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Exceptional Response to Nanoparticle Albumin-Bound Paclitaxel and Gemcitabine in a Patient with a Refractory Adenocarcinoma of the Ampulla of Vater.
Kapp, Markus; Kosmala, Aleksander; Kircher, Stefan; Luber, Verena; Kunzmann, Volker.
Afiliación
  • Kapp M; Division of Medical Oncology, Department of Internal Medicine II, Würzburg, Germany.
  • Kosmala A; Institute of Radiology, University Hospital Würzburg, Würzburg, Germany.
  • Kircher S; Institute of Pathology, University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany.
  • Luber V; Division of Medical Oncology, Department of Internal Medicine II, Würzburg, Germany.
  • Kunzmann V; Division of Medical Oncology, Department of Internal Medicine II, Würzburg, Germany.
Case Rep Oncol ; 9(1): 15-24, 2016.
Article en En | MEDLINE | ID: mdl-26933414
Ampullary carcinoma is a rare tumor and evidence on the treatment of recurrent metastatic disease is scarce. We report the case of a 60-year-old patient with an R0-resected node-positive adenocarcinoma of the papilla of Vater of an initially diagnosed intestinal subtype who developed pulmonary metastases 2 months after adjuvant gemcitabine chemotherapy and, subsequently, liver metastases. Palliative combination chemotherapy with standard regimens for intestinal-type adenocarcinoma (FOLFOX and FOLFIRI) failed. However, subsequent combination chemotherapy with nanoparticle albumin-bound paclitaxel and gemcitabine, a regimen with proven efficacy in metastatic adenocarcinoma of the pancreas, resulted in a durable, very good partial remission. Treatment was manageable and well tolerated. Primary tumor and metastatic tissue were reassessed by immunohistochemistry and had to be reclassified to a mixed phenotype containing predominant elements of the pancreatobiliary subtype. Our case suggests that combination chemotherapy with nanoparticle albumin-bound paclitaxel and gemcitabine could represent a promising option for the treatment of this rare disease and warrants further investigation within controlled clinical trials. Moreover, thorough characterization of ampullary carcinomas by histomorphology and additional immunohistochemistry should become mandatory in order to start a chemotherapeutic regimen tailored for the definitive subtype.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Case Rep Oncol Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Case Rep Oncol Año: 2016 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza