Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2024; 12(7): 1296-1304
Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1296
Extended survival with metastatic pancreatic cancer under fruquintinib treatment after failed chemotherapy: Two case reports
Dan Wu, Qiong Wang, Shuai Yan, Xia Sun, Ya Qin, Ming Yuan, Nan-Yao Wang, Xian-Ting Huang
Dan Wu, Qiong Wang, Shuai Yan, Xia Sun, Ya Qin, Ming Yuan, Nan-Yao Wang, Xian-Ting Huang, Department of Oncology, Jiangyin People's Hospital, Wuxi 214400, Jiangsu Province, China
Co-first authors: Dan Wu and Shuai Yan.
Author contributions: Wu D and Yan S contributed equally to this work in managing cases and recorded; Wang Q reviewed the manuscript; All authors have read and approved the final manuscript.
Supported by Found by the General Program of Wuxi Health and Health Committee, No. MS201908.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict 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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiong Wang, MD, Chief Doctor, Professor, Department of Oncology, Jiangyin People's Hospital, No. 163 Shoushan Road, Jiangyin City, Jiangsu Province, China. wangqiong55@hotmail.com
Received: October 8, 2023
Peer-review started: October 8, 2023
First decision: December 1, 2023
Revised: January 2, 2024
Accepted: February 5, 2024
Article in press: February 5, 2024
Published online: March 6, 2024
Processing time: 145 Days and 0.8 Hours
Abstract
BACKGROUND

Pancreatic cancer is a highly malignant disease. After decades of treatment progress, the current five-year survival rate for patients is still less than 10%. For later-line treatment, the treatment options are even more limited. Anti-angiogenic drugs can improve progression-free survival in patients with advanced pancreatic cancer. Preclinical data show that fruquintinib might improve the prognosis of advanced pancreatic cancer by targeting angiogenesis and lymphopoiesis, improving the abnormal vascular structure, and modulating the tumour immune microenvironment.

CASE SUMMARY

We present two cases of third-line fruquintinib monotherapy that brought an extraprolonged progress-free survival (PFS) of 10 months. Patient 1 took adjuvant gemcitabine-based and first-line nab-paclitaxel-based chemotherapy and then used local radiotherapy combined with programmed cell death 1 receptor (PD-1). Each line lasted approximately 7 months. Moreover, the patient took third-line fruquintinib, which was followed by stable disease for 10 months, during which no additional adverse effect was observed. The patient later refused to take fruquintinib due to difficulty urinating and lower abdominal pain after the coronavirus disease 2019 (COVID-19) infection. The patient died in February 2023. Patient 2 also took two prior lines of chemotherapy and then local radiotherapy combined with S-1. After confirmed disease progression, the patient experienced a continuous partial response after using fruquintinib monotherapy in the third line. After the patient had COVID-19 in December 2022, fruquintinib was discontinued. The patient died in January 2023 due to disease progression.

CONCLUSION

Both cases achieved a PFS benefit from later-line single-agent fruquintinib therapy. With its better safety profile, fruquintinib may be worth exploring and studying in more depth as a later-line treatment for pancreatic cancer patients.

Keywords: Pancreatic cancer; Anti-vascular endothelial growth factor receptor; Fruquintinib; Case report

Core Tip: These two cases achieved a progress-free survival benefit from later-line single-agent fruquintinib therapy. With its better safety profile, fruquintinib may be worth exploring and studying in more depth as a later-line treatment for pancreatic cancer patients. This is the first literary report on Fruquintinib used in metastasis pancreatic cancers.