Intra-Hepatic Cholangiocarcinoma Treated with GEMOX + Cetuximab Protocol

Authors

  • J. S. Sarraf Institute of Education and Reserach Oncologica Brazil Universidade Federal do Pará- UFPA
  • T. C. Puty Institute of Education and Reserach Oncologica Brazil Universidade do Estado do Pará- UEPA
  • A. V.M Besteiro Institute of Education and Reserach Oncologica Brazil Centro Universitário do Pará- CESUPA
  • G.S Jong-A-Liem Institute of Education and Reserach Oncologica Brazil Universidade do Estado do Pará - UEPA
  • M.N Mauro Institute of Education and Reserach Oncologica Brazil Universidade do Estado do Pará- UEPA
  • L.E.W de Carvalho Institute of Education and Reserach Oncologica Brazil Centro Avançado em Oncologia Oncológica Brasil

DOI:

https://doi.org/10.3823/1685

Keywords:

Cholangiocarcinoma, Intrahepatic Cancer, Treatment, Case Report

Abstract

New studies show a possible benefit of combining Gemcitabine, Oxaliplatin and Cetuximab for the treatment of intrahepatic tumors. However, there is currently no consensus on this in the literature. Hence, this article contributes to the debate by presenting a case of cholangiocarcinoma(biliary tract cancer), treated with a modified Gemcitabine, Oxaliplatin and Cetuximab protocol, which evolved to a considerable regression of the tumor and a complete radiologic response assessed by PET-CT Scan. The case report is of a female adult, who presented with a cholangiocarcinoma extending to hepatic segments V and VIII which met the unresectability criteria. She was submitted to chemotherapy,consisting of a combination of Gemcitabine, Oxaliplatin and Cetuximab for a prolonged period,followed by a maintenance interval of Cetuximabmonotherapy. After the 8th cycle, the patient presented better hepatic biomarker levels; after 12months of treatment, she presented a PET-CT scan showing complete radiologic response; after 15 months of treatment, an MRI scanshowed a reduced and resectable tumor. Our case report suggests use of theGemcitabine + Oxaliplatin(GEMOX) plus Cetuximab protocol as a neoadjuvant settingfor patients with unresectable cholangiocarcinoma submitted to the GEMOX protocol, presenting a progressing disease. Additionally, our case report confirms the GEMOX plus Cetuximab protocol can be modified according to clinical response so patients can obtain maximum therapeutic gain despite minor or adverse reactions.

References

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Malka D, Cervera P, Foulon S, et al. Gemcitabine and oxaliplatin with or without cetuximab in advanced biliary-tract cancer (BINGO): a randomised, open-label, non-comparative phase 2 trial. The Lancet Oncology 2014;15:819-28.

Skipworth JR, Keane MG, Pereira SP. Update on the management of cholangiocarcinoma. Digestive diseases 2014;32:570-8.

Servajean C, Gilabert M, Piana G, et al. One case of intrahepatic cholangiocarcinoma amenable to resection after radioembolization. World journal of gastroenterology : WJG 2014;20:5131-4.

Sadeghi S, Finn RS. Systemic therapy for cholangiocarcinoma. Clinical Liver Disease 2014;3:86-9.

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Published

2015-04-27

Issue

Section

Oncology