Mariana Paula Cunha Goncalves
Mario Penna Institute, Brazil
Posters & Accepted Abstracts: Arch Cancer Res
Introduction: Despite the evolution of the treatments and the better knowledge of tumor behavior in patients with metastatic colorectal adenocarcinomas, the poor prognosis associated in those patients who were presented with disease progression after the first line treatment is well known. Long-term relapse-free survival with second-line palliative treatment can be achieved in only a limited number of individual cases. Case Report: A 48-year-old male patient presented with a sigmoid colon adenocarcinoma, with unresectable bilobar liver metastases. Molecular evaluation was conducted with BRAF and All-RAS wild type without microsatellite instability. We started treatment based on chemotherapy with FOLFIRI plus cetuximab. The patient evolved with progression of liver disease after six cycles of first-line therapy. On this occasion second-line chemotherapy with mFOLFOX6 plus bevacizumab was started. Reassessment tests after three treatment cycles showed a significant reduction of hepatic target lesions (3 in total), with no signs of active diseases in other sites indicated surgical approach of these lesions with proportional hepatic segmentectomies aiming at complete resections. The histopathological findings of the analyzed pieces confirmed that free margins were reached in all of them. As a complementary therapy, three additional cycles of mFOLFOX6 plus bevacizumab were given postoperatively. The treatment was, in general, well tolerated, and no grade III or IV toxicity was observed. In the extended follow-up, the patient presents with an interval of 30-month free of disease recurrence, and in excellent clinical conditions. Conclusion: In this case, it was possible to observe the importance of intensive chemotherapy treatment, even in the secondline palliative scenario, associated with an adequate surgical approach to achieve more efficient conversion rates and long-term recurrence-free survival results and in individual cases, increase in overall survival.
Mariana Paula Cunha Gonçalves young oncologist, medical assistant and researcher in Brazil, specializing in the treatment of patients with colorectal cancer at the Mario Penna Institute and ONCOMED clinic of oncology, in the state of Minas Gerais, Brazil. Member of the Brazilian Oncology Society, researcher and associate of the Brazilian Group of Gastrointestinal Tumors and member of the Group of studies on colorectal cancer of Minas Gerais. Young oncologist associated with American and European oncology societies (ASCO and ESMO).
E-mail: [email protected]