New Strategies for Treatment: Pancreatic Adenocarcinoma

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New Strategies for Treatment Pancreatic
Adenocarcinoma
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Program Goal
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Difficult Disease to Treat
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Aggressive, Invasive, Metastatic
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Molecular Progression Model of Pancreatic Cancer
(PanINs)
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End-Stage Disease Proving Ground
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Metastatic vs Locally Advanced Disease
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Gemcitabine vs Fixed-Dose-Rate Gemcitabine vs
Gemcitabine Plus Oxaliplatin
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Gemcitabine vs Gemcitabine Plus Cetuximab
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Gemcitabine vs Gemcitabine Plus Bevacizumab
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Gemcitabine vs Gemcitabine Plus Cisplatin
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Gemcitabine vs Gemcitabine Plus Capecitabine
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Gemcitabine vs Gemcitabine Plus Erlotinib
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PRODIGE 4/ACCORD 11 Trial Design
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Experimental Arm FOLFIRINOX
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FOLFIRINOX vs Gemcitabine Overall Survival
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Safety Main Nonhematologic Adverse Effects (
per Patient)
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Patient Characteristics
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What Other Regimens Are There?
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Gemcitabine and Cisplatin
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Gemcitabine vs Gemcitabine Plus Capecitabine
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Gemcitabine Plus nab-Paclitaxel
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GTX Regimen
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Modified GTX Regimen
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Second-Line Therapies?
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Pathways Tumor Microenvironment
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IPI-926 Plus GemcitabineDecrease in CA 19-9 in
Majority of Patients
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Durable Responses and Stable Disease
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Examples of Potential Targets
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K-Ras Pathway Inhibition
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Phase 2 ISIS-2503 Plus Gemcitabine
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IGF-R1 Inhibitor Studies
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HER2 Inhibition
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PARP Inhibitor ABT-888 Phase 1/2
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Phase 1 Selective Akt Inhibitor, MK-2206
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AGS-1C4D4 Plus Gemcitabine
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Inhibiting the Microenvironment
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Conclusions
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