Recurrence of pancreatic ductal adenocarcinoma after complete histopathological remission caused by FOLFIRINOX
- We previously reported 2 cases of pathologic complete response (pCR) of a pancreatic cancer (PC) following neoadjuvant FOLFIRINOX treatment. We now complete our report by a follow-up on both patients. Patient 1 achieved a disease-free survival of 12 months after initial resection until she developed a singular hepatic metastasis. Treatment by FOLFIRINOX and complete removal of the metastasis by atypical liver resection after 6 months allowed for another 12 months of disease control. After intra-abdominal tumor recurrence and development of intracerebral metastases, the patient died 34 months after primary diagnosis. Patient 2 developed hepatic tumor recurrence only 3 months after initial resection. However, treatment by FOLFIRINOX led to a stable disease for 27 months after resection and was followed by atypical liver resection of multiple segments. Six months later, another hepatic recurrence was suspected. Via next-generation sequencing (NGS) of the tumor genome, a deleterious mutation in the ataxia telangiectasia-mutated (\(\it ATM\)) gene, causing a \(\it BRCA\)ness, was detected. After initial treatment by FOLFOX, maintenance therapy with the poly-ADP-ribose-polymerase (PARP) inhibitor olaparib was initiated. The patient is now alive for 54 months after initial diagnosis of metastasized pancreatic adenocarcinoma. Tumor recurrence is possible even after pCR of PC and remains challenging. In case of multifocal tumor recurrence, chemotherapy remains the standard treatment. Recently, genetic sequencing allows individualized treatments. In selected cases, highly specialized teams can offer a variety of therapeutic options leading to previously unseen clinical courses.
Author: | Philipp HöhnORCiDGND, Chris BraumannORCiDGND, Stefanie Nöpel-DünnebackeORCiDGND, Johanna Barbara MundingGND, Waldemar UhlORCiDGND, Andreas Minh LuuORCiDGND |
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URN: | urn:nbn:de:hbz:294-93379 |
DOI: | https://doi.org/10.1159/000509231 |
Parent Title (English): | Visceral medicine |
Publisher: | Karger |
Place of publication: | Basel |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2022/10/13 |
Date of first Publication: | 2020/07/31 |
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
Tag: | Complete response; FOLFIRINOX; Liver resection; Olaparib; Pancreatic cancer |
Volume: | 37 |
Issue: | 2 |
First Page: | 149 |
Last Page: | 153 |
Note: | Dieser Beitrag ist aufgrund einer nationalen Lizenz frei zugänglich. |
Institutes/Facilities: | Institut für Pathologie |
St. Josef-Hospital Bochum, Klinik für Allgemein- und Viszeralchirurgie | |
St. Josef-Hospital Bochum, Medizinischen Klinik I, Abteilung für Hämatologie, Onkologie und Palliativmedizin | |
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
open_access (DINI-Set): | open_access |
Licence (German): | Nationale Lizenz |