Chemotherapy for Metastatic Pancreatic Cancer
Chemotherapy for Metastatic Pancreatic Cancer
March 2016
- A 63-year-old Caucasian male was admitted to the hospital from the emergency room with symptoms of epigastric pain that radiated toward the back, abdominal distention, vomiting, and jaundice
- Laboratory tests:
- Bilirubin and liver enzymes; elevated
- CBC values WNL
- Hepatitis B, & C testing, negative
- CEA: 34.2 ng/mL; CA 19-9 > 12000 U/mL
- Performance status, 1
- CT reveals 3.5 cm × 3.7 cm mass in the head of the pancreas and multiple liver nodules; also, indicates an obstruction of the bile duct
- Ultrasound-guided percutaneous needle biopsy of a liver metastases shows adenocarcinoma histology
- The patient undergoes biliary stent placement based on endoscopic retrograde cholangiopancreatogram (ERCP) findings
- Diagnosis: stage IV pancreatic cancer with liver metastasis
- The patient was started with treatment on gemcitabine andnab-paclitaxel
- CT with contrast after two treatment cycles showed marked shrinkage of the pancreatic lesion and liver nodules.
- CT after 6 cycles showed stable disease
November 2016
- The patient reports symptoms of rapid weight loss, abdominal pain, dark urine, and jaundice; he has declining functional status and is often bedridden
- Systemic therapy is under consideration
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