内容紹介
Successful Administration of Regorafenib to a Metastatic Colon Cancer Patient with Impaired Performance Status by Reducing the Initial Dose
Summary
A 59-year-old woman had recurrences in the spleen and lung 10 years after radical excision of cecal cancer. After 27 months of treatment with 5-fluorouracil/Leucovorin, oxaliplatin, irinotecan, bevacizumab, and anti-EGFR antibodies, multiple bone metastases and a left adrenal metastasis developed, and the patient's performance status(PS)deteriorated to grade 3. Regorafenib was administered at 80 mg/day. The pain and appetite improved within 2 courses, and her PS improved from grade 3 to 2. Regorafenib was increased to 120 mg/day for the 2nd course, and the patient was treated for 5 months without severe adverse effects. Regorafenib is considered to be a salvage-line treatment only for patients in relatively good condition, because full-dose regorafenib treatment often leads to severe adverse effects. Dose escalation of regorafenib from the low initial dose of 80 mg/day may be a safe and effective way of providing an opportunity of this chemotherapy to patients with impaired PS.
要旨
症例は59歳,女性。盲腸癌術後10年目に脾,肺転移で再発した。5-FU/LV,オキサリプラチン,イリノテカン,ベバシズマブ,抗EGFR抗体薬による2年3か月の治療後,多発骨転移と副腎転移も出現してperformance status(PS)3となった。レゴラフェニブを80 mg/日で開始したところ,2コース目からPS 2に改善し,120 mg/日に増量して5か月間治療が継続できた。レゴラフェニブは開始初期に強い有害事象が出現する傾向がある。標準量での開始が原則であるが,減量して導入し,有害事象が落ち着いたところで増量することにより,比較的状態の悪い患者にも治療対象を広げられる可能性がある。
目次
Summary
A 59-year-old woman had recurrences in the spleen and lung 10 years after radical excision of cecal cancer. After 27 months of treatment with 5-fluorouracil/Leucovorin, oxaliplatin, irinotecan, bevacizumab, and anti-EGFR antibodies, multiple bone metastases and a left adrenal metastasis developed, and the patient's performance status(PS)deteriorated to grade 3. Regorafenib was administered at 80 mg/day. The pain and appetite improved within 2 courses, and her PS improved from grade 3 to 2. Regorafenib was increased to 120 mg/day for the 2nd course, and the patient was treated for 5 months without severe adverse effects. Regorafenib is considered to be a salvage-line treatment only for patients in relatively good condition, because full-dose regorafenib treatment often leads to severe adverse effects. Dose escalation of regorafenib from the low initial dose of 80 mg/day may be a safe and effective way of providing an opportunity of this chemotherapy to patients with impaired PS.
要旨
症例は59歳,女性。盲腸癌術後10年目に脾,肺転移で再発した。5-FU/LV,オキサリプラチン,イリノテカン,ベバシズマブ,抗EGFR抗体薬による2年3か月の治療後,多発骨転移と副腎転移も出現してperformance status(PS)3となった。レゴラフェニブを80 mg/日で開始したところ,2コース目からPS 2に改善し,120 mg/日に増量して5か月間治療が継続できた。レゴラフェニブは開始初期に強い有害事象が出現する傾向がある。標準量での開始が原則であるが,減量して導入し,有害事象が落ち着いたところで増量することにより,比較的状態の悪い患者にも治療対象を広げられる可能性がある。