Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma, When Surgery Could Represent a Therapeutic Option

Metastatic pancreatic ductal adenocarcinoma (PDAC) is characterized by poor prognosis and short survival. Today, the use of new polytherapeutic regimens increases clinical outcome of these patients opening new clinical scenario. A crucial issue related to the actual improvement achieved with these n...

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Main Authors: Antonella Argentiero, Angela Calabrese, Angela Monica Sciacovelli, Sabina Delcuratolo, Antonio Giovanni Solimando, Oronzo Brunetti
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Canadian Journal of Gastroenterology and Hepatology
Online Access:http://dx.doi.org/10.1155/2020/8679751
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author Antonella Argentiero
Angela Calabrese
Angela Monica Sciacovelli
Sabina Delcuratolo
Antonio Giovanni Solimando
Oronzo Brunetti
author_facet Antonella Argentiero
Angela Calabrese
Angela Monica Sciacovelli
Sabina Delcuratolo
Antonio Giovanni Solimando
Oronzo Brunetti
author_sort Antonella Argentiero
collection DOAJ
description Metastatic pancreatic ductal adenocarcinoma (PDAC) is characterized by poor prognosis and short survival. Today, the use of new polytherapeutic regimens increases clinical outcome of these patients opening new clinical scenario. A crucial issue related to the actual improvement achieved with these new regimens is represented by the occasional possibility to observe a radiological complete response of metastatic lesions in patients with synchronous primary tumor. What could be the best therapeutic management of these patients? Could surgery represent an indication? Herein, we reported a case of a patient with PDAC of the head with multiple liver metastases, who underwent first-line chemotherapy with mFOLFIRINOX. After 10 cycles, he achieved a complete radiological response of liver metastases and a partial response of pancreatic lesion. A duodenocephalopancreasectomy was performed. Due to liver a lung metastases after 8 months from surgery, a second-line therapy was started with a disease-free survival and overall survival of 8 months and 45 months, respectively. Improvement in the molecular characterization of PDAC could help in the selection of patients suitable for multimodal treatments. This trial is registered with NCT02892305 and NCT00855634.
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institution Kabale University
issn 2291-2789
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language English
publishDate 2020-01-01
publisher Wiley
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series Canadian Journal of Gastroenterology and Hepatology
spelling doaj-art-0c1697315a4b4e3a9d6cffc36baf21f92025-08-20T03:54:19ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972020-01-01202010.1155/2020/86797518679751Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma, When Surgery Could Represent a Therapeutic OptionAntonella Argentiero0Angela Calabrese1Angela Monica Sciacovelli2Sabina Delcuratolo3Antonio Giovanni Solimando4Oronzo Brunetti5Medical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, ItalyRadiology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, ItalyMedical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, ItalyMedical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, ItalyMedical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, ItalyMedical Oncology Unit, IRCCS Istituto Tumori “Giovanni Paolo II”, Bari, ItalyMetastatic pancreatic ductal adenocarcinoma (PDAC) is characterized by poor prognosis and short survival. Today, the use of new polytherapeutic regimens increases clinical outcome of these patients opening new clinical scenario. A crucial issue related to the actual improvement achieved with these new regimens is represented by the occasional possibility to observe a radiological complete response of metastatic lesions in patients with synchronous primary tumor. What could be the best therapeutic management of these patients? Could surgery represent an indication? Herein, we reported a case of a patient with PDAC of the head with multiple liver metastases, who underwent first-line chemotherapy with mFOLFIRINOX. After 10 cycles, he achieved a complete radiological response of liver metastases and a partial response of pancreatic lesion. A duodenocephalopancreasectomy was performed. Due to liver a lung metastases after 8 months from surgery, a second-line therapy was started with a disease-free survival and overall survival of 8 months and 45 months, respectively. Improvement in the molecular characterization of PDAC could help in the selection of patients suitable for multimodal treatments. This trial is registered with NCT02892305 and NCT00855634.http://dx.doi.org/10.1155/2020/8679751
spellingShingle Antonella Argentiero
Angela Calabrese
Angela Monica Sciacovelli
Sabina Delcuratolo
Antonio Giovanni Solimando
Oronzo Brunetti
Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma, When Surgery Could Represent a Therapeutic Option
Canadian Journal of Gastroenterology and Hepatology
title Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma, When Surgery Could Represent a Therapeutic Option
title_full Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma, When Surgery Could Represent a Therapeutic Option
title_fullStr Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma, When Surgery Could Represent a Therapeutic Option
title_full_unstemmed Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma, When Surgery Could Represent a Therapeutic Option
title_short Complete Response of Synchronous Liver Metastasis in a Pancreatic Ductal Adenocarcinoma, When Surgery Could Represent a Therapeutic Option
title_sort complete response of synchronous liver metastasis in a pancreatic ductal adenocarcinoma when surgery could represent a therapeutic option
url http://dx.doi.org/10.1155/2020/8679751
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