Evidence map›Paper›PMID 36205833›Full record

ArticleSurgical case reports2022

A case of pathological complete response with liposomal irinotecan + 5-FU/LV for unresectable locally advanced pancreatic cancer.

Koji Kikuchi, Akira Umemura, Hiroyuki Nitta, Hirokatsu Katagiri, Masao Nishiya, Noriyuki Uesugi, Tamotsu Sugai, Keisuke Imanari, Akira Sasaki

Open access · goldAbstract read
In one paragraph

Article in Surgical case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.1field-weighted citation impact, top 52% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Koji KikuchiDepartment of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan. kikukoji@iwate-med.ac.jp.ORCID http://orcid.org/0000-0003-4203-8149
Akira UmemuraDepartment of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan.
Hiroyuki NittaDepartment of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan.
Hirokatsu KatagiriDepartment of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan.
Masao NishiyaDepartment of Molecular Diagnostic Pathology, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan.
Noriyuki UesugiDepartment of Molecular Diagnostic Pathology, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan.
Tamotsu SugaiDepartment of Molecular Diagnostic Pathology, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan.
Keisuke ImanariDepartment of Internal Medicine, Division of Gastroenterology, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan.
Akira SasakiDepartment of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, Iwate, 028-3695, Japan.
Iwate Medical University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPancreatic cancer has one of the worst prognoses of any all cancers. 5-FU/leucovorin + irinotecan + oxaliplatin (FOLFIRINOX), gemcitabine (GEM) plus nab-paclitaxel regimens have been recognized as global-standard, first-line treatments for patients with advanced pancreatic cancer. The liposomal irinotecan (nal-IRI) + 5-FU/LV regimen is now included in treatment guidelines as a recommended and approved option for use in patients with metastatic pancreatic cancer that has progressed after GEM-based therapy and who have a suitable performance status and comorbidity profile. There is no report that nal-IRI + 5-FU/LV regimen was significantly effective, and we will report it because we experienced this time. CASE PRESENTATION: A 69-year-old man presented with epigastric pain, and a contrast computed tomography (CT) revealed an enhanced mass lesion measuring 33 × 27 mm on the pancreatic body with encasement of the common hepatic artery (CHA) and the splenic vein. An endoscopic ultrasound-guided fine needle aspiration was performed and demonstrated cytology consistent with adenocarcinoma. Therefore, we diagnosed the patient with unresectable locally advanced pancreatic cancer. The patient received the GEM and S-1 regimen; however, the adverse event was relatively severe. Then, 11 cycles of nal-IRI + 5-FU/LV regimen were administered. A CT scan revealed that the tumor had shrunk to 18 × 7 mm in diameter with encasement of the CHA. The encasement of the splenic vein had disappeared, without any distant metastases. From this post-chemotherapy evaluation and intraoperative frozen section of around the celiac artery, gastroduodenal artery and pancreas stump confirmed absence of tumor cells, we performed distal pancreatectomy with celiac axis resection. A histological examination of the surgical specimen revealed no evidence of residual adenocarcinoma, consistent with a pathological complete response to treatment.

conclusionsWe present the first case of a pathological complete response with nal-IRI + 5-FU/LV for unresectable, locally advanced pancreatic cancer. In the future, nal-IRI may become a key drug for pancreatic cancer treatment.

Indexed as

Liposomal irinotecanPancreatic ductal adenocarcinomaPathological complete responseUnresectable pancreatic cancer

Identifiers

PMID36205833
PMCPMC9547044
OpenAlexW4303438670

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.