This is a "best practice" case report of a non-uncommon clinical scenario, referring to an early liver relapse, judged as technically resectable, following adjuvant oxaliplatin-based treatment for left-sided, RAS and BRAF wild-type colon cancer. The choice of aflibercept vs cetuximab/panitumumab relies on the need to counteract an aggressive disease, without loosing the chance of radical surgery, nor loosing treatment options in the third-line setting. Treatment decisions are evidence-based on efficacy data of neoadjuvant anti-angiogenic treatment, as well as on the detrimental effect derived from the addition of cetuximab to perioperative chemotherapy.
Si descrive un caso clinico di best practice in un paziente non raro da incontrare, con recidiva precoce epatica tecnicamente resecabile dopo trattamento adiuvante a base di oxaliplatino per carcinoma del colon sinistro RAS e BRAF wild-type. La scelta di aflibercept rispetto a cetuximab/panitumumab risiede nella necessità di contrastare una malattia aggressiva e inizialmente non responsiva, senza perdere né l’opportunità chirurgica né quella di trattamento in terza linea. Le scelte terapeutiche sono evidence-based sui dati di efficacia della terapia antiangiogenica nella fase preoperatoria, nonché sull’effetto detrimentale dell’aggiunta di cetuximab alla chemioterapia perioperatoria.
Trattamento con FOLFIRI e aflibercept in paziente con metastasi epatiche potenzialmente resecabili di adenocarcinoma del colon sinistro RAS e BRAF wild-type, dopo terapia adiuvante a base di oxaliplatino = Perioperative treatment with FOLFIRI plus aflibercept in a patient with RAS and BRAF wild-type, left-sided colon cancer, with early relapse following adjuvant oxaliplatin- based treatment due to potentially resectable liver metastases / F. Pietrantonio. - In: RECENTI PROGRESSI IN MEDICINA. - ISSN 2038-1840. - 109:11(2018 Nov), pp. 24e-26e. [10.1701/3031.30303]
Trattamento con FOLFIRI e aflibercept in paziente con metastasi epatiche potenzialmente resecabili di adenocarcinoma del colon sinistro RAS e BRAF wild-type, dopo terapia adiuvante a base di oxaliplatino = Perioperative treatment with FOLFIRI plus aflibercept in a patient with RAS and BRAF wild-type, left-sided colon cancer, with early relapse following adjuvant oxaliplatin- based treatment due to potentially resectable liver metastases
F. Pietrantonio
2018
Abstract
This is a "best practice" case report of a non-uncommon clinical scenario, referring to an early liver relapse, judged as technically resectable, following adjuvant oxaliplatin-based treatment for left-sided, RAS and BRAF wild-type colon cancer. The choice of aflibercept vs cetuximab/panitumumab relies on the need to counteract an aggressive disease, without loosing the chance of radical surgery, nor loosing treatment options in the third-line setting. Treatment decisions are evidence-based on efficacy data of neoadjuvant anti-angiogenic treatment, as well as on the detrimental effect derived from the addition of cetuximab to perioperative chemotherapy.File | Dimensione | Formato | |
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