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She received palliative chemotherapy with 5-fluorouracil, leucovorin, irinotecan and oxaliplatin (FOLFIRINOX) for 6\u2009months, complicated by mucositis, diarrhoea, vomiting and two <jats:italic>Clostridium difficile<\/jats:italic> colitis episodes. Cancer initially responded to chemotherapy. However, due to substantial toxicities, she decided to discontinue cytotoxic chemotherapy and focus on palliation alone. Thereafter, CT and carbohydrate antigen (CA) 19-9 showed further response and ultimately complete cancer regression that has persisted for 33 months after cessation of chemotherapy. This is the first report in the English literature showing spontaneous regression of a PDA with liver metastases. Two possible mechanisms are proposed: antitumoral autoimmunity and tumour hypoxia related to vascular disease.<\/jats:p>","DOI":"10.1136\/bcr-2019-229619","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:10:59Z","timestamp":1678752659000},"page":"e229619","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous regression of pancreatic cancer with liver metastases"],"prefix":"10.1136","volume":"12","author":[{"given":"Patricia","family":"Saade Lemus","sequence":"first","affiliation":[{"name":"Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Anderson","sequence":"additional","affiliation":[{"name":"Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Smith","sequence":"additional","affiliation":[{"name":"Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Bullock","sequence":"additional","affiliation":[{"name":"Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,5,31]]},"reference":[{"key":"2025082710303021000_12.5.e229619.1","first-page":"354","article-title":"The spontaneous regression of cancer","volume":"2","author":"Boyd","year":"1957","journal-title":"Proc Can Cancer Conf"},{"key":"2025082710303021000_12.5.e229619.2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195609000-00007"},{"key":"2025082710303021000_12.5.e229619.3","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21387"},{"key":"2025082710303021000_12.5.e229619.4","unstructured":"American Cancer Society. 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