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A Near-Complete Response to Treatment with Gemcitabine plus nab (®)-Paclitaxel in a Patient with Metastatic Pancreatic Cancer and Poor Performance Status: A Case Report.

Shakir AR - Case Rep Oncol (2014)

Bottom Line: Although her disease was well controlled with gemcitabine plus nab-paclitaxel, she died just over 11 months after diagnosis as a result of her comorbid conditions compounded by treatment-related hematologic toxicity.This case suggests that patients with metastatic pancreatic adenocarcinoma and poor PS may benefit from first-line combination therapy with gemcitabine plus nab-paclitaxel.Further study of this regimen in such patients is warranted.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology/Oncology, Sarah Bush Lincoln Regional Cancer Center, University of Illinois at Chicago, Mattoon, Ill., USA.

ABSTRACT
Patients with metastatic pancreatic adenocarcinoma and poor performance status (PS) are typically excluded from clinical trials of new systemic treatments. Due to concerns that such patients cannot tolerate the greater toxicity sometimes associated with combination chemotherapy regimens, the recommended treatment for pancreatic cancer patients with poor PS is gemcitabine monotherapy. We report the case of a 79-year-old female with pancreatic adenocarcinoma metastatic to the lungs, with multiple comorbidities and an Eastern Cooperative Oncology Group PS of 3, who achieved a rapid and prolonged objective response to gemcitabine plus nab (®)-paclitaxel. The patient received a total of 11 cycles of treatment. Although her disease was well controlled with gemcitabine plus nab-paclitaxel, she died just over 11 months after diagnosis as a result of her comorbid conditions compounded by treatment-related hematologic toxicity. This case suggests that patients with metastatic pancreatic adenocarcinoma and poor PS may benefit from first-line combination therapy with gemcitabine plus nab-paclitaxel. Further study of this regimen in such patients is warranted.

No MeSH data available.


Related in: MedlinePlus

PET scans prior to treatment (a) and after 2 months of gemcitabine plus nab-paclitaxel chemotherapy (b).
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Figure 1: PET scans prior to treatment (a) and after 2 months of gemcitabine plus nab-paclitaxel chemotherapy (b).

Mentions: On May 10, 2013, a plastic stent was inserted by endoscopic retrograde cholangiopancreatography at the Springfield Memorial Hospital, Springfield, Ill., USA. A positron emission tomography (PET) CT scan on May 17 confirmed the results of the previous scan and showed abnormal uptake in the pancreatic head, with a standardized uptake value of 11.5 (fig. 1a). Further uptake in the left lower nodule and the appearance of small, noncalcified nodules suggested metastatic disease. The mesenteric lymph nodes were slightly enlarged. At this time, the carbohydrate antigen (CA) 19-9 level was elevated at 7,925 IU/ml (normal value 0–34 IU/ml).


A Near-Complete Response to Treatment with Gemcitabine plus nab (®)-Paclitaxel in a Patient with Metastatic Pancreatic Cancer and Poor Performance Status: A Case Report.

Shakir AR - Case Rep Oncol (2014)

PET scans prior to treatment (a) and after 2 months of gemcitabine plus nab-paclitaxel chemotherapy (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4255998&req=5

Figure 1: PET scans prior to treatment (a) and after 2 months of gemcitabine plus nab-paclitaxel chemotherapy (b).
Mentions: On May 10, 2013, a plastic stent was inserted by endoscopic retrograde cholangiopancreatography at the Springfield Memorial Hospital, Springfield, Ill., USA. A positron emission tomography (PET) CT scan on May 17 confirmed the results of the previous scan and showed abnormal uptake in the pancreatic head, with a standardized uptake value of 11.5 (fig. 1a). Further uptake in the left lower nodule and the appearance of small, noncalcified nodules suggested metastatic disease. The mesenteric lymph nodes were slightly enlarged. At this time, the carbohydrate antigen (CA) 19-9 level was elevated at 7,925 IU/ml (normal value 0–34 IU/ml).

Bottom Line: Although her disease was well controlled with gemcitabine plus nab-paclitaxel, she died just over 11 months after diagnosis as a result of her comorbid conditions compounded by treatment-related hematologic toxicity.This case suggests that patients with metastatic pancreatic adenocarcinoma and poor PS may benefit from first-line combination therapy with gemcitabine plus nab-paclitaxel.Further study of this regimen in such patients is warranted.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology/Oncology, Sarah Bush Lincoln Regional Cancer Center, University of Illinois at Chicago, Mattoon, Ill., USA.

ABSTRACT
Patients with metastatic pancreatic adenocarcinoma and poor performance status (PS) are typically excluded from clinical trials of new systemic treatments. Due to concerns that such patients cannot tolerate the greater toxicity sometimes associated with combination chemotherapy regimens, the recommended treatment for pancreatic cancer patients with poor PS is gemcitabine monotherapy. We report the case of a 79-year-old female with pancreatic adenocarcinoma metastatic to the lungs, with multiple comorbidities and an Eastern Cooperative Oncology Group PS of 3, who achieved a rapid and prolonged objective response to gemcitabine plus nab (®)-paclitaxel. The patient received a total of 11 cycles of treatment. Although her disease was well controlled with gemcitabine plus nab-paclitaxel, she died just over 11 months after diagnosis as a result of her comorbid conditions compounded by treatment-related hematologic toxicity. This case suggests that patients with metastatic pancreatic adenocarcinoma and poor PS may benefit from first-line combination therapy with gemcitabine plus nab-paclitaxel. Further study of this regimen in such patients is warranted.

No MeSH data available.


Related in: MedlinePlus