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TAS-102联合贝伐单抗及经动脉化疗栓塞术对KRAS突变型和微卫星稳定型转移性结直肠癌挽救性治疗的持久反应:一例报告

Durable responses to TAS-102 plus bevacizumab and TACE in salvage-line treatment of KRAS-mutated and MSS metastatic colorectal cancer: a case report.

作者信息

Zhao Wensi, Song Jian

机构信息

Department of Clinical Oncology, Renmin Hospital of Wuhan University Wuhan, Hubei, China.

Department of Clinical Pharmacy, Renmin Hospital of Wuhan University Wuhan, Hubei, China.

出版信息

Am J Transl Res. 2023 Jul 15;15(7):4805-4812. eCollection 2023.

Abstract

Patients with KRAS-mutated and microsatellite-stable (MSS) metastatic colorectal cancer (mCRC) often have limited options in salvage-line treatment. Reasonable combination strategy may be a valuable exploration. Here, we report a patient with KRAS-mutated and MSS metastatic rectal adenocarcinoma at stage IVB. After failure of previous standard treatment, a durable stable disease was achieved under the fifth-line treatment of TAS-102 plus bevacizumab and transcatheter arterial chemoembolization (TACE). To date, the patient had a PFS of more than 11.6 months with significantly declined tumor markers, alleviated clinical symptoms and improved quality of life. This case suggests that TAS-102 combined with re-challenged bevacizumab and well-timed TACE intervention is an effective strategy for KRAS-mutated and MSS mCRC, with good tolerance and manageable safety, even following disease progression on prior fruquintinib and regorafenib therapies.

摘要

KRAS 基因发生突变且微卫星稳定(MSS)的转移性结直肠癌(mCRC)患者在挽救性治疗中往往选择有限。合理的联合策略可能是一种有价值的探索。在此,我们报告一例处于 IVB 期的 KRAS 基因发生突变且 MSS 的转移性直肠腺癌患者。在先前的标准治疗失败后,在 TAS-102 联合贝伐单抗及经动脉化疗栓塞术(TACE)的五线治疗下实现了疾病持久稳定。截至目前,该患者的无进展生存期超过 11.6 个月,肿瘤标志物显著下降,临床症状缓解,生活质量改善。该病例表明,TAS-102 联合再次使用的贝伐单抗以及适时的 TACE 干预是 KRAS 基因发生突变且 MSS 的 mCRC 的一种有效策略,耐受性良好且安全性可控,即使在先前使用呋喹替尼和瑞戈非尼治疗后疾病进展的情况下亦是如此。

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