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. On adding bevacizumab to GFLIP, serial measures on CT confirmed an objective (RECIST) response. The tumor marker CA19-9 fell rapidly from 24,000 U/ml to less than 400 U/ml. This was accomplished with clinically inconsequential side-effects. This is the first demonstrated benefit of bevacizumab used in combination with previously failed chemotherapy for pancreatic cancer.