Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2017; 23(41): 7478-7488
Published online Nov 7, 2017. doi: 10.3748/wjg.v23.i41.7478
Extraordinary response of metastatic pancreatic cancer to apatinib after failed chemotherapy: A case report and literature review
Cheng-Ming Li, Zhi-Chao Liu, You-Ting Bao, Xin-Dong Sun, Lin-Lin Wang
Cheng-Ming Li, Zhi-Chao Liu, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan 250101, Shandong Province, China
Cheng-Ming Li, Zhi-Chao Liu, You-Ting Bao, Xin-Dong Sun, Lin-Lin Wang, Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117, Shandong Province, China
You-Ting Bao, Department of Oncology, Weifang Medical University, Weifang 261042, Shandong Province, China
Lin-Lin Wang, School of Medicine, Shandong University, Jinan 250012, Shandong Province, China
Author contributions: Li CM collected the case data and wrote the paper; Sun XD and Wang LL treated the patient; Li CM, Liu ZC and Bao YT contributed to the literature search; Wang LL reviewed and revised the manuscript; All authors have read and approved the final manuscript.
Supported by The National Natural Science Foundation of China, No. 81402299; the Project of Postdoctoral Innovation of Shandong Province, No. 201501010; and the Project of Postdoctoral Science Foundation of China, No. 2016M590640.
Institutional review board statement: The case report was reviewed and approved by the Institutional Review Board of Shandong Cancer Hospital Affiliated to Shandong University, Jinan, China.
Informed consent statement: The husband of the patient provided written informed consent.
Conflict-of-interest statement: All the authors declare that there is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lin-Lin Wang, MD, PhD, Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, No. 440, Jiyan Road, Jinan 250117, Shandong Province, China. 13793187739@163.com
Telephone: +86-531-67626142 Fax: +86-531-67626141
Received: July 14, 2017
Peer-review started: August 1, 2017
First decision: August 31, 2017
Revised: September 13, 2017
Accepted: September 26, 2017
Article in press: September 26, 2017
Published online: November 7, 2017
Processing time: 96 Days and 10 Hours
Abstract

Chemotherapy has limited efficacy in the treatment of advanced and metastatic pancreatic cancer (PC), and has serious side effects. The development of novel effective agents, especially targeted therapy, is essential for patients with PC. We present a 58-year-old Chinese woman initially diagnosed with locally advanced PC. As the disease progressed to Stage IV, the patient was unable to tolerate chemotherapy after the fourth-line treatment. She was then treated with apatinib, a novel and highly selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2 and achieved a progression-free-survival of 7 mo. All drug-related side effects were well controlled with medication. To the best of our knowledge, this is the first case of PC which responded to apatinib. Considering this remarkable response, apatinib may be a promising agent in the treatment of PC. We also reviewed the literature on chemotherapy and targeted therapy, especially the anti-angiogenesis therapy for patients with PC, and investigated the effect of apatinib in other solid tumors as well.

Keywords: Anti-angiogenesis; Apatinib; Pancreatic cancer; Targeted therapy; Vascular endothelial growth factor receptor-2

Core tip: As chemotherapy has limited efficacy in the treatment of advanced and metastatic pancreatic cancer, targeted therapy is becoming increasingly important in patients with pancreatic cancer. The case reported herein suggests that apatinib, a novel and highly selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2, may be a promising and useful agent in the treatment of pancreatic cancer.