西妥昔单抗治疗转移性结肠癌的疗效——病例报告

Efficacy of cetuximab in metastatic colon cancer - case report.

作者信息

Grigorean V T, Ciuhu A N, Rahnea Nita G, Strambu V, Straja D N, Popescu M, Sandu A M, Rahnea Nita R A

出版信息

Chirurgia (Bucur). 2014 May-Jun;109(3):383-9.

Abstract

In recent years, targeted therapies have proved effective in the treatment of colon cancer, but even in these conditions,metastatic disease is generally considered incurable.Cetuximab is approved for the treatment of advanced colorectal cancer patients with KRAS wild-type, in order to increase survival and hinder progression of the disease. We report a case of a 55 year-old woman, diagnosed with stenosing sigmoid cancer and liver metastases, which underwent multimodal treatment: palliative surgery -Hartmann segmental colectomy, and adjuvant chemotherapy -second line monotherapy with cetuximab, according to standard protocols. After 6 months of XELOX chemotherapy,during which she showed progression of metastatic disease, she was switched to monotherapy with cetuximab, with favorable outcome. Comparing relevant literature, in which complete response to treatment with cetuximab is obtained in low percentages ( 3%) after 3 months of treatment with cetuximab the patient shows clinical and paraclinical complete response and increased quality of life. Proper selection of patients with metastatic colon cancer for treatment with anti-EGFR therapy may lead to prolonged survival and time to progression.

摘要

近年来，靶向治疗已被证明在结肠癌治疗中有效，但即便如此，转移性疾病通常仍被认为无法治愈。西妥昔单抗被批准用于治疗KRAS野生型的晚期结直肠癌患者，以提高生存率并阻碍疾病进展。我们报告了一例55岁女性患者，诊断为乙状结肠狭窄癌并伴有肝转移，该患者接受了多模式治疗：姑息性手术——哈特曼节段性结肠切除术，以及辅助化疗——按照标准方案使用西妥昔单抗进行二线单药治疗。在进行了6个月的XELOX化疗后，期间她出现了转移性疾病进展，随后改用西妥昔单抗单药治疗，结果良好。与相关文献相比，文献中使用西妥昔单抗治疗3个月后获得完全缓解的比例较低（3%），而该患者表现出临床和副临床完全缓解且生活质量提高。为转移性结肠癌患者正确选择抗表皮生长因子受体（EGFR）治疗可能会延长生存期和疾病进展时间。