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Metastatic pancreatic cancer with complete response to FOLFIRINOX treatment
  1. Paige T Shelemey1,
  2. Carla P Amaro2,
  3. Danny Ng3,
  4. Vincent Falck4 and
  5. Vincent C Tam2
  1. 1Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
  2. 2Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada
  3. 3Radiology, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada
  4. 4Pathology and Laboratory Medicine, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada
  1. Correspondence to Dr Vincent C Tam; vincent.tam{at}albertahealthservices.ca

Abstract

A 59-year-old woman presented with abdominal pain associated with nausea and night sweats. A large mass was found in the pancreatic tail and innumerable liver lesions were identified. Ultrasound-guided biopsy of a liver nodule confirmed moderately differentiated adenocarcinoma consistent with a pancreatobiliary primary. On FOLFIRINOX chemotherapy, subsequent CT scans showed shrinkage of the pancreatic mass and liver metastases. Her cancer antigen 19-9 (CA 19-9) normalised after 11 months. Oxaliplatin was discontinued due to peripheral neuropathy but she completed 37 cycles of FOLFIRI during which her pancreatic mass disappeared, liver lesions decreased in size and were subsequently deemed to be scar tissue by the radiologist. After 4 years of treatment, the patient agreed to a break from chemotherapy. Eighteen months afterwards, an MRI abdomen continues to demonstrate no visible pancreatic mass and the two remaining liver lesions, believed to be scar tissue, remain stable. Her CA 19-9 level remains normal. This appears to be a complete response to FOLFIRINOX/FOLFIRI chemotherapy in a patient with metastatic pancreatic cancer.

  • oncology
  • pancreatic cancer
  • cancer intervention
  • chemotherapy

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Footnotes

  • Contributors Each of the authors has contributed in the following ways. PTS: Planning, conception and design, acquisition and interpretation of data, drafting the manuscript, editing and revising the manuscript (primary author). CPA: Planning, acquisition/interpretation of data, editing and revising the manuscript. DN: Acquisition and analysis/interpretation of data, revising and editing the manuscript. VF: Acquisition and analysis/interpretation of data, revising and editing the manuscript. VCT: Planning, conception, interpretation of data, revising and editing of the manuscript (corresponding author). All authors have approved of the final version of the manuscript and agree to be accountable for the article and agreed to thoroughly investigate and resolve any questions regarding accuracy or integrity of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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