title: Surgical resection after TNFerade therapy for locally advanced pancreatic cancer.
abstract: BACKGROUND
  Treatment of pancreatic cancer remains a major oncological challenge and survival is dismal. Most patients, present with advanced disease at diagnosis and are not candidates for curative resection. Preoperative chemoradiation may downstage and improve survival in locally advanced pancreatic cancer. This has prompted investigators to look for novel neoadjuvant therapies. Gene therapy for pancreatic cancer is a novel investigational approach that may have promise. TNFerade is a replication deficient adenovirus vector carrying the human tumor necrosis factor (TNF)-alpha gene regulated under control of a radiation-inducible gene promoter. Transfection of tumor cells with TNFerade maximizes the antitumor effect of TNF-alpha under influence of radiation leading to synergistic effects in preclinical studies.
  
  
  METHODS
  We describe a case of locally advanced unresectable pancreatic cancer treated with a novel multimodal approach utilizing gene therapy with TNFerade and concurrent chemoradiation that was followed by successful surgical resection.
  
  
  CONCLUSIONS
  Neoadjuvant TNFerade based chemoradiation therapy may be a useful adjunct to treatment of locally advanced pancreatic cancer.
authors.affiliation: Department of Medicine, Roswell Park Cancer Institute and State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Manpreet K
authors.initials: MK
authors.lastname: Chadha
authors.forename: Alan
authors.initials: A
authors.lastname: Litwin
authors.forename: Charles
authors.initials: C
authors.lastname: Levea
authors.forename: Renuka
authors.initials: R
authors.lastname: Iyer
authors.forename: Gary
authors.initials: G
authors.lastname: Yang
authors.forename: Milind
authors.initials: M
authors.lastname: Javle
authors.forename: John F
authors.initials: JF
authors.lastname: Gibbs
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D015316:Genetic Therapy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010190:Pancreatic Neoplasms / Q000628:therapy*; D016577:Pancreaticoduodenectomy / Q000379:methods; D011401:Promoter Regions, Genetic / Q000235:genetics / Q000528:radiation effects; D011878:Radiotherapy / Q000379:methods; D015533:Transcriptional Activation / Q000528:radiation effects; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*
chemical_list: D014409:Tumor Necrosis Factor-alpha