Long-term progression-free survival in a metastatic pancreatic cancer patient treated with first-line nab-paclitaxel and gemcitabine.
BACKGROUND
Prognosis of patients with metastatic pancreatic cancer is dismal. Recently, two first-line combination chemotherapy regimens have shown a survival benefit over single-agent gemcitabine.


METHODS
A 57-year old metastatic pancreatic cancer patient from our department (Eastern Cooperative Oncology Group performance status (ECOG PS): 0, baseline carbohydrate antigen (CA) 19-9 level: 2,900 U/ml) received 12 cycles of first-line chemotherapy with nab-paclitaxel and gemcitabine until disease progression within the pivotal Metastatic Pancreatic Adenocarcinoma Clinical Trial (MPACT).


RESULTS
Treatment with nab-paclitaxel and gemcitabine resulted in a partial response by Response Evaluation Criteria in Solid Tumors (RECIST), a rapid biochemical CA 19-9 response, a progression-free survival of 13 months and an overall survival of 20 months. Leukopenia grade 3 prompted dose reduction by two dose levels. Non-hematological toxicities included alopecia, skin rash, nail changes and peripheral neuropathy (all grade 2 or less).


CONCLUSIONS
First-line combination chemotherapy with nab-paclitaxel and gemcitabine is an effective and manageable treatment option for patients with metastatic pancreatic cancer with the potential for long-term disease control.
Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany stefan.boeck@med.uni-muenchen.de.
Stefan
S
Boeck
Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany.
Michael
M
Haas
Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany.
Stephan
S
Kruger
Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany.
Volker
V
Heinemann
D000418:Albumins / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018395:CA-19-9 Antigen / Q000097:blood; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017239:Paclitaxel / Q000008:administration & dosage; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000093542:Gemcitabine
C520255:130-nm albumin-bound paclitaxel; D000418:Albumins; D018395:CA-19-9 Antigen; D003841:Deoxycytidine; D017239:Paclitaxel; D000093542:Gemcitabine
Chemotherapy; gemcitabine; nab-paclitaxel; pancreatic cancer