title: Conversion Therapy Using mFOLFOX6 With Panitumumab for Unresectable Liver Metastases From Multiple Colorectal Cancers With Familial Adenomatous Polyposis.
abstract: A 39-year-old man received a diagnosis of unresectable multiple liver metastases from multiple colorectal cancers with familial adenomatous polyposis. After construction of an ileostomy, modified FOLFOX6 (mFOLFOX6) with panitumumab was administrated because rectal cancer and sigmoid colon cancer are KRAS wild type. The 13 courses of chemotherapy resulted in a marked reduction in the size of liver metastases and sigmoid colon cancer. Consequently, curative resection with total colectomy, ileal pouch anal anastomosis, and liver metastasis resection with radiofrequency ablation was performed. Progression of KRAS wild-type rectal cancer after chemotherapy suggested that each clone from rectal and sigmoid colon cancer might have a different sensitivity to epidermal growth factor receptor antibody. Immunohistochemical analysis revealed loss of PTEN expression in rectal cancer compared with liver metastases from sigmoid colon cancer, showing that the difference of mFOLFOX6 with panitumumab might be related to activation of the PI3K-AKT pathway.
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Graduate School of Medicine, Mie University, Mie, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Toiyama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Takahito
authors.initials: T
authors.lastname: Kitajima
authors.forename: Masato
authors.initials: M
authors.lastname: Okigami
authors.forename: Mikio
authors.initials: M
authors.lastname: Kawamura
authors.forename: Aya
authors.initials: A
authors.lastname: Kawamoto
authors.forename: Yoshinaga
authors.initials: Y
authors.lastname: Okugawa
authors.forename: Jyunichiro
authors.initials: J
authors.lastname: Hiro
authors.forename: Koji
authors.initials: K
authors.lastname: Tanaka
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Mohri
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols; D017115:Catheter Ablation; D003082:Colectomy; D039021:Colonic Pouches; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D005472:Fluorouracil; D006801:Humans; D002955:Leucovorin; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D008297:Male; D009944:Organoplatinum Compounds; D000077544:Panitumumab; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D009944:Organoplatinum Compounds; D000077544:Panitumumab; D002955:Leucovorin; D005472:Fluorouracil
keywords: Colorectal cancer; Familial adenomatous polyposis; Liver metastases; Panitumumab; mFOLFOX6