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Chemotherapy rechallenge in metastatic colon cancer:A case report and literature review
Chemotherapy rechallenge in metastatic colon cancer:A case report and literature review
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摘要：
BACKGROUND Colorectal cancer(CRC)is the third leading cause of cancer-related death in males and females in the United States.Approximately,20%-22%of patients have metastatic disease at the time of presentation,and 50%-60%will develop metastasis over the course of their disease.Despite advances in systemic therapies,there remains a paucity of effective third-and later-line therapies for patients with ongoing disease progression.However,rechallenging chemoresistant CRC tumors with previously administered therapies is an emerging concept that may be a life-prolonging option for heavily treated metastatic colorectal cancer(mCRC).CASE SUMMARY A 41-year-old man with no previous medical history initially presented with worsening diffuse abdominal tenderness.Computed tomography was significant for a splenic flexure mass and hepatic lesions concerning for metastatic disease.He underwent a colectomy with anastomosis.Postoperative pathology was diagnostic for moderately to well-differentiated adenocarcinoma(T4bN1bM1a).He received adjuvant 5-fluorouracil,leucovorin,and oxaliplatin(FOLFOX),but therapy was discontinued due to the development of atrial fibrillation.Additional workup indicated a carcinoembryonic antigen level of 508.2 ng/mL,and mutational analysis found that the tumor was microsatellite instability-high and KRAS/BRAF wild-type.He was started on irinotecan with oxaliplatin(IROX),and bevacizumab(14 cycles),developed disease progression,was transitioned to FOLFOX and cetuximab,and then eventually three cycles of pembrolizumab.Following disease progression,he was rechallenged with IROX therapy,as he previously responded well to oxaliplatin-based therapy.The IROX rechallenge provided this patient with a ten-month survival benefit,decreased metastatic burden,and marked improvement in his clinical condition.CONCLUSION Rechallenge of previous lines of well-tolerated systemic chemotherapy regimens may be a valuable therapeutic strategy in patients with heavily-treated mCRC.
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| 篇名 | Chemotherapy rechallenge in metastatic colon cancer:A case report and literature review | ||
| 来源期刊 | 世界临床肿瘤学杂志:英文版 | 学科 | 医学 |
| 关键词 | Metastatic colorectal cancer Rechallenge therapy Treatment holiday OXALIPLATIN IRINOTECAN Case report CHEMORESISTANCE Palliative option | ||
| 年，卷（期） | 2020,（11） | 所属期刊栏目 | |
| 研究方向 | 页码范围 | 959-967 | |
| 页数 | 9页 | 分类号 | R73 |
| 字数 | 语种 | ||
| DOI | |||
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Metastatic
colorectal
cancer
Rechallenge
therapy
Treatment
holiday
OXALIPLATIN
IRINOTECAN
Case
report
CHEMORESISTANCE
Palliative
option
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世界临床肿瘤学杂志：英文版
主办单位：
百世登出版集团有限公司
出版周期：
不定期
ISSN：
2218-4333
CN：
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出版地：
北京市朝阳区东四环中路62号楼远洋国际中
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44
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0
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