This is the case report of a patient with right-sided, RAS and BRAF wild-type metastatic colorectal cancer, with borderline/potentially resectable liver-limited disease. Following neoadjuvant treatment with FOLFOX plus bevacizumab and radical resection, an early intra-hepatic disease relapse was observed and deemed as potentially resectable. Therefore, treatment with FOLFIRI plus aflibercept was started: a major partial response and radical re-resection were achieved. Following unresectable disease relapse, second-line treatment with FOLFIRI aflibercept was resumed and achieved again a partial response that is still ongoing after more than 9 months. This case report highlights how treatment goals (potentially curative resection vs palliation), molecular status and primary tumor location influence treatment strategies in order to maximize patients' outcomes.
Si tratta del caso clinico di un paziente con carcinoma metastatico del colon destro, RAS e BRAF wildtype, con malattia limitata al fegato potenzialmente resecabile. Dopo trattamento neoadiuvante con FOLFOX bevacizumab e chirurgia epatica radicale, è stata osservata una recidiva intraepatica precoce, giudicata ancora potenzialmente resecabile. Pertanto, è stato iniziato trattamento con FOLFIRI e aflibercept, ottenendo una risposta tumorale “maggiore” e una ri-resezione chirurgica radicale. Dopo un’ulteriore recidiva inoperabile, il trattamento di seconda linea con FOLFIRI e aflibercept è stato ripreso, ottenendo di nuovo una risposta parziale che risulta essere a tutt’oggi mantenuta dopo oltre 9 mesi. Questo caso clinico sottolinea come gli obiettivi del trattamento (chirurgia potenzialmente curativa verso palliazione), lo status molecolare e la sede del tumore primitivo condizionino le strategie di trattamento con lo scopo di massimizzare l’“outcome” dei pazienti.
Trattamento con FOLFIRI e aflibercept in paziente con adenocarcinoma del colon destro RAS e BRAF wild-type e metastasi epatiche potenzialmente resecabili = Treatment with FOLFIRI plus aflibercept in a patient with RAS and BRAF wild-type, right-sided colon cancer and potentially resectable liver metastases / F. Pietrantonio. - In: RECENTI PROGRESSI IN MEDICINA. - ISSN 2038-1840. - 109:11(2018 Nov), pp. e20-e23. [10.1701/3031.30302]
Trattamento con FOLFIRI e aflibercept in paziente con adenocarcinoma del colon destro RAS e BRAF wild-type e metastasi epatiche potenzialmente resecabili = Treatment with FOLFIRI plus aflibercept in a patient with RAS and BRAF wild-type, right-sided colon cancer and potentially resectable liver metastases
F. Pietrantonio
2018
Abstract
This is the case report of a patient with right-sided, RAS and BRAF wild-type metastatic colorectal cancer, with borderline/potentially resectable liver-limited disease. Following neoadjuvant treatment with FOLFOX plus bevacizumab and radical resection, an early intra-hepatic disease relapse was observed and deemed as potentially resectable. Therefore, treatment with FOLFIRI plus aflibercept was started: a major partial response and radical re-resection were achieved. Following unresectable disease relapse, second-line treatment with FOLFIRI aflibercept was resumed and achieved again a partial response that is still ongoing after more than 9 months. This case report highlights how treatment goals (potentially curative resection vs palliation), molecular status and primary tumor location influence treatment strategies in order to maximize patients' outcomes.File | Dimensione | Formato | |
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