12018
2014
eng
648-55
3
7
article
1
2015-10-13
--
--
Intensified neoadjuvant chemotherapy with nab-paclitaxel plus gemcitabine followed by FOLFIRINOX in a patient with locally advanced unresectable pancreatic cancer
The prognosis of patients with locally advanced pancreatic cancer can be improved if secondary complete (R0) resection is possible. In patients initially staged as unresectable this may be achieved with neoadjuvant treatment which is usually chemoradiotherapy based. We report the case of a 46-year-old patient with an unresectable, locally advanced pancreatic cancer (pT4 Nx cM0 G2) who was treated with a sequential neoadjuvant chemotherapy regimen consisting of 2 cycles of nab-paclitaxel plus gemcitabine followed by 4 cycles of FOLFIRINOX. Neoadjuvant chemotherapy resulted in secondary resectability (R0 resection). After 2 cycles of nab-paclitaxel plus gemcitabine, the patient already had a complete metabolic remission as measured by integrated fludeoxyglucose ((18)F) positron emission tomography and computerized tomography. After a follow-up of 18 months the patient is alive without progression of disease. We propose to assess the clinical benefit of sequencing the combinations nab-paclitaxel plus gemcitabine and FOLFIRINOX as neoadjuvant therapy for patients with locally advanced and initially unresectable pancreatic cancer in a controlled clinical trial.
Case Reports in Oncology
10.1159/000367966
1662-6575
25408659
urn:nbn:de:bvb:20-opus-120189
Case Reports in Oncology 2014;7:648–655 DOI: 10.1159/000367966
Volker Kunzmann
Ken Herrmann
Christina Bluemel
Markus Kapp
Ingo Hartlapp
Ulrich Steger
eng
uncontrolled
nab-paclitaxel
eng
uncontrolled
neoadjuvant chemotherapy
eng
uncontrolled
oxaliplatin
eng
uncontrolled
pancreatic cancer
eng
uncontrolled
locally advanced disease
eng
uncontrolled
irinotecan
eng
uncontrolled
gemcitabine
eng
uncontrolled
folinic acid
eng
uncontrolled
5-Fluorouracil
Krankheiten
open_access
Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I)
Klinik und Poliklinik für Nuklearmedizin
Medizinische Klinik und Poliklinik II
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/12018/080_Kunzemann_Case_Rep._Oncol.pdf
16835
2016
eng
15-24
1
9
article
1
2018-09-19
--
--
Exceptional Response to Nanoparticle Albumin-Bound Paclitaxel and Gemcitabine in a Patient with a Refractory Adenocarcinoma of the Ampulla of Vater
Ampullary carcinoma is a rare tumor and evidence on the treatment of recurrent metastatic disease is scarce. We report the case of a 60-year-old patient with an R0-resected node-positive adenocarcinoma of the papilla of Vater of an initially diagnosed intestinal subtype who developed pulmonary metastases 2 months after adjuvant gemcitabine chemotherapy and, subsequently, liver metastases. Palliative combination chemotherapy with standard regimens for intestinal-type adenocarcinoma (FOLFOX and FOLFIRI) failed. However, subsequent combination chemotherapy with nanoparticle albumin-bound paclitaxel and gemcitabine, a regimen with proven efficacy in metastatic adenocarcinoma of the pancreas, resulted in a durable, very good partial remission. Treatment was manageable and well tolerated. Primary tumor and metastatic tissue were reassessed by immunohistochemistry and had to be reclassified to a mixed phenotype containing predominant elements of the pancreatobiliary subtype. Our case suggests that combination chemotherapy with nanoparticle albumin-bound paclitaxel and gemcitabine could represent a promising option for the treatment of this rare disease and warrants further investigation within controlled clinical trials. Moreover, thorough characterization of ampullary carcinomas by histomorphology and additional immunohistochemistry should become mandatory in order to start a chemotherapeutic regimen tailored for the definitive subtype.
Case Reports in Oncology
10.1159/000443304
urn:nbn:de:bvb:20-opus-168358
Case Reports in Oncology 2016, 9(1), 15-24. DOI: 10.1159/000443304
false
true
CC BY-NC: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell 4.0 International
Markus Kapp
Aleksander Kosmala
Stefan Kircher
Verena Luber
Volker Kunzmann
eng
uncontrolled
adenocarcinoma of the ampulla of Vater
eng
uncontrolled
intestinal-type adenocarcinoma
eng
uncontrolled
pancreatobiliary type
eng
uncontrolled
FOLFOX
eng
uncontrolled
FOLFIRI
eng
uncontrolled
gemcitabine
eng
uncontrolled
nanoparticle albumin-bound paclitaxel
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik II
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/16835/Kapp_Case_Reports_in_Oncology.pdf