内容紹介
Anti-EGFR Antibody Combination Chemotherapy Was Effective against Locally Advanced Ascending Colon Cancer as Well as a Recurrent Lesion―A Case Report
Summary
Here we report a case in which a locally advanced ascending colon cancer was successfully treated with anti-EGFR immunotherapy combined with chemotherapy and curative resection, and recurrent cancer was treated with the same chemotherapy. A 71-year-old man was diagnosed with ascending colon cancer in our department. No distant metastasis was observed, but curative resection was considered impossible because of extensive local cancer invasion. Because a genetic analysis revealed the presence of the wild-type KRAS gene, 6 courses of mFOLFOX6 plus cetuximab were administered. A cPR was obtained and curative resection was performed. The final diagnosis was ypT3N1M0, ypStageⅢa colon cancer, and chemotherapy improved the cancer stage to Grade 1b. Six courses of FOLFOX6 were then administered, followed by observation. After 2 years 6 months, a tumor of approximately 5 cm in size was noted in the right buttock using surveillance CT and was diagnosed as recurrent colon cancer. We considered further curative resection difficult and therefore 6 courses of mFOLFOX6 plus panitumumab were administered, a cPR was obtained, and right hip tumor extirpation surgery was performed. These results suggest that chemotherapy combined with anti-EGFR antibody immunotherapy is effective in treating recurrent colon cancer.
要旨
局所進行上行結腸癌に抗EGFR抗体薬併用化学療法が奏効し治癒切除し得たが,その再発に対しても同剤を併用した化学療法が著効した1例を経験した。症例は71歳,男性。上行結腸癌の診断で治療目的に当科に入院した。遠隔転移はないが,局所の癌の過進展のため治癒切除不能と判断した。KRASが野生型のためmFOLFOX6+cetuximabを6コース施行し,cPRと判定し根治切除を施行した。最終診断はypT3N1M0,ypStageⅢa,化学療法効果判定はGrade 1bであった。術後 mFOLFOX6 を6コース施行し経過観察していたが,切除2年6か月後のCTで右臀部に約5 cm大の腫瘍を認め,上行結腸癌の再発と診断した。治癒切除は困難と判断し,mFOLFOX6+panitumumabを6コース施行したところcPRが得られ,再発巣切除術を施行した。病理組織学的所見ではpCRであった。自験例は抗EGFR抗体薬併用化学療法治療後の再発に対しても同剤の再投与が著効した示唆に富む症例と考えられた。
目次
Summary
Here we report a case in which a locally advanced ascending colon cancer was successfully treated with anti-EGFR immunotherapy combined with chemotherapy and curative resection, and recurrent cancer was treated with the same chemotherapy. A 71-year-old man was diagnosed with ascending colon cancer in our department. No distant metastasis was observed, but curative resection was considered impossible because of extensive local cancer invasion. Because a genetic analysis revealed the presence of the wild-type KRAS gene, 6 courses of mFOLFOX6 plus cetuximab were administered. A cPR was obtained and curative resection was performed. The final diagnosis was ypT3N1M0, ypStageⅢa colon cancer, and chemotherapy improved the cancer stage to Grade 1b. Six courses of FOLFOX6 were then administered, followed by observation. After 2 years 6 months, a tumor of approximately 5 cm in size was noted in the right buttock using surveillance CT and was diagnosed as recurrent colon cancer. We considered further curative resection difficult and therefore 6 courses of mFOLFOX6 plus panitumumab were administered, a cPR was obtained, and right hip tumor extirpation surgery was performed. These results suggest that chemotherapy combined with anti-EGFR antibody immunotherapy is effective in treating recurrent colon cancer.
要旨
局所進行上行結腸癌に抗EGFR抗体薬併用化学療法が奏効し治癒切除し得たが,その再発に対しても同剤を併用した化学療法が著効した1例を経験した。症例は71歳,男性。上行結腸癌の診断で治療目的に当科に入院した。遠隔転移はないが,局所の癌の過進展のため治癒切除不能と判断した。KRASが野生型のためmFOLFOX6+cetuximabを6コース施行し,cPRと判定し根治切除を施行した。最終診断はypT3N1M0,ypStageⅢa,化学療法効果判定はGrade 1bであった。術後 mFOLFOX6 を6コース施行し経過観察していたが,切除2年6か月後のCTで右臀部に約5 cm大の腫瘍を認め,上行結腸癌の再発と診断した。治癒切除は困難と判断し,mFOLFOX6+panitumumabを6コース施行したところcPRが得られ,再発巣切除術を施行した。病理組織学的所見ではpCRであった。自験例は抗EGFR抗体薬併用化学療法治療後の再発に対しても同剤の再投与が著効した示唆に富む症例と考えられた。