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Pancreatic Neoplasms: HELP
Articles by David Watkins
Based on 2 articles published since 2010
(Why 2 articles?)

Between 2010 and 2020, David Watkins wrote the following 2 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Clinical Trial miR-21 expression and clinical outcome in locally advanced pancreatic cancer: exploratory analysis of the pancreatic cancer Erbitux, radiotherapy and UFT (PERU) trial. 2016

Khan, Khurum / Cunningham, David / Peckitt, Clare / Barton, Sarah / Tait, Diana / Hawkins, Maria / Watkins, David / Starling, Naureen / Rao, Sheela / Begum, Ruwaida / Thomas, Janet / Oates, Jacqui / Guzzardo, Vincenza / Fassan, Matteo / Braconi, Chiara / Chau, Ian. ·Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, Sutton, UK. · CRUK/MRC Oxford Institute for Radiation Oncology, Gray Laboratories, University of Oxford, Oxford, UK. · Department of Medicine, University of Padua, Padua, IT. · Division of Cancer Therapeutics, The Institute of Cancer Research, Sutton, UK. ·Oncotarget · Pubmed #26862857.

ABSTRACT: BACKGROUND: Locally advanced pancreatic cancer (LAPC) is associated with high mortality, and biomarker-driven treatment approach is currently lacking. This study evaluated safety and efficacy of a combination approach of chemotherapy followed by chemo-radiotherapy (CRT) +/- cetuximab, and the prognostic role of miR-21 in patients with LAPC treated with a multimodality approach. PATIENTS AND METHODS: This was a randomised phase II trial in which patients with inoperable LAPC were offered gemcitabine and capecitabine (GEM-CAP) for 16 weeks. Patients with stable disease or response after GEM-CAP were randomised to capecitabine or UFT plus radiotherapy (RT) (A), or capecitabine or UFT plus cetuximab plus RT (B). The primary outcome of the study was overall survival (OS). Clinical outcome was compared according to baseline circulating miR-21 levels. RESULTS: 17 patients were enrolled and treated with GEM-CAP, with 13 patients achieving disease control and being randomised to arms A (n:7) and B (n:6). After a median follow-up of 61.2 months, median progression free survival (PFS) was 10.4 months and 12.7 months, median OS was 15.8 months and 22.0 months in arms A and B respectively (p > 0.05). Patients with high baseline plasma miR-21 had worse PFS (3.5 vs. 12.7 months; p:0.032) and OS (5.1 vs 15.3 months; p:0.5) compared to patients with low miR-21. Circulating miR-21 levels reflected miR-21 expression within the tissues. CONCLUSIONS: Addition of Cetuximab to CRT following induction chemotherapy did not improve survival. High miR-21 baseline plasma expression was associated with poor clinical outcome in LAPC patients treated with induction chemotherapy followed by chemo-radiotherapy.

2 Article FOLFIRINOX for locally advanced or metastatic pancreatic ductal adenocarcinoma: the Royal Marsden experience. 2014

Moorcraft, Sing Yu / Khan, Khurum / Peckitt, Clare / Watkins, David / Rao, Sheela / Cunningham, David / Chau, Ian. ·Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, Surrey, United Kingdom. · Gastrointestinal Unit, The Royal Marsden NHS Foundation Trust, Surrey, United Kingdom. Electronic address: ian.chau@rmh.nhs.uk. ·Clin Colorectal Cancer · Pubmed #25442814.

ABSTRACT: BACKGROUND: Pancreatic ductal adenocarcinoma (PDA) has a very poor prognosis. Treatment with FOLFIRINOX has been shown to improve outcomes, but can be associated with significant toxicity. MATERIALS AND METHODS: A retrospective review was performed of all patients with locally advanced or metastatic PDA treated with FOLFIRINOX at the Royal Marsden between November 2010 and November 2013. Efficacy, tolerability, and potential prognostic factors were evaluated. RESULTS: Twenty-seven patients with metastatic PDA and 22 patients with locally advanced PDA were treated with FOLFIRINOX. Patients received a median of 9 cycles (range, 1-26) of FOLFIRINOX. The overall response rate was 41% (20 patients), and a further 17 patients (35%) had stable disease. Thirty-five patients (71%) received FOLFIRINOX in the first-line setting, with a median progression-free survival and overall survival, respectively, of 12.9 months and 18.4 months for patients with locally advanced disease; and 8.4 months and 12.2 months for patients with metastatic disease. The most frequently occurring Grade 3/4 toxicities were neutropenia (29%), fatigue (18%), febrile neutropenia (14%), thromboembolism (12%), and thrombocytopenia (10%). In a univariate analysis, reduction in CA 19-9 of >50% (P < .001), normalization of CA19-9 (P < .001), surgery after FOLFIRINOX (P = .004), and use of prophylactic pegfilgrastim (P = .005) were prognostic for overall survival. CONCLUSION: The efficacy and tolerability of FOLFIRINOX for PDA at our institution is similar to that reported in clinical trials. Careful selection of patients and monitoring of response (according to CA19-9) and toxicities can help maximize advantage in this patient population.