type 2 diabetes mellitus that induce hyperinsulinemia (i.e., sulfonylureas) are thought to increase cancer risk, whereas treatments that lower insulin resistance and hyperinsulinemia (i.e., metformin) are considered cancer prevention strategies. Metformin is a cornerstone in the treatment of diabetes mellitus type 2. Retrospective studies have shown a survival benefit in diabetic patients with many solid tumors including pancreatic cancer that have been treated with metformin compared with patients treated with insulin or sulfonylureas. Metformin influences various cellular pathways, including activation of the LKB1/AMPK pathway, inhibition of cell division, promotion of apoptosis and autophagy, down-regulation of circulating insulin, and activation of the immune system. Ongoing research is redefining our understanding about how metformin modulates the molecular pathways implicated in pancreatic cancer. The authors review the topic critically and also give their opinion. Further studies investigating the effect of metformin in combination with chemotherapy, targeted agents, or radiation therapy are undergoing. In addition, the role of metabolic and other biomarkers is needed.

22 Review Lanreotide for the treatment of gastroenteropancreatic neuroendocrine tumors. 2016

Saif, Muhammad Wasif. ·a Tufts University Medical Center , Department of Hematology/Oncology , Boston , MA , USA. ·Expert Opin Pharmacother · Pubmed #26635177.

ABSTRACT: INTRODUCTION: The prevalence of gastropancreatic neuroendocrine tumors (GEP-NETs), a largely sporadically occurring group of neoplasms, has rapidly increased. NET diagnoses often occur late and entail treatment challenges; treatment beyond surgical resection is typically required. Somatostatin analogs (SSAs), the cornerstone of GEP-NET therapy, target somatostatin receptors on NET cell surfaces and can ameliorate NET-related symptoms and prevent tumor progression. AREAS COVERED: This expert review summarizes the development of the SSA lanreotide and its role in treating NETs. Key lanreotide preclinical and clinical findings in acromegaly, carcinoid syndrome, and NETs are discussed, along with future treatment goals and therapeutic prospects. EXPERT OPINION: The role of SSAs in NET treatment was historically one of symptom management. Although this is a critical therapeutic component, ideal treatment would include prevention of tumor progression. As GEP-NETs are biologically diverse, progression prevention can be difficult, depending on primary tumor site and functional status. Recent data indicate that lanreotide significantly prolonged progression-free survival in metastatic GEP-NET patients. Practice patterns seem to be shifting toward using SSAs as first-line therapy. Response to SSAs has typically been categorized as either symptomatic or biochemical. However, SSA use to prevent tumor progression will lead to a new, objective response category based on tumor growth.

23 Review Pancreatic neuroendocrine tumors: targeting the molecular basis of disease. 2015

Khagi, Simon / Saif, M Wasif. ·aTufts Medical Center bTufts University School of Medicine, Boston, Massachusetts, USA. ·Curr Opin Oncol · Pubmed #25390554.

ABSTRACT: PURPOSE OF REVIEW: Pancreatic neuroendocrine tumors (pNETs) are a rare and heterogeneous group of neoplasia. Presentation of these tumors can vary widely. Current treatment modalities range from potentially curative surgical interventions in localized disease to the use of varied hormonal analogues, cytotoxic agents and targeted therapy for the management of locally advanced and metastatic disease. With such a wide variety of therapeutic modalities, clinicians are faced with the task of building an effective and comprehensive treatment strategy for their patients. RECENT FINDINGS: Targeted therapy for pNET is limited to sunitinib and everolimus. There have been a number of important studies assessing the efficacy of other targeted agents, in addition to the conjugation of these agents in the management of advanced pNET. This review will stand to highlight currently available targeted therapies for the treatment of advanced pNET. SUMMARY: The use of targeted agents in the management of advanced pNET has significant potential to change the current standard of care. In addition to the use of long-acting somatostatin analogues, targeting the mammalian target of rapamycin and vascular endothelial growth factor pathways can be well tolerated and may lead to long periods of disease control in a wide variety of neuroendocrine tumors involving the pancreas.

24 Review Targeted agents in treatment of neuroendocrine tumors of pancreas. 2014

Karampelas, Ilias N / Syrigos, Kostas N / Saif, Muhammad Wasif. ·Oncology Department, Athens Medical Group. Athens, Greece. iliasnkarampe@gmail.com. ·JOP · Pubmed #25076341.

ABSTRACT: Neuroendocrine tumors (NET) of the pancreas are uncommon neoplasms that arise from the pancreatic islet cells. Surgical resections are being tested, as well as multiple chemotherapy agents. Current treatment options for nonresectable disease include somatostatin analogs and chemotherapy. New therapies focus on specific molecular targets such as sunitinib, angiogenesis inhibitor, that target vascular endothelial growth factor receptor (VEGFR) and other growth factor receptors and everolimus, an inhibitor of the mammalian target of rapamycin. Functionally based medical therapies for NET include somatostatin analogs to control symptoms. The 2014 annual meeting of American Society of Clinical Oncology (ASCO) brought us new insights into the management of pancreatic neuroendocrine tumors. The focus of this review will serve to highlight specific Abstracts (#e15160 and #e15161), that shed light on new therapeutic options that help target the unique pathways of this malignancies.

25 Review KRAS in pancreatic cancer. 2014

Agarwal, Archana / Saif, Muhammad Wasif. ·Department of Medicine, Steward Carney Hospital. Boston, MA, USA. archana.agarwal@steward.org. ·JOP · Pubmed #25076326.

ABSTRACT: Pancreatic cancer is one of the most feared malignancies. The most common form of pancreatic cancer is adenocarcinoma arising from the ductal epithelium. KRAS is the most common oncogene that has been found to be mutated. However, targeting KRAS directly has been difficult. We do not know a lot about the relationship between KRAS and other signaling pathways. At the same time, little is known about the non KRAS mutated or wild type (WT) tumors. Most of the data that we have as far, as mutational status is concerned, has been obtained from the tumor itself and not from metastatic lesions. In this review, we discuss two abstracts (Abstracts #e15214 and #e15207) published in conjunction with the 2014 ASCO Annual Meeting. These discuss the relationship between KRAS and other signaling pathways and the differences between mutated KRAS and WT tumors. The studies found low rate of KRAS mutation in cells obtained from ascitic fluid. While the studies are small, these are novel findings that are worth exploring further. They increase our understanding of the biology of the disease and take us a step closer to treating this deadly malignancy.

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