Histological complete response in a patient with advanced biliary tract cancer treated by gemcitabine/cisplatin/S-1 combination chemotherapy: A case report

Matsubara,Tokuhiro; Nishida,Tsutomu; Tomimaru,Yoshito; Yamamoto,Masashi; Hayashi,Shiro; Nakajima,Sachiko; Fukui,Koji; Dono,Keizo; Adachi,Shiro; Ioka,Tatsuya; Kanai,Masashi; Inada,Masami

doi:10.3892/mco.2016.1065

Histological complete response in a patient with advanced biliary tract cancer treated by gemcitabine/cisplatin/S-1 combination chemotherapy: A case report

Authors:
- Tokuhiro Matsubara
- Tsutomu Nishida
- Yoshito Tomimaru
- Masashi Yamamoto
- Shiro Hayashi
- Sachiko Nakajima
- Koji Fukui
- Keizo Dono
- Shiro Adachi
- Tatsuya Ioka
- Masashi Kanai
- Masami Inada
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Affiliations: Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan, Department of Surgery, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan, Department of Pathology, Toyonaka Municipal Hospital, Toyonaka, Osaka 560-8565, Japan, Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-0025, Japan, Department of Clinical Oncology and Pharmacogenomics, Kyoto University Hospital, Kyoto 606-8507, Japan
Published online on: October 26, 2016 https://doi.org/10.3892/mco.2016.1065
Pages: 757-761
Copyright: © Matsubara et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

A 68-year-old woman was referred to our hospital with increased levels of biliary enzymes. On imaging, the patient was diagnosed with unresectable intrahepatic biliary tract cancer (BTC) with invasion of the portal vein and para-aortic lymph node metastasis (cT3N1M1, cStage IVb) and underwent endoscopic biliary drainage for the biliary stricture prior to therapy. The patient was subsequently enrolled in a phase III randomized trial (UMIN000014371/NCT02182778) and randomly assigned to receive gemcitabine/cisplatin/S-1 (GCS) combination therapy intravenously at doses of 1,000 or 25 mg/m2 on day 1 and orally twice daily at a dose of 80 mg/m2 on days 1-7 every 2 weeks. After 12 cycles of scheduled therapy without uncontrollable adverse effects, the patient achieved a good partial response with chemotherapy. Computed tomography (CT) revealed a marked reduction of the primary and metastatic lesions. In addition,18F-fluorodeoxyglucose-positron emission tomography/CT revealed diminishing abnormal uptake and no macroscopic evidence of factors adversely affecting tumor resectability. Therefore, the patient underwent extended right hepatic lobectomy, lymph node dissection and left hepaticojejunostomy. Finally, histological examination of the resected tissues revealed no residual cancer cells, suggesting a pathologically complete response. We herein present the case of a patient with intrahepatic BTC who achieved a pathologically complete response following combination chemotherapy with GCS.

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