Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3441-3446
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3441
Icotinib plus gemcitabine for metastatic pancreatic cancer: A case report
Jing Zhao, Hong Shen, Han-Guang Hu, Jian-Jin Huang
Jing Zhao, Hong Shen, Han-Guang Hu, Jian-Jin Huang, Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Zhao J and Shen H wrote the manuscript; Hu HG participated in the clinical management of the patient; Huang JJ was in charge of the patient; and all authors approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81201640; Department of Education of Zhejiang Province of China, No. Y201225802; and Medical and Technology Plan of Zhejiang Province of China, No. 2013KYA093.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Jian-Jin Huang, MD, Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jie-Fang Road, Hangzhou 310009, Zhejiang Province, China.
Telephone: +86-571-87784795 Fax: +86-571-87767088
Received: August 8, 2014
Peer-review started: August 9, 2014
First decision: September 15, 2014
Revised: October 5, 2014
Accepted: November 19, 2014
Article in press: November 19, 2014
Published online: March 21, 2015

A large majority of patients diagnosed with pancreatic cancer have advanced metastatic disease with unresectable malignancies. Despite treatment advances, the survival benefit from chemotherapeutic regimens and targeted drugs is limited. Moreover, their application is limited in China because of high toxicity and cost. Recently, inhibitors of epidermal growth factor receptor activity have shown promise for the treatment of solid cancers when used in combination with standard therapy. However, these drugs have not been evaluated extensively for the treatment of pancreatic cancer. Here, we report the treatment of a 64-year-old male with metastatic pancreatic cancer using a novel regimen of icotinib with gemcitabine. Marked shrinkage of the mass was observed after two treatment cycles, and partial remission was achieved. The abdominal pain was relieved. The adverse effects were tolerable and treatment cost was acceptable. This is the first reported case for the treatment of advanced pancreatic cancer with icotinib plus gemcitabine and demonstrates a promising therapeutic alternative.

Keywords: Epidermal growth factor receptor tyrosine kinase inhibitor, Gemcitabine, Icotinib, Metastatic pancreatic cancer, Regimen

Core tip: Patients with advanced metastatic pancreatic cancer have a poor prognosis. Currently, treatments available in China are accompanied by high toxicity and cost, with minimal benefit. Icotinib is a newly developed oral epidermal growth factor receptor tyrosine kinase inhibitor, which was combined with standard gemcitabine therapy for treatment of metastatic pancreatic cancer in a 64-year-old male patient. This case report demonstrates that the novel regimen produced partial remission with marked shrinkage of the pancreatic mass. Thus, icotinib combined with gemcitabine may be a promising therapeutic alternative for metastatic pancreatic cancer.