Molecular profiling of a case of advanced pancreatic cancer identifies an active and tolerable combination of targeted therapy with backbone chemotherapy

Benny Johnson, Vanderwalde Ari, Nader Javadi, Rebecca Feldman, Sandeep Bobby Reddy

Research output: Contribution to journalArticle

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Abstract

Typical survival with common 1st-line regimens for pancreatic cancer range from 6-11 months. We report a case of a patient with stage IVB pancreatic adenocarcinoma treated with gemcitabine and erlotinib who stopped therapy after 3 months without achieving a response due to intolerance. To decide upon additional treatment options, molecular analysis was performed on liver metastasis which revealed KRAS, FBXW7, APC, and ATM mutations, with thymidylate synthase (TS) negativity and PD-1 positivity. Based on this profile of TS negativity and ATM mutation, a combination strategy was devised consisting of capecitabine, oxaliplatin, bevacizumab and vorinostat. The patient had a near complete response to therapy with this regimen. In refractory metastatic pancreatic cancer, responses of this magnitude are rarely seen. To our knowledge, this represents the first demonstrated activity of this combination in the metastatic setting which could prompt further investigation of its use in large scale clinical trials.

Original languageEnglish (US)
Pages (from-to)E6-E12
JournalJournal of Gastrointestinal Oncology
Volume7
Issue number2
DOIs
StatePublished - Apr 1 2016

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Pancreatic Neoplasms
Thymidylate Synthase
oxaliplatin
gemcitabine
Drug Therapy
Mutation
Adenocarcinoma
Therapeutics
Clinical Trials
Neoplasm Metastasis
Survival
Liver

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology

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Molecular profiling of a case of advanced pancreatic cancer identifies an active and tolerable combination of targeted therapy with backbone chemotherapy. / Johnson, Benny; Ari, Vanderwalde; Javadi, Nader; Feldman, Rebecca; Reddy, Sandeep Bobby.

In: Journal of Gastrointestinal Oncology, Vol. 7, No. 2, 01.04.2016, p. E6-E12.

Research output: Contribution to journalArticle

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