Combination chemotherapy with gemcitabine and nab-paclitaxel for a metastatic pancreatic ductal adenocarcinoma patient undergoing hemodialysis

  • Takashi KanekoEmail author
  • Kazuya Sugimori
  • Yuichiro Tozuka
  • Taito Fukushima
  • Kazuya Okada
  • Hiroyuki Oka
  • Hiroshi Okazaki
  • Shin Maeda
Case Report


In cancer patients, impairment of kidney function is not uncommon. Recently, the efficacy of the combination of gemcitabine and nab-paclitaxel for pancreatic ductal adenocarcinoma (PDAC) patients has been reported, however, there is no recommendation for dose and administration to patients undergoing hemodialysis (HD). A 66-year-old man began receiving HD for chronic renal failure 4 years previously. He suffered from diarrhea, back pain, and loss of appetite, and his weight gradually decreased. Abdominal dynamic computed tomography showed a 45-mm hypodense mass in the pancreatic body and a 30-mm hypodense mass in the liver. The patient was diagnosed with metastatic PDAC. He started combination chemotherapy of gemcitabine and nab-paclitaxel without dose modification. He developed pneumonia and neutropenia in the first and second courses, so we modified to a 60% dose of gemcitabine and nab-paclitaxel on day 1 every 2 weeks. After dose modification, he continued combination chemotherapy for over 7 months without severe adverse events or tumor progression. Combination chemotherapy using gemcitabine and nab-paclitaxel was effective in a PDAC patient undergoing HD. While it is possible to originally administer these drugs with no dose modification, early dose modification was needed for our patient because of severe adverse events.


Pancreatic cancer Hemodialysis Gemcitabine Nab-paclitaxel Combination chemotherapy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human rights

All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed Consent

Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  1. 1.Department of GastroenterologyYokohama Minami Kyosai HospitalYokohamaJapan
  2. 2.Gastroenterological Center, Yokohama City University Medical CenterYokohamaJapan
  3. 3.Department of Nephrology/HypertensionYokohama Minami Kyosai HospitalYokohamaJapan
  4. 4.Gastroenterology DivisionYokohama City University, Graduate School of MedicineYokohamaJapan

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