Possibility of sandwiched liver surgery with molecular targeting drugs, cetuximab and bevacizumab on colon cancer liver
- PDF / 716,223 Bytes
- 5 Pages / 595.28 x 793.7 pts Page_size
- 59 Downloads / 170 Views
WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Possibility of sandwiched liver surgery with molecular targeting drugs, cetuximab and bevacizumab on colon cancer liver metastases: a case report Yoichi Toyama1*, Takuro Ushigome1, Kazuhiro Watanabe1, Hiroaki Kitamura1, Shinji Onda1, Ryota Saito1, Seiya Yoshida1, Hidejiro Kawahara1, Satoru Yanagisawa1 and Katsuhiko Yanaga2
Abstract A 31-year-old man with sigmoid colon cancer with concomitant simultaneous multiple liver metastases had received FOLFIRI (leucovorin, fluorouracil and irinotecan) and FOLFOX6 (leucovorin, fluorouracil and oxaliplatin) after an ordinary sigmoidectomy. However, his serum carcinoembryonic antigen (CEA) level increased rapidly during the fifteen months after the operation while he was on FOLFOX6. Abdominal computed tomography revealed expanding multiple liver tumors. As the third line chemotherapy, a combination therapy of cetuximab with irinotecan was given, which markedly reduced his levels of serum CEA, and the size and number of liver tumors. He underwent lateral segmentectomy of the liver and microwave coagulation of the liver metastases in the remnant liver. Thereafter, a good quality of life with tumor dormancy was obtained for 6 months. However, his serum CEA started to rise again in the absence of liver tumors. Therefore, FOLFOX6 with bevacizumab was chosen as the fourth line chemotherapy, and the serum CEA was reduced with tumor dormancy. A good quality of life was obtained again at 3 years after the first surgery. This report indicates the effectiveness of sandwiched liver surgery with the molecular targeting drugs cetuximab and bevacizumab on multiple liver metastases of colon cancer, and suggests the possibility of a regimen consisting of bevacizumab following cetuximab. Keywords: Bevacizumab, Cetuximab, Colon cancer liver metastases, Molecular targeting drug, Sandwiched liver surgery
Background Recently, various molecular targeting drugs have appeared through developing biotechnology [1]. Cetuximab, a new molecular drug, has a notable ability as an anti-epidermal growth factor receptor (EGFR) monoclonal antibody [2]. A randomized European study suggested that cetuximab was effective in patients with irinotecan-refractory metastatic colorectal cancer [3]. A KRAS mutation is an important predictive factor for resistance to cetuximab chemotherapy in patients with metastatic colorectal cancer [4]. Moreover, it has been
* Correspondence: [email protected] 1 Department of Surgery, The Jikei University Kashiwa Hospital, 163-1, Kashiwashita, Chiba Prefecture, Kashiwa City 277-8567, Japan Full list of author information is available at the end of the article
reported that the combination of cetuximab and chemotherapy improves the resectability of colorectal cancer liver metastases (CCLM) [5]. Bevacizumab, an anti-vascular endothelial growth factor receptor (VEGFR) monoclonal antibody, is also an important drug among these new agents [6]. An open-label study, NO16966, reported the non-inferiority of XELOX (capecitab
Data Loading...
