Li Xuesong, Liu Hao, Yu Zhuo
Department of Medical Oncology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
Department of Pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
Front Oncol. 2025 Aug 22;15:1567760. doi: 10.3389/fonc.2025.1567760. eCollection 2025.
In metastatic colorectal cancer (mCRC) patients with proficient mismatch repair (pMMR)/microsatellite stability (MSS), beyond third-line therapies were extremely limited. Here, we reported a case of a 21-year-old male patient with pMMR/MSS mCRC who failed to respond to both first- and second-line treatment and subsequently received non-standard third-line therapy at a local hospital. This patient was referred to our hospital, and we initiated salvage therapies. The fourth-line treatment, including tislelizumab, regorafenib, pemetrexed, and raltitrexed, was administered with a progression-free survival (PFS) of 13 months. Then, this patient received fifth-line treatment with chidamide, fruquintinib, toripalimab, raltitrexed, and nanoparticle albumin-bound paclitaxel with a PFS of 8 months. During the whole treatment, side effects were tolerable and significantly alleviated with appropriate symptomatic therapies. In addition, cystoscopy plus transurethral resection of a metastatic bladder tumor was successfully conducted to halt the bleeding. The sixth-line regimen was started, and he is still under follow-up. Collectively, this patient achieved long-term survival with a high quality of life through therapies beyond the third line.
在错配修复功能正常（pMMR）/微卫星稳定（MSS）的转移性结直肠癌（mCRC）患者中，三线以上治疗极其有限。在此，我们报告了一例21岁的男性pMMR/MSS mCRC患者，其一线和二线治疗均无效，随后在当地医院接受了非标准的三线治疗。该患者转诊至我院，我们启动了挽救治疗。四线治疗包括替雷利珠单抗、瑞戈非尼、培美曲塞和雷替曲塞，无进展生存期（PFS）为13个月。然后，该患者接受了五线治疗，使用西达本胺、呋喹替尼、托瑞帕利单抗、雷替曲塞和纳米白蛋白结合型紫杉醇，PFS为8个月。在整个治疗过程中，副作用可耐受，通过适当的对症治疗明显减轻。此外，成功进行了膀胱镜检查加经尿道转移性膀胱肿瘤切除术以止血。启动了六线治疗方案，他仍在随访中。总体而言，该患者通过三线以上治疗实现了长期生存且生活质量较高。
