Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
Anticancer Drugs. 2024 Jun 1;35(5):459-461. doi: 10.1097/CAD.0000000000001587. Epub 2024 Mar 5.
Colorectal cancer (CRC) ranks third in global cancer prevalence, with 40% presenting as metastatic colorectal cancer (mCRC). KRAS mutations in mCRC patients confer resistance to anti-EGFR treatments. Promising inhibitors such as sotorasib and adagrasib targeting KRASG12C mutations have demonstrated efficacy. Herein, we present a heavily pretreated mCRC case with a progression-free survival of 12 months with sotorasib and panitumumab. In 2017, a 27-year-old male presented with abdominal pain and received a diagnosis of stage IIIC KRAS G12C mutant CRC. Following surgery and adjuvant chemotherapy, he developed metastases in the liver and lungs in 2020. Treatment with FOLFIRINOX and bevacizumab, and later FOLFIRI and bevacizumab, with surgeries and local interventions resulted in partial responses. Upon disease progression, sotorasib and panitumumab were initiated, achieving a complete metabolic response. After 12 months of progression-free survival, oligoprogressive liver lesions were surgically resected. This case highlights the remarkable outcome of a heavily treated KRAS G12C mutant mCRC patient. The combination of sotorasib and panitumumab, along with multidisciplinary approaches including surgery and local interventions, played an important role in our patient's survival.
结直肠癌(CRC)在全球癌症发病率中排名第三,其中 40%为转移性结直肠癌(mCRC)。mCRC 患者的 KRAS 突变赋予了其对抗 EGFR 治疗的耐药性。针对 KRASG12C 突变的有前途的抑制剂,如 sotorasib 和 adagrasib,已显示出疗效。本文报道了一例 KRAS G12C 突变的 mCRC 患者,在接受 sotorasib 和 panitumumab 治疗后,无进展生存期为 12 个月。2017 年,一名 27 岁男性因腹痛就诊,被诊断为 IIIIC 期 KRAS G12C 突变型 CRC。手术后接受辅助化疗,2020 年肝和肺转移。接受 FOLFIRINOX 和 bevacizumab,后 FOLFIRI 和 bevacizumab 治疗,并进行了手术和局部干预,取得了部分缓解。疾病进展后,开始使用 sotorasib 和 panitumumab,达到完全代谢缓解。无进展生存期 12 个月后,肝内寡进展性病变行手术切除。本例突出了治疗后 KRAS G12C 突变 mCRC 患者的显著疗效。sotorasib 和 panitumumab 的联合应用,以及包括手术和局部干预在内的多学科方法,在我们患者的生存中发挥了重要作用。