{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T07:05:40Z","timestamp":1778223940075,"version":"3.51.4"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>EUS associated with contrast-enhanced harmonic EUS (CH-EUS) and EUS elastography (EUS-E) are used in clinical practice to assess pancreatic tumor at the diagnosis. In case of pancreatic ductal adenocarcinoma (PDAC) with liver metastasis, nab-paclitaxel combined with gemcitabine is a first-line treatment option. We aimed to assess the modification of PDAC microenvironment induced by the combination of nab-paclitaxel with gemcitabine, by endoscopic ultrasonography techinics. This single center phase III study conducted between February 2015 and June 2016 included patients with pancreatic adenocarcinoma with mesurable liver metastasis and no prior cancer treatment fit for two cycles of nab-paclitaxel combined with gemcitabine. We aimed to perform EUS with CH-EUS and EUS-E of the pancreatic tumor, CT scan and contrast enhanced ultrasonogram (CE-US) of a reference liver metastasis, before and after the two cylces of chemotherapy. Primary end point was modification of vascularizaion of primary tumor and a reference liver metastasis. Secondary end points were modification of stromal content, safety profile of drug combination and tumor response rate. Sixteen patients were analyzed, but only 13 received two cycled of chemotherapy (CT) (toxicity [<jats:italic toggle=\"yes\">n<\/jats:italic> = 1] or death [<jats:italic toggle=\"yes\">n<\/jats:italic> = 2]). There was no statistical modification induced by CT concering vascularity of primary tumor (time to maximum intensity <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.24, value of maximum intensity <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.71, hypoechogenic aspect generated by injection of contrast enhancing agent), vascularity of a reference liver metastasis (time to maximum intensity <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.99, value of maximum intensity <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.71) and tumor elasticity (<jats:italic toggle=\"yes\">P<\/jats:italic> = 0.22). Eleven patients had tumor response assessement, 6\/11 (54%) had measurable disease response 4\/11 (36%) with partial responses and 2\/11 (18%) with stable disease. All other patients showed disease progression. No serious side effects occurred, 6\/11 patients had a dose adjustment. We did not show significant modification of vascularity and elasticity but these results should be taken with caution because of important limitations.<\/jats:p>","DOI":"10.4103\/eus-d-22-00040","type":"journal-article","created":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T03:50:37Z","timestamp":1682913037000},"page":"273-276","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of biological effect of nab-paclitaxel combined with gemcitabine, using contrast enhanced ultrasonography and elastography, in advanced pancreatic ductal carcinoma: A single-center pilot study"],"prefix":"10.1097","volume":"12","author":[{"given":"Yanis","family":"Dahel","sequence":"first","affiliation":[{"name":"Department of Endoscopy, Paoli-Calmettes Institute, Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brice","family":"Chanez","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Paoli-Calmettes Institute, Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christophe","family":"Zemmour","sequence":"additional","affiliation":[{"name":"Department of Clinical Research and Investigation, Biostatistics and Methodology Unit, Paoli-Calmettes Institute, Aix Marseille University, INSERM, IRD, SESSTIM, Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles","family":"Piana","sequence":"additional","affiliation":[{"name":"Department of Radiology, Paoli-Calmettes Institute, Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Mitry","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Paoli-Calmettes Institute, Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Giovannini","sequence":"additional","affiliation":[{"name":"Department of Endoscopy, Paoli-Calmettes Institute, Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"R1-20250826","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1080\/0284186X.2016.1197419","article-title":"More deaths from pancreatic cancer than breast cancer in the EU by 2017","volume":"55","author":"Ferlay","year":"2016","journal-title":"Acta Oncol"},{"key":"R2-20250826","doi-asserted-by":"crossref","first-page":"2913","DOI":"10.1158\/0008-5472.CAN-14-0155","article-title":"Projecting cancer incidence and deaths to 2030:The unexpected burden of thyroid, liver, and pancreas cancers in the United States","volume":"74","author":"Rahib","year":"2014","journal-title":"Cancer Res"},{"issue":"Suppl 5","key":"R3-20250826","doi-asserted-by":"crossref","first-page":"v56","DOI":"10.1093\/annonc\/mdv295","article-title":"Cancer of the pancreas:ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"26","author":"Ducreux","year":"2015","journal-title":"Ann Oncol"},{"key":"R4-20250826","doi-asserted-by":"crossref","first-page":"e000587","DOI":"10.1136\/esmoopen-2019-000587","article-title":"First-line and second-line treatment of patients with metastatic pancreatic adenocarcinoma in routine clinical practice across Europe:A retrospective, observational chart review study","volume":"5","author":"Taieb","year":"2020","journal-title":"ESMO Open"},{"key":"R5-20250826","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1200\/JCO.2018.78.9636","article-title":"Metastatic pancreatic cancer:ASCO clinical practice guideline update","volume":"36","author":"Sohal","year":"2018","journal-title":"J Clin Oncol"},{"key":"R6-20250826","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1056\/NEJMoa1304369","article-title":"Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine","volume":"369","author":"Von","year":"2013","journal-title":"N Engl J Med"},{"key":"R7-20250826","first-page":"1","journal-title":"Abraxane Combined with Gemcitabine is Indicated as First Line Treatment of Adult with Metastatic Pancreatic Adenocarcinoma;HAS - 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