Successful palliative approach with high-intensity focused ultrasound in a patient with metastatic anaplastic pancreatic carcinoma: a case report

Abstract

We report a case of a 74-year-old man with a metastatic anaplastic pancreatic carcinoma (APC). After an early tumour progression on first-line chemotherapy with cisplatin and gemcitabine, even though it was badly tolerated, he was treated with a combination of systemic modified FOLFIRI and high-intensity focused ultrasound (HIFU) on the pancreatic mass. A tumour showing partial response with a clinical benefit was obtained. HIFU was preferred to radiotherapy because of its shorter course and minimal side effects, in order to improve the patient’s clinical conditions.The patient is currently on chemotherapy, asymptomatic with a good performance status.In referral centres, with specific expertise, HIFU could be safely and successfully combined with systemic chemotherapy for treatment of metastatic pancreatic carcinoma.

Focused ultrasound for immuno-adjuvant treatment of pancreatic cancer: An emerging clinical paradigm in the era of personalized oncotherapy

“…Similar effects have been observed by others [114, 130–132]. In all cases, patients received systemic chemotherapy concurrently with FUS treatments, but chemotherapy had been ineffective prior to initiation of FUS therapy.…”

Systemic Chemotherapy for Advanced Rare Pancreatic Histotype Tumors

“…The patient was treated with this drug achieving a complete response (CR) after 2 cycles and a disease-free survival of 23 months. 46 Ungaro et al 47 reported the lack of activity of cisplatin plus gemcitabine in a patient who received FOLFIRI in combination with high-intensity focused ultrasound with a PR. Shinagare et al 48 described the history of a patient treated with FOLFIRINOX who showed a PR even if OS was only of 5 months because of the deterioration of the clinical status.…”

Pulsed focused ultrasound can improve the anti-cancer effects of immune checkpoint inhibitors in murine pancreatic cancer

“…This may result in mechanical damage to the tissue in the absence of a significant temperature change [24]. Focused ultrasound has been used to treat pancreatic cancer either as a standalone treatment or in combination with chemotherapy and/or radiotherapy [25][26][27][28]. For example, a clinical review of 3022 patients with advanced pancreatic cancer showed that treatment with HIFU ablation alone, or in combination with chemotherapy, resulted in a median survival of 10 months, whereas treatment with chemotherapy alone yielded a median survival of 7.6 months.…”