Nab‑paclitaxel plus gemcitabine as first‑line palliative chemotherapy in a patient with metastatic pancreatic cancer with Eastern Cooperative Oncology Group performance status of 2

Muñoz Martín,Andrés J.; García Alfonso,Pilar; Rupérez,Ana B.; Martín Jiménez,Miguel

doi:10.3892/ol.2016.4667

Nab‑paclitaxel plus gemcitabine as first‑line palliative chemotherapy in a patient with metastatic pancreatic cancer with Eastern Cooperative Oncology Group performance status of 2

Authors:
- Andrés J. Muñoz Martín
- Pilar García Alfonso
- Ana B. Rupérez
- Miguel Martín Jiménez
View Affiliations

Affiliations: Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Madrid 28007, Spain
Published online on: June 1, 2016 https://doi.org/10.3892/ol.2016.4667
Pages: 727-730

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Metastatic pancreatic cancer (PC) has been associated with a considerably poor prognosis. Due to its toxicity, first‑line combination chemotherapy is limited to patients with a good performance status (PS). Previously nab‑paclitaxel plus gemcitabine has been demonstrated to improve the overall survival rate in patients with advanced pancreatic cancer with a good PS. The present study reports a case of a patient with metastatic PC with a poor PS (Eastern Cooperative Oncology Group 2) and a complex set of comorbidities treated with nab‑paclitaxel plus gemcitabine as a first‑line palliative therapy. Adjusted doses of nab‑paclitaxel plus gemcitabine reached a favourable clinical, radiological and biochemical response in the present patient, which increased the quality of life for the patient. Eventually, the patient succumbed to acute cholangitis. Based on the results of the present study, nab‑paclitaxel plus gemcitabine appears to be a favourable treatment as first‑line palliative chemotherapy for patients with metastatic PC, comorbidities and poor PS.

View Figures

View References

1	American Cancer Society: Cancer Facts & Figures. American Cancer Society. Atlanta, GA: 2014.
2	Malvezzi M, Bertuccio P, Levi F, La Vecchia C and Negri E: European cancer mortality predictions for the year 2013. Ann Oncol. 24:792–800. 2013. View Article : Google Scholar : PubMed/NCBI
3	Neoptolemos JP, Dunn JA, Stocken D, Almond J, Link K, Beger H, Bassi C, Falconi M, Pederzoli P, Dervenis C, et al: Adjuvant chemoradiotherapy and chemotherapy in resectable pancreatic cancer: A randomised controlled trial. Lancet. 358:1576–1585. 2001. View Article : Google Scholar : PubMed/NCBI
4	Vincent A, Herman J, Schulick R, Hruban RH and Goggins M: Pancreatic cancer. Lancet. 378:607–620. 2011. View Article : Google Scholar : PubMed/NCBI
5	Adsay NV, Basturk O, Cheng JD and Andea AA: Ductal neoplasia of the pancreas: nosologic, clinicopathologic, and biologic aspects. Semin Radiat Oncol. 15:254–264. 2005. View Article : Google Scholar : PubMed/NCBI
6	Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP and Talamonti MS: National failure to operate on early stage pancreatic cancer. Ann Surg. 246:173–180. 2007. View Article : Google Scholar : PubMed/NCBI
7	Von Hoff DD, Ervin T, Arena FP, et al: Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 369:1691–1703. 2013. View Article : Google Scholar : PubMed/NCBI
8	Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, et al: Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 5:649–655. 1982. View Article : Google Scholar : PubMed/NCBI
9	Ferrone CR, Finkelstein DM, Thayer SP, Muzikansky A, Fernandez-delCastillo C and Warshaw AL: Perioperative CA19-9 levels can predict stage and survival in patients with resectable pancreatic adenocarcinoma. J Clin Oncol. 24:2897–2902. 2006. View Article : Google Scholar : PubMed/NCBI
10	Sobin LH, Gospodarowicz MK and Wittekind C: TNM Classification of Malignant Tumours (7th). Wiley-Blackwell. Hoboken, NJ, USA: 3241–3244. 2009.
11	Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 92:205–216. 2009. View Article : Google Scholar
12	Borad MJ, Saadati H, Lakshmipathy A, Campbell E, Hopper P, Jameson G, Von Hoff DD and Saif MW: Skeletal metastases in pancreatic cancer: A retrospective study and review of the literature. Yale J Biol Med. 82:1–6. 2009.PubMed/NCBI
13	Burris HA 3rd, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, et al: Improvements in survival and clinical benefit with gencitabine as first-line therapy for patients with advanced pancreas cancer: A randomized trial. J Clin Oncol. 15:2403–2413. 2007.
14	Moore MJ, Goldstein D, Hamm J, Figer A, Hecht JR, Gallinger S, Au HJ, Murawa P, Walde D, Wolff RA, et al: Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: A phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 25:1960–1966. 2007. View Article : Google Scholar : PubMed/NCBI
15	Conroy T, Desseigne F, Ychou M, Bouché O, Guimbaud R, Bécouarn Y, Adenis A, Raoul JL, Gourgou-Bourgade S, de la Fouchardière C, et al: FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 364:1817–1825. 2011. View Article : Google Scholar : PubMed/NCBI
16	Buccheri G, Ferrigno D and Tamburini M: Karnofsky and ECOG performance status scoring in lung cancer: A prospective, longitudinal study of 536 patients from a single institution. Eur J Cancer. 32A:1135–1141. 1996. View Article : Google Scholar : PubMed/NCBI
17	Shakir AR: 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. Case Rep Oncol. 7:711–717. 2014. View Article : Google Scholar : PubMed/NCBI
18	Guillen-Ponce C, López R, Macarulla T, Rivera F, Cubillo A, Carrato A, et al: A phase I/II trial to evaluate the efficacy and safety of nab-paclitaxel in combination with gemcitabine for the treatment of frail patients with advanced or metastatic pancreatic cancer: Safety results of the Phase I trial. Ann Oncol. 25(suppl 4): iv2382014.