Recurrent disease four years after surgery and adjuvant chemotherapy.
A 71-year-old man with previous primary resection was found to have extensive liver metastases. Chemotherapy was initiated with FOLFIRI plus bevacizumab, in hopes of reducing the hepatic tumor burden; this resulted in manageable toxicity and was sufficiently effective to allow resection. After 6 weeks, 6 cycles of chemotherapy with FOLFIRI plus bevacizumab were administered; the patient was free of new lesions for the next 19 months. Readministration of FOLFIRI plus bevacizumab resulted in minor response and symptom control for another 9 months before further progression was observed. The subsequent administration of FOLFOX for 8 cycles and FOLFIRI plus cetuximab were unable to prevent further decline. Detailed explanation of the selection of appropriate surgical and chemotherapeutic options are provided throughout the case discussion.
Pozzo
Carmelo
C
Unit of Medical Oncology, Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy. carmelo.pozzo@rm.unicatt.it
Barone
Carlo
C
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy*; D009944:Organoplatinum Compounds / Q000627:therapeutic use
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin