He Chunxia, Chi Jiaxin, Du Zhihua, Zhuang Zhenjie, Li Liuning
Department of Medical Oncology, Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical Medical College, University of Guangzhou Traditional Chinese Medicine, Guangzhou, China.
The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangdong, Guangzhou, China.
Front Oncol. 2024 Dec 20;14:1468532. doi: 10.3389/fonc.2024.1468532. eCollection 2024.
Patients with microsatellite stable (MSS) metastatic colorectal cancer (mCRC) who fail first- and second-line treatments face significant challenges in third-line therapy, where monotherapies often yield poor outcomes and limited survival benefits. The prognosis is particularly poor for mCRC with the unique molecular subtype of BRAF V600E mutation. This report describes sustained benefits from a third-line treatment regimen (SFS) combining tegafur/gimeracil/oteracil (S-1), fruquintinib, and sintilimab in a patient with BRAF V600E-mutated MSS mCRC. A 23-year-old woman was admitted with dizziness, and enhanced computed tomography (CT) and colonoscopy revealed colon cancer. Based on pathological and genetic testing, the final diagnosis was colon adenocarcinoma with lymph node and liver metastases (cT3N1M1, stage IVc, BRAF-V600E(+), MSS type). Following progressive disease (PD) after FOLFOX chemotherapy and surgery, the patient received 40 cycles of the SFS regimen (S-1 60 mg bid po d1-14 + fruquintinib 3 mg qd d1-21 + sintilimab 200 mg ivd q3w), achieving stable disease (SD). At the most recent follow-up, the patient has remained in sustained remission for over 3 years. The SFS regimen may be an attractive therapeutic strategy for patients with BRAF V600E-mutated MSS mCRC, warranting further evaluation in a larger patient cohort. We have registered a related clinical study (registration number: ChiCTR2300079188) and hope that the results will bring new hope for patients with MSS mCRC.
微卫星稳定（MSS）的转移性结直肠癌（mCRC）患者在一线和二线治疗失败后，三线治疗面临重大挑战，单药治疗往往疗效不佳，生存获益有限。对于具有BRAF V600E突变这一独特分子亚型的mCRC患者，预后尤其差。本报告描述了一名BRAF V600E突变的MSS mCRC患者采用替吉奥（S-1）、呋喹替尼和信迪利单抗联合的三线治疗方案（SFS）所获得的持续获益。一名23岁女性因头晕入院，增强计算机断层扫描（CT）和结肠镜检查显示患有结肠癌。根据病理和基因检测，最终诊断为伴有淋巴结和肝转移的结肠腺癌（cT3N1M1，IVc期，BRAF-V600E(+)，MSS型）。在FOLFOX化疗和手术后疾病进展（PD）后，患者接受了40个周期的SFS方案（S-1 60 mg，口服，每日两次，第1 - 14天 + 呋喹替尼3 mg，每日一次，第1 - 21天 + 信迪利单抗200 mg，静脉滴注，每3周一次），病情达到稳定（SD）。在最近一次随访时，患者已持续缓解超过3年。SFS方案可能是BRAF V600E突变的MSS mCRC患者的一种有吸引力的治疗策略，值得在更大的患者队列中进一步评估。我们已注册一项相关临床研究（注册号：ChiCTR2300079188），希望研究结果能为MSS mCRC患者带来新希望。
