Patient-Derived Tumor Xenograft Combined with Chemotherapy Drug Sensitivity Test in a Patient with Pancreatic Neuroendocrine Carcinoma
Introduction: Pancreatic neuroendocrine carcinoma (p-NEC) with liver metastasis has a poor prognosis. The treatment is mainly chemotherapy which is now still a huge challenge on NEC with high ki-67 index.
Aim(s): To search for more effective therapies for p-NEC.
Materials and methods: A male patient got abdominal CT detection which indicated a 6.2*4.9cm tumor at pancreatic neck with enlarged paraaortic lymph nodes in 2016. Then, we carried out EUS+FNA of the pancreatic tumor with pathology and immunohistochemistry listed below: p-NEC, CK++, Syn++, CD56 +, CgA +, ki-67 index 80%. He began to accept chemotherapy with etoposide and Cisplatin for 12 courses and get stable disease. Then, he got Carbon ion of 51 GyE for 17 times within 23 days and found a decreased tumor size which was shrunk by 1/4. However, a 9 mm nodule was found in right lobe of liver. He began to get PD-1 (Ketruda) and used until now. Meanwhile, he got FOLFIRI for 8 courses and FORFOX6 for 6 courses. Unfortunately, there was gradually increasing size of liver nodules. He had to get hepatic artery embolization of the liver 5S lobe. After that, his liver lesions gradually increased with a diameter of 6 cm. We underwent CT-guided percutaneous liver biopsy and sent the specimens for patient-derived tumor xenograft (PDTX) combined with chemotherapy sensitivity tests.
Conference: 17th Annual ENETSConcerence (2020)
Presenting Author: Bai J
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