gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Cholangiocellular carcinoma responding on Gemcitabine in combination with EGF-Receptor antibody (Cetuximab) – A Case Report

Meeting Abstract

  • corresponding author presenting/speaker Martin Sprinzl - Universitätsklinikum, Mainz, Deutschland
  • Christoph Schimanski - Universitätsklinikum, Mainz
  • Peter Galle - Universitätsklinikum, Mainz
  • Markus Moehler - Universitätsklinikum, Mainz
  • Stephan Kanzler - Universitätsklinikum, Mainz

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPE236

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter:

Veröffentlicht: 20. März 2006

© 2006 Sprinzl et al.
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Extensive cholangiocellular carcinoma (CCC) determines the overall outcome and limits curative resection. Despite chemotherapy, which has been introduced to improve the outcome of biliary tract malignancies, the benefit in survival is still marginal. We report about a 69 year old patient with non-resectable CCC, showing hepatic metastasis and peritoneal carcinomatosis. Diagnosis was based on radiography, mini laparoscopy and bioptic specimens. Histology revealed an adeno-carcinoma of the biliary tract, with expression of EGF-receptor. After informed consent the patient received experimental gemcitabine (1000 mg/m²) every other week and cetuximab (loading-dose 400 mg/m², maintenance-dose 250 mg/m²) weekly for palliative chemotherapy. During reported follow up, 20 cycles of chemotherapy were administered. Relevant chemotherapy-related toxicity was limited on gemcitabine-associated side effects. Predominantly, haematological toxicity (CTC, Grade 3) and neutropenic fever (CTC, Grade 3) promoted by catheter related sepsis were observed. Cetuximab caused only mild skin toxicity (CTC, Grade 1). During chemotherapy a partial response (> 30% reduction, RECIST) of the target lesions and disappearance of the peritoneal carcinomatosis was recognized by computed tomography. Partial response occurred after 17 weeks of treatment, and remained stable until end of follow up, 9.7 months later. In parallel, Ca-19.9 serum levels, which were elevated 5-fold at time of diagnosis, returned to normal after 16 weeks of treatment. The performance status improved and intravenous alimentation, supplemented since time of diagnosis, has been discontinued. A combination of cytotoxic chemotherapy with targeted agents, such as cetuximab, seems to be a safe and efficient way to improve quality of life and survival, as reported in this case of a patient suffering from CCC. Therefore cetuximab might be an efficient component of palliative chemotherapy against biliary-tract cancer, which needs further evaluation in prospective randomized trials.