Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2020; 11(10): 844-853
Published online Oct 24, 2020. doi: 10.5306/wjco.v11.i10.844
Albumin-bound paclitaxel as new treatment for metastatic cholangiocarcinoma: A case report
Roberto Martin Huertas, Raquel Fuentes-Mateos, Juan Jose Serrano Domingo, Elena Corral de la Fuente, Mercedes Rodríguez-Garrote
Roberto Martin Huertas, Raquel Fuentes-Mateos, Juan Jose Serrano Domingo, Elena Corral de la Fuente, Mercedes Rodríguez-Garrote, Medical Oncology Department, Hospital Universitario Ramon y Cajal, Madrid 28034, Spain
Author contributions: All authors contributed equally to this case report and all of them gave final approval for its publication.
Informed consent statement: The patient gave informed consent and the identifiers have been removed prior to submission for publication.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Roberto Martin Huertas, MD, Medical Oncology Department, Hospital Universitario Ramon y Cajal, Ctra. de Colmenar Viejo km. 9100, Madrid 28034, Spain. robertomartinhuertas@outlook.com
Received: May 4, 2020
Peer-review started: May 4, 2020
First decision: July 25, 2020
Revised: July 31, 2020
Accepted: September 8, 2020
Article in press: September 8, 2020
Published online: October 24, 2020
Processing time: 169 Days and 23.1 Hours
Abstract
BACKGROUND

Cholangiocarcinomas are rare and very aggressive tumors. Most patients have advanced-stage or unresectable disease at presentation, and the systemic therapies have limited efficacy. Albumin-bound paclitaxel (nab-paclitaxel) is a solvent-free taxane that has been approved for the treatment of some cancers such as breast, non-small cell lung and pancreatic cancer, however it has not been applied to treat cholangiocarcinoma. We have both preclinical and clinical evidence of the efficacy of nab-paclitaxel in cholangiocarcinoma, yet no phase 3 trials have been made.

CASE SUMMARY

A 63-year-old man was diagnosed in December 2016 with stage III B intrahepatic cholangiocarcinoma. Surgery was performed, followed by adjuvant chemotherapy treatment with capecitabine and gemcitabine; although, the gemcitabine was suspended due to allergic reaction after two cycles. In April 2019, metastatic cholangiocarcinoma relapse was diagnosed, and a first-line treatment with FOLFOX scheme was started. Eight cycles were administered, producing an initial clinical improvement and decrease in blood tumor marker levels. Radiological and serological progression was noted in September 2019. As a second-line treatment, FOLFIRI was not recommended due to risk of worsening the patient’s tumor-related diarrhea. A combination therapy with gemcitabine was not feasible, as the patient had previously suffered from an allergic reaction to this treatment. We decided to use nab-paclitaxel as a second-line treatment, and four cycles were administered. Both clinical and serological responses were observed, and a radiological mixed response was also noted.

CONCLUSION

Advanced cholangiocarcinoma could be treated with nab-paclitaxel monotherapy, which should be studied in combination with other types of treatment (chemotherapy, fibroblast growth factor receptor inhibitors).

Keywords: Cholangiocarcinoma; Chemotherapy; Albumin-bound paclitaxel; Case report; Metastatic; Clinical trial

Core Tip: Cholangiocarcinomas are very aggressive tumors. Most patients have advanced-stage disease at presentation and the efficacy of systemic therapies for this setting is limited. Albumin bound paclitaxel (nab-paclitaxel) has been approved in some cancers but not in cholangiocarcinoma. We present a clinical case of metastatic cholangiocarcinoma treatment with second-line nab-paclitaxel and we review the preclinical and clinical evidence about its useful in these tumors.