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Japanese Journal of Clinical Oncology 2007 37(12):973; doi:10.1093/jjco/hym146
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© The Author (2008). Published by Oxford University Press. All rights reserved

A Case of Gemcitabine-refractory Pancreatic Cancer Responsive to Second-line Chemotherapy Using S-1

Chigusa Morizane

Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, Tokyo, Japan

A 63-year-old man was referred to our institute for the treatment of a pancreatic tumor. Diagnostic imaging and histological findings yielded a definitive diagnosis of pancreatic cancer with a liver metastasis (Fig. 1). Systemic administration of gemcitabine (GEM) was started as the first-line chemotherapy, and the best tumor response was no change. Two months after the initiation of the treatment, the patient developed obstructive jaundice and duodenal bleeding (oozing) as a result of tumor progression. Following percutaneous transhepatic biliary drainage, second-line chemotherapy was started using S-1. Thereafter, a tumor regression was achieved (best tumor response was partial response: Fig. 2) and the gastrointestinal bleeding was stopped. Finally, progression of the disease was confirmed by CT scan ~9.5 months after the start of the second-line chemotherapy, and a favorable quality of life was maintained until the withdrawal of this treatment. GEM monotherapy or GEM-containing chemotherapy has become the standard first-line therapy for advanced pancreatic cancer. However, no standard treatment regimen is available for GEM-refractory disease and there have been only a few patients in whom some benefits have been obtained by the second-line treatment, as in our present case.


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This Article
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