[Experience with Gemcitabine plus Nab-Paclitaxel Therapy for Advanced Metastatic Pancreatic Cancer in Our Hospital].

A 71-year-old-man was referred to our hospital because of jaundice of the skin. On biochemical examination of blood, we identified an elevation in the levels of AST and ALT, the serum level of biliary enzymes, and the serum levels of tumor markers. We found pancreatic head cancer with invasion to the main blood vessels and duodenum, with liver metastases, on abdominal CT. We made a diagnosis of unresectable advanced pancreatic head cancer with distant metastasis, and we initiated gemcitabine plus nab-paclitaxel therapy as first-line chemotherapy. The serum CA19-9 level decreased gradually after initiating therapy; both the primary tumor and liver metastases slightly reduced in size after 3 courses of first-line therapy, as assessed on abdominal CT. Hair loss, peripheral neuropathy, and neutropenia were observed as adverse events, but treatment continued as it was tolerable. Finally, because his disease condition worsened after 7 courses of the therapy, we switched to TS-1 as second-line therapy. Eleven months have elapsed since treatment was initiated, and the patient is continuing secondline therapy while maintaining PS.