• PDF / 170,745 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 24 Downloads / 160 Views

DOWNLOAD

REPORT

---

1

S

Acute pancreatitis: 2 case reports In a case series (data extracted from a Phase I/II Study), 2 patients (a woman in her 60s and a man in his 50s) [exact ages not stated] were described, who developed acute pancreatitis during treatment with gemcitabine and paclitaxel for metastatic pancreatic cancer [routes, dosages and times to reactions onsets not stated]. Case 1: The woman in her 60s, who was diagnosed with nmetsatatic pancreatic cancer, received five cycles of gemcitabine and paclitaxel [nab-paclitaxel]. Thereafter, she developed acute grade 3 pancreatitis; during cycle 2 of chemotherapy, she had 3 episodes of pancreatitis. Her CRP and serum amylase levels were elevated (noted at 1 month post chemotherapy initiation). A CT-scan revealed a low density in the pancreas parenchyma with acute necrotic collection and slight dilation of the pancreatic duct. The woman received fluid replacement, and treatment with nafamostat [nafamostat mesilate] for pancreatitis. She was also advised to temporarily fast. Pancreatitis resolved thereafter. The woman was re-initiated on gemcitabine and paclitaxel. Acute pancreatitis with acute necrotic collection continued to recur every few weeks. Nafamostat therapy was continued. During the schedule of chemotherapy cycle 5, she received treatment with only gemcitabine. However, she again exhibited acute pancreatitis with acute necrotic collection. One month later, the pancreatitis resolved. Case 2: The man in his 50s, who had metastatic pancreatic cancer, received 10 cycles of gemcitabine and paclitaxel [nabpaclitaxel]. The therapy was discontinued due to disease progression. After two months of discontinuation, he developed grade 2 acute pancreatitis with acute necrotic collection. A CT scan confirmed pancreatitis with a low-density area in the body of the pancreatic parenchyma and tail of the pancreas. The man received fluid replacement and treatment with gabexate [gabexate mesilate]. He was also advised to temporarily fast. The man was re-initiated on gemcitabine and paclitaxel. Thereafter, he exhibited recurrence of acute pancreatitis (at grade 3). Despite treatment with pancrelipase and camostat mesilate, the pancreatitis worsened to grade 4. Aditionally, a radiological cyst was evident. A walled-off necrosis was noted with elevated CRP level in cycle 4. He underwent an endoscopic ultrasound-guided cyst drainage, and the grade 4 acute pancreatitis recsolved. Gemcitabine and paclitaxel was continued for 10 months with continuous cyst drainage. The pancreatitis recurred, but in a non-severe form. Author comment: "[T]wo patients were reported as experiencing pancreatitis due to chemotherapy." Ueno M, et al. Phase I/II study: Experience with the late onset of acute pancreatitis after the start of chemotherapy with gemcitabine plus nab-paclitaxel for metastatic pancreatic cancer. Internal Medicine 58: 2957-2962, No. 20, 2019. Available from: 803438166 URL: http://doi.org/10.2169/internalmedicine.2362-18 - Japan

0114-9954/19/1782-0001/$14.95 Adis © 2019 Springer Nature Switzerla