title: [A case of advanced pancreatic cancer with remarkable response to thalidomide, celecoxib and gemcitabine].
abstract: Advanced human pancreatic cancer is considered a chemoresistant disease. To date, no treatments have had a significant efficacy on the disease. Patients with pancreatic cancer, however, experienced an improvement in the related symptoms with gemcitabine. Thalidomide has been shown to have antiangiogenic and immunomodulatory effects, including the inhibition of vascular endothelial growth factor, basic fibroblast growth factor and tumor necrosis factor alpha. The reported biological consequences of COX-2 up-regulation include inhibition of apoptosis, increased metastatic potential and promotion of angiogenesis. These events may contribute to cell transformation and tumor progression. Antiangiogenesis represents a significant new strategy for cancer treatment; however, most tumors are biologically heterogeneous, especially in endothelial cell diversity. As vessels of most solid tumors are structurally and functionally abnormal, tumor vessels differ from normal blood vessels in their responses to antiangiogenic agents. Therefore, it is important to accept a wide range of different inhibitors, such as thalidomide and selective COX-2 inhibitors, with conventional cytotoxic agents. Here we show a case of advanced pancreatic cancer with remarkable improvement in tumor shrinkage, CA19-9, and a cessation of dirty exudate from umbilicus.
authors.affiliation: Surgical Dept., Ashitaka Hospital.
authors.forename: Masato
authors.initials: M
authors.lastname: Hada
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Mizutari
mesh_terms: D000284:Administration, Oral; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068579:Celecoxib; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D006801:Humans; D007262:Infusions, Intravenous; D007527:Isoenzymes / Q000037:antagonists & inhibitors; D008297:Male; D008565:Membrane Proteins; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D011451:Prostaglandin-Endoperoxide Synthases; D011720:Pyrazoles; D013449:Sulfonamides / Q000008:administration & dosage; D013792:Thalidomide / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D020533:Angiogenesis Inhibitors; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D011720:Pyrazoles; D013449:Sulfonamides; D003841:Deoxycytidine; D013792:Thalidomide; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D000068579:Celecoxib; D000093542:Gemcitabine