Advancing Outcomes in Metastatic Pancreatic Cancer
Advancing Outcomes in Metastatic Pancreatic Cancer
A 57-Year-Old Man With Abdominal Pain and Unexplained Weight Loss
- A 57-year-old man was referred from his primary care clinician with complaints of persistent pain in his upper abdomen that radiate to his back
- History
- Former smoker (35 years, quit 5 years ago)
- Was obese (BMI 29.0), but began losing weight despite not changing his eating habits
- Reports feeling “tired” despite regular sleep habits
- Treated for DVT 8 months ago
- Hypertension controlled on medication, impaired glucose tolerance
- Family history: mother alive with type 2 diabetes, father died (MI)
- Clinical evaluation
- CT reveals mass in head of pancreas with metastases in liver and blood vessels
- CA19-9 level: 55 times upper limit of normal
- ECOG PS: 1
- Diagnosis: unresectable metastatic pancreatic cancer
- Patient began treatment with IV nab-paclitaxel (125 mg/m2) plus IV gemcitabine (1000 mg/m2) on days 1, 8 and 15 of a 28-day cycle
- Experienced grade 3 neutropenia; did not require growth factors
- Had mild peripheral neuropathy that did not progress or require dose adjustment
- At 6 months, patient progressed and received second-line treatment with liposomal irinotecan in combination with 5-FU/LV
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