Moving the needle on pancreatic disorders: 2023 data show triumphs, middling successes
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From pancreatitis complications to the impact of long COVID, FDA updates to gender disparity in pancreatic cancer, Healio has been at the forefront of coverage for pancreatic disorders in 2023. What have you missed this year?
So far this year, there have been several pivotal developments in pancreatic disease research, including the advantage of immediate direct endoscopic necrosectomy vs. step-up approach in necrotizing pancreatitis, a machine learning model that shows promise for early detection of pancreatic cancer and a regimen of antibiotics alongside gemcitabine that boosted survival in metastatic pancreatic ductal adenocarcinoma.
In case you missed any of these updates, Healio has put together a list of the latest news in pancreatic disorders you should be aware of.
Direct endoscopic necrosectomy reduced reinterventions in necrotizing pancreatitis
Immediate direct endoscopic necrosectomy significantly reduced the number of reinterventions and decreased length of hospital stay compared with a step-up approach in patients with infected necrotizing pancreatitis.
“The mortality in pancreatic necrosis ranges from 8% to 39% with higher rates in the presence of secondary infection,” Ji Young Bang, MD, a gastroenterologist at the Digestive Health Institute Center for Advanced Endoscopy, Research and Education at Orlando Health, told attendees at Digestive Disease Week. “An endoscopic step-up treatment approach is associated with lower rate of adverse events and death compared to minimally invasive surgery and is the performance of direct endoscopic necrosectomy when there is no clinical improvement after transluminal stent placement. This approach necessitates the need for more interventions and prolonged hospitalization.” Read more.
Perichemotherapy antibiotics improve PDAC survival in patients treated with gemcitabine
Receipt of perichemotherapy antibiotics correlated with improved survival in patients with metastatic pancreatic ductal adenocarcinoma treated with gemcitabine, but not fluorouracil, according to results in JAMA Network Open.
“The rapid development of multifactorial resistance to chemotherapy is an important contributor to the dismal prognosis in pancreatic ductal adenocarcinoma,” Daniel J. Fulop, BA, of the Henry D. Janowitz Division of Gastroenterology at the Icahn School of Medicine at Mount Sinai, and colleagues wrote. “Some preclinical studies have similarly discovered bacteria-mediated mechanisms of fluorouracil resistance while others have identified bacteria-mediated mechanisms of fluorouracil activation.” Read more.
Women younger than 55 years have a 2.4% higher incidence of pancreatic cancer vs. men
The incidence of pancreatic cancer increased at a faster rate over time among women aged younger than 55 years compared with their male counterparts, according to research published in Gastroenterology.
“A previously published nationwide study by our team showed that the incidence of pancreatic cancer has been significantly increasing in younger women at a greater rate compared to younger men,” Yazan Abboud, MD, a postdoctoral research scientist at Cedars-Sinai Medical Center in Los Angeles, told Healio. “However, the study was limited in such that it represented 36.7% of the U.S. population, and thus, the generalizability of the findings was somewhat limited.” Read more.
FDA grants fast track designation for olezarsen in familial chylomicronemia syndrome
The FDA has granted fast track designation for olezarsen in the treatment of familial chylomicronemia syndrome, according to a press release from Ionis Pharmaceuticals.
Olezarsen is an investigational ligand-conjugated antisense drug developed to inhibit the production of apolipoprotein C-III in patients with elevated triglyceride levels, including those with familial chylomicronemia syndrome (FCS). Read more.
Care must continue ‘well after date of surgery’ in patients with chronic pancreatitis
Infection, cardiovascular disease, narcotic dependence and other psychosocial issues were among causes linked to reduced 10-year survival in patients who underwent surgical intervention for chronic pancreatitis, researchers reported.
“Medical treatment is first-line therapy for chronic pancreatitis,” Gregory C. Wilson, MD, FACS, assistant professor of clinical surgery at the University of Cincinnati Pancreatic Disease Center, and colleagues wrote in the Journal of the American College of Surgeons. “However, a significant number of these patients fail conservative measurements and require surgical therapy. Surgical interventions, based on disease morphology including ductal anatomy and extent of parenchymal disease, can provide a definitive resolution for these patients.” Read more.
Machine learning model accurately identifies tertiary lymphoid structures up to nearly 98%
A machine learning model may aid the detection and classification of associated with gastrointestinal cancers based on routine tissue slides, according to research in JAMA Network Open.
“Currently, the most common and well-accepted approach to [tertiary lymphoid structure] detection is tissue staining for markers of immune cell lineages by multiplex immunohistochemistry or immunofluorescence techniques,” Zhe Li, BS, of the School of Computer Science and Engineering at Northwestern Polytechnical University in China, and colleagues wrote. “On the other hand, hematoxylin-eosin (H&E) staining is widely available and remains the clinical standard in histopathology. Read more.
Q&A: We must ‘outsmart the virus’: Strategy needed to curb risk for long COVID, GI issues
Infection with SARS-CoV-2 increased the risk for long-term gastrointestinal problems within 1 year, including motility disorders, acute pancreatitis and liver disease, according to a study published in Nature Communications.
“There are a lot of different hypotheses to explain why SARS-CoV-2, which we all thought of as a respiratory virus that leads to pneumonia or other respiratory problems, can actually result in GI disorders,” Ziyad Al-Aly, MD, chief of research and development service at Veterans Affairs St. Louis Health Care System and clinical epidemiologist at Washington University in St. Louis, told Healio. Read more.