A Case of Locally Advanced Pancreatic Cancer in which GEM+nab-PTX Therapy Achived Pathological Complete Response

Abstract

A 60-year-old woman who had locally advanced borderline resectable pancreatic cancer associated with extensive portal vein invasion was determined not to be a candidate for reconstruction of portal veins. Consequently, she underwent 12 cycles of gemcitabine+nab-paclitaxel therapy followed by 23 cycles of gemcitabine therapy. In an early time after initiation of the chemotherapy, abnormally high tumor marker levels were normalized and the size of the primary tumor was significantly reduced. Since the primary tumor had become obscure and the tumor marker levels were kept within normal ranges for a long time, she underwent subtotal stomach-preserving pancreatic duodenectomy. Histopathological findings revealed fibrosis covering a wide range of the specimen and absence of tumor cells, and she was diagnosed to have achieved pathological complete response. She received adjuvant chemotherapy with S-1 monotherapy for 6 months, and she has been alive without recurrence as of 8 months after the operation.