Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
권호 표지

A Case of Gemcitabine Plus Nanoparticle Albumin Bound (nab)-paclitaxel Induced Cardiotoxicity in Patient of Metastatic Pancreatic Cancer

전이성 췌장암 환자에서 Gemcitabine과 Nanoparticle Albumin Bound (nab)-Paclitaxel로 인한 허혈성 심독성 발생 1례

  • Mi Kang Kim (Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Se Woo Park (Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine)
  • 김미강 (한림대학교 의과대학 동탄성심병원 소화기내과) ;
  • 박세우 (한림대학교 의과대학 동탄성심병원 소화기내과)
  • Received : 2017.05.30
  • Accepted : 2017.06.18
  • Published : 2017.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Pancreatic cancer is an aggressive disease and despite the efforts of the past few decades, the 5-year overall survival (OS) rate remains disappointing and does not exceed 10% in Korea. Especially, only 15-20% of patients are candidates for surgical resection because most patients are diagnosed with locally advanced or metastatic disease, and their only treatment approach is palliative chemotherapy. Since the first chemo-regimen of Gemcitabine and Nanoparticle albumin bound (nab) - paclitaxel was brought to clinical practice in 2013, the improvement in overall survival, progression-free survival, and response rate was achieved in patients with metastatic pancreatic adenocarcinoma. We report the case of a young patient with cardiogenic shock accompanied by multi-organ failure after 4th cycle Gemcitabine and nab-paclitaxel chemotherapy with partial response.

2013년 실제 임상에 Gemcitabine과 nab-paclitaxel 병용요법이 적용된 후 NCCN Guideline에서 절제 불가능한 췌장암 환자에서 일차적으로 선택할 수 있는 약제로 제시하고 있다. 이 병용요법으로 인한 가장 흔한 Grade 3 부작용으로는 호중구감소증, 피로, 말초신경병증이 보고되었으며, 심장독성은 흔하지 않다. 본 증례에서는 심장표지자의 상승 및 심초음파에서의 우측관상동맥의 허혈 손상이 확인되어 병용요법으로 인한 심장 허혈 손상 및 심낭삼출물이 발생하여, 심장성 쇼크로 사망하였을 것으로 추정해 볼 수 있다. Gemcitabine과 nab-paclitaxel에 의한 심장 허혈 손상의 더 많은 증례 보고 및 연구가 필요하며, 병용요법을 투여 받는 환자들에 대한 심장독성에 대하여 주의 깊은 관찰이 필요할 것으로 생각된다.

Keywords

References

  1. Ryan DP, Hong TS, Bardeesy N. Pancreatic adenocarcinoma. N Engl J Med 2014;371:1039-1049.
  2. 류지곤. 절제 불가능한 췌장암 항암치료의 최신 지견. 대한소화기학회지 2015;66:150-153.
  3. Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med 2013;369:1691-1703.
  4. Abraxane Prescribing Information. Abraxane Celgene Corporation 2013. Web. 01 July. 2014. .
  5. Von Hoff D, Ramanathan R, Borad M, et al. Gemcitabine plus Nab-paclitaxel Is an Active Regimen in Patients with Advanced Pancreatic Cancer: A Phase I/II Trial. J Clin Oncol 2011;29:4548-4554.
  6. Preethi John, Harriet Butler, Muhammad Wasif Saif. Congestive Heart Failure Secondary to GemcitabineNab-paclitaxel in Patients with Pancreatic Cancer. Anticancer Research 2014;34:7267-7270.
  7. Dan T Vogl, Eli Glatstein, Joseph R Carver, et al. Gemcitabine-induced pericardial effusion and tamponade after unblocked cardiac irradiation. Leukemia & Lymphoma 2005;46:1313-1320.