内容紹介
Long-Term Survival of a Patient with KRAS Mutated Colon Cancer Successfully Treated with Regorafenib
Summary
A 65-year-old woman underwent iliocecal resection for cecal cancer. During post-operative follow-up, she was diagnosed with metastasis to the abdominal wall and a curative resection was performed. After 12 courses of adjuvant chemotherapy with a modified combination of folinic acid, 5-fluorouracil, and oxaliplatin(mFOLFOX6), recurrence was noted in the lung. A curative resection was successfully performed and she was subsequently treated with bevacizumab and a combination of folinic acid, 5-fluorouracil, and irinotecan(FOLFIRI). One year after surgical resection, recurrence in the remnant lung was diagnosed. Because of the KRAS mutation, she could not be treated with anti-epidermal growth factor antibodies. The metastatic lung tumor continued to enlarge. Therefore, we selected regorafenib as third-line chemotherapy. After treatment with regorafenib, the size of the target lesion decreased significantly.
要旨
レゴラフェニブ投与にて腫瘍縮小を認め,長期生存しているKRAS変異型大腸癌の1例を経験したので報告する。症例は65歳,女性。盲腸癌術後,右腹壁に再発を生じ切除施行。術後mFOLFOX6を12コース施行した。1年7か月後に両側肺転移を生じ切除施行。術後bevacizumab+FOLFIRIを開始した。1年後に残肺再発を生じたがKRAS遺伝子変異型であり,抗EGFR抗体薬が使用できず,その後再発巣の増悪を認めレゴラフェニブ投与を開始したところ,転移巣の縮小を認めた。
目次
Summary
A 65-year-old woman underwent iliocecal resection for cecal cancer. During post-operative follow-up, she was diagnosed with metastasis to the abdominal wall and a curative resection was performed. After 12 courses of adjuvant chemotherapy with a modified combination of folinic acid, 5-fluorouracil, and oxaliplatin(mFOLFOX6), recurrence was noted in the lung. A curative resection was successfully performed and she was subsequently treated with bevacizumab and a combination of folinic acid, 5-fluorouracil, and irinotecan(FOLFIRI). One year after surgical resection, recurrence in the remnant lung was diagnosed. Because of the KRAS mutation, she could not be treated with anti-epidermal growth factor antibodies. The metastatic lung tumor continued to enlarge. Therefore, we selected regorafenib as third-line chemotherapy. After treatment with regorafenib, the size of the target lesion decreased significantly.
要旨
レゴラフェニブ投与にて腫瘍縮小を認め,長期生存しているKRAS変異型大腸癌の1例を経験したので報告する。症例は65歳,女性。盲腸癌術後,右腹壁に再発を生じ切除施行。術後mFOLFOX6を12コース施行した。1年7か月後に両側肺転移を生じ切除施行。術後bevacizumab+FOLFIRIを開始した。1年後に残肺再発を生じたがKRAS遺伝子変異型であり,抗EGFR抗体薬が使用できず,その後再発巣の増悪を認めレゴラフェニブ投与を開始したところ,転移巣の縮小を認めた。