Akhoundova Sanoyan Dilara, Reiner Cäcilia S, Papageorgiou Panagiota, Siebenhüner Alexander R
Department of Medical Oncology and Hematology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Institute for Diagnostic and Interventional Radiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Case Rep Oncol. 2020 Feb 6;13(1):79-84. doi: 10.1159/000504471. eCollection 2020 Jan-Apr.
Pancreatic ductal adenocarcinoma (PDAC) is typically diagnosed at an advanced or metastatic stage, when curative surgery is not recommended. Therefore, the prognosis is poor for this dismal disease, with only 1-2% of the patients reaching the 5-year survival follow-up. Current advances in systemic treatment with gemcitabine regimens, specifically polychemotherapy with gemcitabine plus nab-paclitaxel or other multidrug regimens such as FOLFIRINOX in the first line, have improved disease control over time. This higher efficacy of systemic treatment enables metastatic PDAC patients to receive second-line treatment more often nowadays. Currently, there is only one regimen for second-line treatment approved by the EMA, FDA, and Swissmedic, based on the phase III NAPOLI-1 study. In this case report, we present an outstanding response to sequential treatment with gemcitabine plus nab-paclitaxel followed by second-line treatment with nal-irinotecan plus 5-fluorouracil.
胰腺导管腺癌（PDAC）通常在晚期或转移阶段被诊断出来，此时不建议进行根治性手术。因此，这种可怕疾病的预后很差，只有1%-2%的患者能达到5年生存随访。目前，吉西他滨方案的全身治疗取得了进展，特别是一线使用吉西他滨联合白蛋白结合型紫杉醇的多药化疗或其他多药方案，如FOLFIRINOX，随着时间的推移，疾病控制得到了改善。全身治疗的这种更高疗效使转移性PDAC患者如今更常接受二线治疗。目前，基于III期NAPOLI-1研究，只有一种二线治疗方案获得了欧洲药品管理局（EMA）、美国食品药品监督管理局（FDA）和瑞士药品监管局（Swissmedic）的批准。在本病例报告中，我们展示了对吉西他滨联合白蛋白结合型紫杉醇序贯治疗，随后使用纳武单抗伊立替康联合5-氟尿嘧啶进行二线治疗的显著反应。
