title: Poorly differentiated endocrine carcinoma of the pancreas responded to gemcitabine: Case report.
abstract: Poorly differentiated endocrine carcinoma (PDEC) of the pancreas is a rare and aggressive tumor. First-line treatment is commonly a combination of etoposide and cisplatin, but there is no consensus regarding further treatment recommendations. In this report, we describe a case of pancreatic PDEC treated with gemcitabine as third-line chemotherapy. A 62-year-old man with pancreatic PDEC was administered etoposide plus cisplatin as first-line treatment; he then received irinotecan for tumor relapse. However, because irinotecan induced ileus in this patient, we chose gemcitabine as third-line chemotherapy. After two cycles of gemcitabine (1000 mg/m(2) on days 1, 8 and 15 every 4 wk), a partial tumor response was noted by computed tomography (approximately 68% reduction in tumor size). Our patient survived for 15 mo after diagnosis. This is a rare case of unresectable pancreatic PDEC, which showed a partial response to gemcitabine after the failure of two other regimens. Gemcitabine could be an effective treatment option for pancreatic PDEC that is resistant to other treatments.
authors.affiliation: Department of Gastroenterology and Hepatology, National Hospital Organization, Osaka National Hospital, Chuo-ku, Osaka City, Osaka 540-0006, Japan. nakazuru@onh.go.jp
authors.forename: Shoichi
authors.initials: S
authors.lastname: Nakazuru
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yoshio
authors.forename: Shigeki
authors.initials: S
authors.lastname: Suemura
authors.forename: Mari
authors.initials: M
authors.lastname: Itoh
authors.forename: Manabu
authors.initials: M
authors.lastname: Araki
authors.forename: Chiaki
authors.initials: C
authors.lastname: Yoshioka
authors.forename: Makiyo
authors.initials: M
authors.lastname: Ohta
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sueyoshi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohta
authors.forename: Hiroko
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Kaori
authors.initials: K
authors.lastname: Morita
authors.forename: Takashi
authors.initials: T
authors.lastname: Toyama
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kuzushita
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kodama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mano
authors.forename: Eiji
authors.initials: E
authors.lastname: Mita
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000009:adverse effects / Q000031:analogs & derivatives; D002454:Cell Differentiation; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D004701:Endocrine Gland Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D045823:Ileus / Q000139:chemically induced; D000077146:Irinotecan; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D003841:Deoxycytidine; D005047:Etoposide; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin; D000093542:Gemcitabine