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This refers to a specific chemotherapeutic cocktail consisting of gemcitabine (19 mg/mL) and paclitaxel (3 mg/mL) developed by the Milton S. Hershey Medical Center (Penn State Health) for the ablation of mucinous pancreatic cysts. The intervention is delivered via endoscopic ultrasound-guided fine needle infusion (EUS-FNI) directly into the cyst cavity, often following a lavage with either ethanol or normal saline. This approach, evaluated in the CHARM (Chemotherapy for Ablation and Resolution of Mucinous Pancreatic Cysts) trial series, targets precancerous lesions such as mucinous cystic neoplasms and intraductal papillary mucinous neoplasms (IPMNs). By inducing localized cytotoxicity and microtubule stabilization within the cyst epithelium, the cocktail aims to achieve complete cyst resolution and prevent progression to pancreatic adenocarcinoma. Clinical data from the CHARM II trial indicated that an alcohol-free protocol using this cocktail achieved high rates of complete ablation with a reduced risk of adverse events compared to traditional ethanol-based methods.
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