Objectives: This study was aimed to report a patient with metastatic pancreatic cancer treated with modified Bangam-tang and Gunchil-dan in conjunction with gemcitabine. There were better survival-related outcomes compared to gemcitabine alone. Methods: The patient with metastatic pancreatic cancer received gemcitabine as palliative chemotherapy since June 2016 concurrent with modified Bangam-tang and Gunchil-dan since October 2016 to October 2017. To evaluate the effect of treatment, tumor markers (carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA)), Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and overall survival were checked. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results: After 12 months with the combination treatment, levels of CA19-9 were decreased from 8747 to 265.7 ng/ml and CEA from 42.2 to 6.5 U/ml. Clinical partial response state was shown until May 2, 2017 and stable disease state was maintained from August 4, 2017. In March 2018, the patient got an operation including pancreatectomy and diagnosed with no evidence of disease state in September, 2018. In conclusion, it showed the overall survival of 29 months from June, 2016 to November, 2018. Serious adverse events were not identified. Conclusions: This study suggested that combined treatment with modified Bangam-tang and Gunchil-dan may show better outcome in patient with metastatic pancreatic cancer than gemcitabine alone.

Objective: The purpose of this study is to report the case of a patient with non-small cell lung cancer (NSCLC) with Programmed cell death protein 1 (PD-1) mutation treated by Integrative Medicine Therapy (IMT). Methods: A patient with metastatic NSCLC received pembrolizumab 200mg intravenously for every 3 weeks from July 2017. Repeat cycle every 3 weeks since July 2017. The patient has been treated with Integrative Medicine Therapy (IMT) since December 2016. The tumor size was measured by computed tomography (CT) and magnetic resonance imaging(MRI). Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After combined treatment, the extent of proximal portion of primary tumor in the left lower lobe was decreased and disease status was stable radiologically. No evidence of newly developed metastatic lesions in the brain since May 2017. The patient did not experience any adverse event according to NCI-CTCAE ver. 5.0. Conclusion: This case study suggests that Integrative Medicine Therapy (IMT) may contribute to tumor response, in conjunction with Pembrolizumab on the treatment of patients with NSCLC.

Objective: The purpose of this study is to report the therapeutic possibility of a primary peritoneal carcinoma (PPC) patient with Traditional Korean Medicine (TKM). Methods: A 37 years old female patient diagnosed with PPC suffered from operation site pain, neck pain, nausea, headache and fatigue after undergoing operation and chemotherapy (Paclitaxel/Carboplain). The patient was treated with acupuncture, pharmacoacupuncture, moxibution and herbal medicine. Laboratory study and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0 were used to evaluate the safety and adverse events of treatments. The performance status was measured by Eastern Cooperative Oncology Group (ECOG) scale. Results: After treatments, cancer did not show any progression. Related symptoms such as postoperative pain, nausea, fatigue and quality of life have improved. Conclusion: This case study implies that TKM may have therapeutic possibility in treating PPC patient.

Objective: The purpose of this study is to report a metastatic adrenocortical carcinoma patient treated with wheel balanced cancer therapy (WBCT) regimen. Methods: A 52-year-old female patient diagnosed and incised with metastatic adrenocortical carcinoma visited the East West Cancer Center (EWCC) on Sep. 1st, 2018 for WBCT. The patient was treated with WBCT for an approximately 2 months, from Sep. 1st to Nov. 9th. Computed tomography (CT) was used to follow-up the tumor site. Laboratory analysis and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0 were used to evaluate the safety of WBCT. Results: The surgical beds after surgery (Lt. Laparoscopic adrenalectomy) were maintained without recurrence at follow up chest CT, and related symptoms and quality of life (QOL) were improved during the WBCT. Conclusion: This case study suggests that WBCT may help to improve QOL of adrenocortical carcinoma patient.