Correlation Between the Acquisition of Resistance to Gemcitabine Therapy and the Expression of HuR in Pancreatic Ductal Adenocarcinoma: A Case Report
| Autor: | Shinji Tanaka, Hiromitsu Ito, Satoshi Matsumura, Arihiro Aihara, Atsushi Kudo, Yusuke Mitsunori, Takanori Ochiai, Minoru Tanabe, Atsushi Oba, Susumu Kirimura, Daisuke Ban |
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| Rok vydání: | 2018 |
| Předmět: |
Oncology
medicine.medical_specialty Chemotherapy Pancreatic ductal adenocarcinoma business.industry medicine.medical_treatment medicine.disease Gemcitabine 03 medical and health sciences 0302 clinical medicine Antigen 030220 oncology & carcinogenesis Internal medicine Pancreatic cancer medicine Biomarker (medicine) 030211 gastroenterology & hepatology Surgery Personalized therapy business medicine.drug |
| Zdroj: | International Surgery. 103:116-120 |
| ISSN: | 2520-2456 0020-8868 |
| DOI: | 10.9738/intsurg-d-15-00278.1 |
| Popis: | Recently, several studies have revealed the usefulness of biomarkers to predict the response to chemotherapy for pancreatic ductal adenocarcinoma (PDAC). Among them, human antigen R (HuR) is reported as a powerful marker for response to gemcitabine chemotherapy for PDAC. The present report describes a patient with PDAC who underwent gemcitabine therapy before resection and after recurrence, and HuR expression was examined at multiple stages. A 72-year-old man was diagnosed with locally advanced unresectable PDAC invading the common hepatic artery. After 9 cycles of gemcitabine treatment, a computed tomography (CT) scan demonstrated a partial response. He underwent distal pancreatectomy with portal vein resection. The pathologic assessment for response to the chemotherapy was grade Ib by Evans's criteria, and HuR expression was high. Serum carbohydrate antigen 19-9 (CA19-9) level rose rapidly at 4 months after the first resection. A CT scan and needle biopsy revealed a solitary recurrence in the abdominal wall, and HuR expression remained high. After 4 cycles of gemcitabine and S-1 combination therapy, a CT scan demonstrated a partial response, and serum CA19-9 decreased. However, after 2 additional cycles of the therapy, a CT scan demonstrated progressive disease, and serum CA19-9 increased slightly. By laparotomy, an abdominal wall recurrence and multiple peritoneal dissemination were found. HuR expression in the biopsy specimen obtained during the laparotomy was decreased. Although gemcitabine therapy was reinitiated, the disease progressed rapidly so the treatment was stopped. In this case, a correlation between the acquisition of resistance to gemcitabine therapy and change in HuR expression was demonstrated. |
| Databáze: | OpenAIRE |
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