BACKGROUND: Unresectable locally advanced pancreatic cancer (LAPC) has an extremely poor prognosis. Results of neoadjuvant (radio-)chemotherapy approaches aiming at achieving resectability are currently not satisfactory. CASE REPORT: We report the case of a 67-year-old woman with histologically confirmed pancreas carcinoma that was not resectable on first surgical exploration who achieved a well-documented complete pathological remission (pCR). The carcinoma became resectable after consecutive neoadjuvant treatment with nanoparticle albumin-bound (nab)-paclitaxel/gemcitabine and FOLFIRINOX chemotherapy regimens. CONCLUSION: This is the first reported LAPC case in which neoadjuvant chemotherapy alone has been shown to lead to demonstrated pCR. CA19-9 levels, but not imaging criteria, were useful for response prediction and timing of the Whipple's procedure. The findings in this case suggest possible conceptual changes in the treatment approach for LAPC, and indicate that the new effective chemotherapy regimens should be integrated into clinical trials for LAPC.
BACKGROUND: Unresectable locally advanced pancreatic cancer (LAPC) has an extremely poor prognosis. Results of neoadjuvant (radio-)chemotherapy approaches aiming at achieving resectability are currently not satisfactory. CASE REPORT: We report the case of a 67-year-old woman with histologically confirmed pancreas carcinoma that was not resectable on first surgical exploration who achieved a well-documented complete pathological remission (pCR). The carcinoma became resectable after consecutive neoadjuvant treatment with nanoparticle albumin-bound (nab)-paclitaxel/gemcitabine and FOLFIRINOX chemotherapy regimens. CONCLUSION: This is the first reported LAPC case in which neoadjuvant chemotherapy alone has been shown to lead to demonstrated pCR. CA19-9 levels, but not imaging criteria, were useful for response prediction and timing of the Whipple's procedure. The findings in this case suggest possible conceptual changes in the treatment approach for LAPC, and indicate that the new effective chemotherapy regimens should be integrated into clinical trials for LAPC.
Authors: Jordan M Cloyd; Huamin Wang; Michael E Egger; Ching-Wei D Tzeng; Laura R Prakash; Anirban Maitra; Gauri R Varadhachary; Rachna Shroff; Milind Javle; David Fogelman; Robert A Wolff; Michael J Overman; Eugene J Koay; Prajnan Das; Joseph M Herman; Michael P Kim; Jean-Nicolas Vauthey; Thomas A Aloia; Jason B Fleming; Jeffrey E Lee; Matthew H G Katz Journal: JAMA Surg Date: 2017-11-01 Impact factor: 14.766
Authors: Andreas Minh Luu; Torsten Herzog; Philipp Hoehn; Anke Reinacher-Schick; Johanna Munding; Waldemar Uhl; Chris Braumann Journal: J Gastrointest Oncol Date: 2018-04
Authors: Andreas Minh Luu; Philipp Hoehn; Sina Rabea Vogel; Anke Reinacher-Schick; Johanna Munding; Waldemar Uhl; Chris Braumann Journal: Visc Med Date: 2019-04-03