Chemotherapeutic management of small bowel adenocarcinoma associated with Crohn's disease.

Four patients with metastatic primary small bowel adenocarcinoma associated with Crohn's disease were successfully treated with low dose combination chemotherapy consisting of 5-fluorouracil, leucovorin and irinotecan with or without gemcitabine. Benefits included prolonged survival, objective responses, response of resistant tumors, downstaging, and a successful secondary complete resection (Ro) with a durable remission.

Bevacizumab as treatment for chemotherapy-resistant pancreatic cancer.

A 74-year-old male, with refractory stage IV pancreatic cancer, was successfully treated with bevacizumab 5 mg/kg and combination chemotherapy consisting of gemcitabine, fluorouracil leucovorin, irinotecan and cisplatin (GFLIP) every two weeks. The patient had rapidly failed initial treatment with GFLIP given in an identical dose and schedule. Large new liver lesions developed during active treatment.