Application of two lines of chemotherapy: gemcitabine with nab-paclitaxel and liposomal irinotecan with 5-fluorouracil and leucovorin in patient with advanced pancreatic adenocarcinoma Case report

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Krystyna Ostrowska-Cichocka
Marek Z. Wojtukiewicz


Pancreatic cancer is a disease with high mortality. It is predicted to become the second leading cause of cancer death in some regions of the world. Frequent diagnosis at an advanced stage contributes to 5-year survival at a highly unsatisfactory level of 2–9%. Due to the lack of early symptoms, nearly 80% of patients receive a diagnosis when distant metastases develop. So far, the most frequently used programs in the treatment of patients with pancreatic cancer in the stage of neoplastic spreading include: FOLFIRINOX (oxaliplatin, 5-fluorouracil, irinotecan, leucovorin), gemcitabine alone or in combination with nab-paclitaxel or erlotinib.

Based on the results of the phase III study NAPOLI-1, liposomal irinotecan in combination with 5-fluorouracil (5-FU) and leucovorin (LV ) was approved as the first regimen for use in the second or subsequent line of therapy in patients with advanced pancreatic cancer previously treated with gemcitabine. This paper presents a case of a patient with advanced pancreatic cancer who was treated with two lines of chemotherapy – gemcitabine in combination with nab-paclitaxel and liposomal irinotecan with 5-FU/LV . The treatment was well tolerated and was considered a valuable therapeutic option. A 2-year overall survival was obtained from the diagnosis of the disease.


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Ostrowska-Cichocka K, Wojtukiewicz MZ. Application of two lines of chemotherapy: gemcitabine with nab-paclitaxel and liposomal irinotecan with 5-fluorouracil and leucovorin in patient with advanced pancreatic adenocarcinoma. OncoReview [Internet]. 2021Jul.11 [cited 2022May16];11(3(43):68-2. Available from:


1. Ducreux M, Cuhna A. Sa, Caramella C et al. Cancer of the pancreas: ESMO Clinical Practice.Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015; 26(suppl 5): v56-v68.
2. Lambert A, Schwarz L, Borbath I et al. An update on treatment options for pancreatic adenocarcinoma. Adv Med Oncol. 2019; 11: 1143.
3. McGuigan A, Kelly P, Turkington RC et al. Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol. 2018; 24(43): 4846-61.
4. Taieb J, Abdallah R. How I treat pancreatic cancer. ESMO Open. 2020; 4: e000818. open-2020-0008.
5. Moore MJ, Goldstein D, Hamm J et al. Erlotinib plus gemcitabine compared with gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 2007; 25: 1960-6.
6. Jassem J, Krzakowski M, Potemski P. Nowotwory układu pokarmowego. 2nd ed. Via Medica, Gdańsk 2019.
7. Conroy T, Desseigne F, Ychou M et al. FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer. N Engl J Med. 2011; 364: 1817-25.
8. Tempero MA, Malafa MP, Chiorean EG et al. Pancreatic adenocarcinoma, version 1.2021. NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2019; 17(3): 202-10.
9. Tehfe M, Dowden S, Kennecke H et al. nab-Paclitaxel Plus Gemcitabine Versus Gemcitabine in Patients with Metastatic Pancreatic Adenocarcinoma: Canadian Subgroup Analysis of the Phase 3 MPACT Trial. Adv Ther. 2016; 33(5): 747-59.
10. Von Hoff DD, Ervin T, Arena FP et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013; 369: 1691-703.
11. Czyżykowski R, Janiak M, Krakowska M et al. Palliative systemic treatment of patients with pancreatic cancer – should reimbursement of nab-paclitaxel change the current management paradigm? Oncol Clin Pract. 2017; 13: 8-13.
12. Wang-Gillam A, Li C-P, Bodoky G et al. Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy (NAPOLI-1): a global, randomised, open-label, phase 3 trial. Lancet. 2016; 387: 545-57.
13. Klank-Sokołowska E, Kucharewicz M, Wojtukiewicz MZ. Nanoliposomalny irynotekan – nowe perspektywy leczenia uogólnionego raka trzustki. Onkol Prakt Klin. 2019; 5: 1-9.