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• W4385568921 abstract "Periampullary cancers consist of three pathologically different tumor subtypes in close anatomic proximity: distal cholangiocarcinoma, adenocarcinoma of the duodenum, and the ampulla of Vater. The incidence of periampullary cancers is as low as 0.3 per 100<ts>000 population in European figures, a rare group of cancers. The variation in terms of biologic, molecular, and genomic profiles highlights the variable treatment responses and survival in periampullary cancers. In an effort to reduce recurrence rates and improve survival following surgical resection, the role of adjuvant therapies, including chemotherapy and chemoradiation, has been explored. A median survival of 43.1 months versus 35.2 months with the use of adjuvant chemotherapy in resected periampullary tumors was demonstrated in the ESPAC 3 trial. Recent trials have also investigated treatment of locally advanced or metastatic periampullary cancers utilizing combined chemotherapy agents as opposed to monoagents. Second-line chemotherapy agents in a palliative setting have been investigated in the ABC-06 trial, demonstrating a significant survival outcome when compared with standard first-line chemotherapy regimens and active symptom control. The majority of the existing evidence on management of periampullary cancers is extrapolated from retrospective case series that grouped various tumor subtypes together, with very few randomized trials. At present, there is a high unmet need to improve outcomes for patients with these tumors. Future studies will need to address these tumor subtypes and develop novel and applicable, tumor-specific, targeted therapies." @default.
• W4385568921 created "2023-08-05" @default.
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• W4385568921 date "2023-08-04" @default.
• W4385568921 modified "2023-09-27" @default.
• W4385568921 title "Adjuvant and Palliative Chemotherapy of Periampullary Cancers" @default.
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• W4385568921 doi "https://doi.org/10.1002/9781119876007.ch164" @default.
• W4385568921 hasPublicationYear "2023" @default.
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