Gemcitabine and lenalidomide combination in a patient with metastatic pancreatic cancer: a case study

Abstract

The proportion of people surviving pancreatic cancer is extremely low, with just 10% of patients diagnosed with any stage of the disease living beyond 1 year and a 5-year relative survival rate of <5%. The lack of effective therapy is one the main reason for such a bleak outlook. Herein, we report on a patient with pancreatic adenocarcinoma and metastatic disease treated with a combination regimen of gemcitabine and lenalidomide, without major complications. We also present in vitro data that highlight a hyper-additive effect of the two drugs when used in combination. To date, 33 months after diagnosis, the patient remains well and continues in full-time employment.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. 1.

    Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin. 2008;58:71–96. doi:10.3322/CA.2007.0010.

    Article  PubMed  Google Scholar 

  2. 2.

    Hariharan D, Saied A, Kocher HM. Analysis of mortality rates for pancreatic cancer across the world. HPB (Oxford). 2008;10:58–62.

    CAS  Google Scholar 

  3. 3.

    Office National Statistics: http://www.statistics.gov.uk/StatBase/xsdataset.asp?vlnk=982&Pos=&ColRank=1&Rank=544. Accessed 23 Oct 2008.

  4. 4.

    Fryer RA, Galustian C, Dalgleish AG. Recent advances and developments in treatment strategies against pancreatic cancer. Curr Clin Pharmacol. 2009;4:102–12.

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Burris HA 3rd, Moore MJ, Andersen J, Green MR, Rothenberg ML, Modiano MR, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997;15:2403–13.

    CAS  PubMed  Google Scholar 

  6. 6.

    Li D, Xie K, Wolff R, Abbruzzese JL. Pancreatic cancer. Lancet. 2004;363:1049–57. doi:10.1016/S0140-6736(04)15841-8.

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Bartlett JB, Michael A, Clarke IA, Dredge K, Nicholson S, Kristeleit H, et al. Phase I study to determine the safety, tolerability and immunostimulatory activity of thalidomide analogue CC-5013 in patients with metastatic malignant melanoma and other advanced cancers. Br J Cancer. 2004;90:955–61. doi:10.1038/sj.bjc.6601579.

    Article  CAS  PubMed  Google Scholar 

  8. 8.

    Liu WM. Enhancing the cytotoxic activity of novel targeted therapies—is there a role for a combinatorial approach? Curr Clin Pharmacol. 2008;3:108–17. doi:10.2174/157488408784293714.

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Bronte V, Apolloni E, Cabrelle A, Ronca R, Serafini P, Zamboni P, et al. Identification of a CD11b(+)/Gr-1(+)/CD31(+) myeloid progenitor capable of activating or suppressing CD8(+) T cells. Blood. 2000;96:3838–46.

    CAS  PubMed  Google Scholar 

  10. 10.

    Serafini P, De Santo C, Marigo I, Cingarlini S, Dolcetti L, Gallina G, et al. Derangement of immune responses by myeloid suppressor cells. Cancer Immunol Immunother. 2004;53:64–72. doi:10.1007/s00262-003-0443-2.

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Suzuki E, Kapoor V, Jassar AS, Kaiser LR, Albelda SM. Gemcitabine selectively eliminates splenic Gr-1+/CD11b+ myeloid suppressor cells in tumor-bearing animals and enhances antitumor immune activity. Clin Cancer Res. 2005;11:6713–21. doi:10.1158/1078-0432.CCR-05-0883.

    Article  CAS  PubMed  Google Scholar 

  12. 12.

    Bartlett JB, Dredge K, Dalgleish AG. The evolution of thalidomide and its IMiD derivatives as anticancer agents. Nat Rev Cancer. 2004;4:314–22. doi:10.1038/nrc1323.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding authors

Correspondence to Wai M. Liu or Angus G. Dalgleish.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Liu, W.M., Nizar, S. & Dalgleish, A.G. Gemcitabine and lenalidomide combination in a patient with metastatic pancreatic cancer: a case study. Med Oncol 27, 430–433 (2010). https://doi.org/10.1007/s12032-009-9228-6

Download citation

Keywords

  • Pancreatic cancer
  • Drug combination therapy
  • Gemcitabine
  • Lenalidomide