Adjusted gemcitabine plus S-1 regimen as first-line chemotherapy in unresectable advanced pancreatic cancer: a long-term survival case report
Year: 2025
Type: article
Study design: Case Report
Abstract: Background: The gemcitabine plus S-1 (GS) regimen is a first-line chemotherapy for unresectable locally advanced or metastatic pancreatic cancer (PC), a disease associated with high mortality. However, severe adverse events associated with the standard GS (gemcitabine plus daily S-1) regimen adversely affect treatment adherence and clinical outcomes. Recent studies suggest that modified GS regimens may improve tolerability without compromising efficacy in select populations. Here, we report a case demonstrating that an adjusted GS (gemcitabine plus alternate-day S-1) regimen could represent a viable alternative first-line chemotherapy for patients with standard GS protocol intolerance. Case Description: on alternate days) in March 2020. The patient tolerated this adjusted GS regimen well, achieving partial remission with reduced carbohydrate antigen 19-9 (CA19-9; from >1,000 to 85.3 U/mL) and decreased tumor size (59 mm × 20 mm to 25 mm × 18 mm) within 14 months. She completed 12 cycles of adjusted GS regimen, followed by S-1 monotherapy. At 58-month follow-up, she remained alive with controlled disease (stable tumor size) and preserved quality of life. Conclusions: This case highlights the potential of an adjusted GS regimen to achieve prolonged disease control and manageable toxicity in patients with standard GS intolerance. This modified approach may serve as a potential alternative to the standard GS regimen for select patients who experience intolerance to conventional therapy. A future multicenter randomized controlled study will investigate the efficacy and safety of this adjusted GS treatment strategy.
Source: AME Case Reports
DOI: 10.21037/acr-24-274
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414394351