Cargando…

Nab-Paclitaxel and Gemcitabine as First-Line Treatment of Metastatic Ampullary Adenocarcinoma with a Novel R-Spondin2 RNA Fusion and NTRK3 Mutation

Ampullary adenocarcinoma is a rare malignancy that lacks standard systemic treatment. We describe a case of recurrent metastatic ampullary adenocarcinoma of the pancreaticobiliary subtype treated with nanoparticle albumin-bound (nab)-paclitaxel and gemcitabine as first-line treatment. This report al...

Descripción completa

Detalles Bibliográficos
Autores principales: Linscott, Maryknoll P., Markus, Havell, Sennett, Mackenzie, Abendroth, Catherine, Yee, Nelson S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452745/
https://www.ncbi.nlm.nih.gov/pubmed/37626821
http://dx.doi.org/10.3390/biomedicines11082326
_version_ 1785095748027678720
author Linscott, Maryknoll P.
Markus, Havell
Sennett, Mackenzie
Abendroth, Catherine
Yee, Nelson S.
author_facet Linscott, Maryknoll P.
Markus, Havell
Sennett, Mackenzie
Abendroth, Catherine
Yee, Nelson S.
author_sort Linscott, Maryknoll P.
collection PubMed
description Ampullary adenocarcinoma is a rare malignancy that lacks standard systemic treatment. We describe a case of recurrent metastatic ampullary adenocarcinoma of the pancreaticobiliary subtype treated with nanoparticle albumin-bound (nab)-paclitaxel and gemcitabine as first-line treatment. This report also highlights the molecular profile of the ampullary adenocarcinoma and circulating tumor DNA (ctDNA). This is a case of pancreaticobiliary ampullary adenocarcinoma in a 67-year-old woman who initially presented with painless jaundice. Endoscopic and imaging evaluation revealed biliary ductal dilation secondary to an ampullary mass. Pathology confirmed the diagnosis of ampullary adenocarcinoma of the pancreaticobiliary subtype. She underwent surgical resection of the tumor, followed by adjuvant chemotherapy with gemcitabine and capecitabine. The tumor subsequently recurred in the liver. She received palliative chemotherapy with nab-paclitaxel and gemcitabine, resulting in an objective tumor response for 14 months. Molecular profiling of the tumor and ctDNA revealed a novel MATN2-RSPO RNA fusion and a novel NTRK3 mutation, respectively. Our report suggests that long-term durable response can be achieved in metastatic pancreaticobiliary ampullary adenocarcinoma using nab-paclitaxel and gemcitabine. Molecular profiling of the tumor identified a novel R-Spondin2 RNA fusion and NTRK3 mutation that can be potentially targeted for treatment.
format Online
Article
Text
id pubmed-10452745
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-104527452023-08-26 Nab-Paclitaxel and Gemcitabine as First-Line Treatment of Metastatic Ampullary Adenocarcinoma with a Novel R-Spondin2 RNA Fusion and NTRK3 Mutation Linscott, Maryknoll P. Markus, Havell Sennett, Mackenzie Abendroth, Catherine Yee, Nelson S. Biomedicines Case Report Ampullary adenocarcinoma is a rare malignancy that lacks standard systemic treatment. We describe a case of recurrent metastatic ampullary adenocarcinoma of the pancreaticobiliary subtype treated with nanoparticle albumin-bound (nab)-paclitaxel and gemcitabine as first-line treatment. This report also highlights the molecular profile of the ampullary adenocarcinoma and circulating tumor DNA (ctDNA). This is a case of pancreaticobiliary ampullary adenocarcinoma in a 67-year-old woman who initially presented with painless jaundice. Endoscopic and imaging evaluation revealed biliary ductal dilation secondary to an ampullary mass. Pathology confirmed the diagnosis of ampullary adenocarcinoma of the pancreaticobiliary subtype. She underwent surgical resection of the tumor, followed by adjuvant chemotherapy with gemcitabine and capecitabine. The tumor subsequently recurred in the liver. She received palliative chemotherapy with nab-paclitaxel and gemcitabine, resulting in an objective tumor response for 14 months. Molecular profiling of the tumor and ctDNA revealed a novel MATN2-RSPO RNA fusion and a novel NTRK3 mutation, respectively. Our report suggests that long-term durable response can be achieved in metastatic pancreaticobiliary ampullary adenocarcinoma using nab-paclitaxel and gemcitabine. Molecular profiling of the tumor identified a novel R-Spondin2 RNA fusion and NTRK3 mutation that can be potentially targeted for treatment. MDPI 2023-08-21 /pmc/articles/PMC10452745/ /pubmed/37626821 http://dx.doi.org/10.3390/biomedicines11082326 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Linscott, Maryknoll P.
Markus, Havell
Sennett, Mackenzie
Abendroth, Catherine
Yee, Nelson S.
Nab-Paclitaxel and Gemcitabine as First-Line Treatment of Metastatic Ampullary Adenocarcinoma with a Novel R-Spondin2 RNA Fusion and NTRK3 Mutation
title Nab-Paclitaxel and Gemcitabine as First-Line Treatment of Metastatic Ampullary Adenocarcinoma with a Novel R-Spondin2 RNA Fusion and NTRK3 Mutation
title_full Nab-Paclitaxel and Gemcitabine as First-Line Treatment of Metastatic Ampullary Adenocarcinoma with a Novel R-Spondin2 RNA Fusion and NTRK3 Mutation
title_fullStr Nab-Paclitaxel and Gemcitabine as First-Line Treatment of Metastatic Ampullary Adenocarcinoma with a Novel R-Spondin2 RNA Fusion and NTRK3 Mutation
title_full_unstemmed Nab-Paclitaxel and Gemcitabine as First-Line Treatment of Metastatic Ampullary Adenocarcinoma with a Novel R-Spondin2 RNA Fusion and NTRK3 Mutation
title_short Nab-Paclitaxel and Gemcitabine as First-Line Treatment of Metastatic Ampullary Adenocarcinoma with a Novel R-Spondin2 RNA Fusion and NTRK3 Mutation
title_sort nab-paclitaxel and gemcitabine as first-line treatment of metastatic ampullary adenocarcinoma with a novel r-spondin2 rna fusion and ntrk3 mutation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10452745/
https://www.ncbi.nlm.nih.gov/pubmed/37626821
http://dx.doi.org/10.3390/biomedicines11082326
work_keys_str_mv AT linscottmaryknollp nabpaclitaxelandgemcitabineasfirstlinetreatmentofmetastaticampullaryadenocarcinomawithanovelrspondin2rnafusionandntrk3mutation
AT markushavell nabpaclitaxelandgemcitabineasfirstlinetreatmentofmetastaticampullaryadenocarcinomawithanovelrspondin2rnafusionandntrk3mutation
AT sennettmackenzie nabpaclitaxelandgemcitabineasfirstlinetreatmentofmetastaticampullaryadenocarcinomawithanovelrspondin2rnafusionandntrk3mutation
AT abendrothcatherine nabpaclitaxelandgemcitabineasfirstlinetreatmentofmetastaticampullaryadenocarcinomawithanovelrspondin2rnafusionandntrk3mutation
AT yeenelsons nabpaclitaxelandgemcitabineasfirstlinetreatmentofmetastaticampullaryadenocarcinomawithanovelrspondin2rnafusionandntrk3mutation