Combination chemotherapy with gemcitabine and nab-paclitaxel for a metastatic pancreatic ductal adenocarcinoma patient undergoing hemodialysis.

Abstract

In cancer patients, impairment of kidney function is not uncommon. Recently, the efficacy of the combination of gemcitabine and nab-paclitaxel for pancreatic ductal adenocarcinoma (PDAC) patients has been reported, however, there is no recommendation for dose and administration to patients undergoing hemodialysis (HD). A 66-year-old man began receiving HD for chronic renal failure 4 years previously. He suffered from diarrhea, back pain, and loss of appetite, and his weight gradually decreased. Abdominal dynamic computed tomography showed a 45-mm hypodense mass in the pancreatic body and a 30-mm hypodense mass in the liver. The patient was diagnosed with metastatic PDAC. He started combination chemotherapy of gemcitabine and nab-paclitaxel without dose modification. He developed pneumonia and neutropenia in the first and second courses, so we modified to a 60% dose of gemcitabine and nab-paclitaxel on day 1 every 2 weeks. After dose modification, he continued combination chemotherapy for over 7 months without severe adverse events or tumor progression. Combination chemotherapy using gemcitabine and nab-paclitaxel was effective in a PDAC patient undergoing HD. While it is possible to originally administer these drugs with no dose modification, early dose modification was needed for our patient because of severe adverse events.

• Authors: Takashi Kaneko, Kazuya Sugimori, Yuichiro Tozuka, Taito Fukushima, Kazuya Okada, Hiroyuki Oka, Hiroshi Okazaki, Shin Maeda
• Journal: Clinical journal of gastroenterology (Clin J Gastroenterol) Vol. 12 Issue 5 Pg. 484-489 (Oct 2019) ISSN: 1865-7265 [Electronic] Japan
• PMID: 30993653 (Publication Type: Case Reports, Journal Article)

Chemical References

• 130-nm albumin-bound paclitaxel
• Albumins
• Deoxycytidine
• Paclitaxel
• Gemcitabine

Topics

• Aged
• Albumins (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Pancreatic Ductal (diagnostic imaging, drug therapy)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Fatal Outcome
• Humans
• Kidney Failure, Chronic (therapy)
• Liver Neoplasms (diagnostic imaging, drug therapy, secondary)
• Male
• Paclitaxel (administration & dosage)
• Pancreatic Neoplasms (diagnostic imaging, drug therapy)
• Peritoneal Dialysis
• Tomography, X-Ray Computed
• Gemcitabine