Optimal Treatment of Chemoresistant mCRC
Optimal Treatment of Chemoresistant mCRC
Case: A 60-Year-Old Male With mCRC
Initial presentation
April 2015
- A 60-yearold man was referred to gastroenterology after complaining of general malaise and alternating constipation with bloody diarrhea.
- PE: Showed left-sided lower abdominal pain
- Carcinoembryonic antigen (CEA); 8.1 mg/L
- Colonoscopy revealed a left-sided adenocarcinoma of the colon
- Surgery: left hemicolectomy
- Pathology: well-differentiated adenocarcinoma
- PET/CT: 15/15 lymph nodes tested negative
- Staging: IIIA
- ECOG PS 0
- Patient received adjuvant mFOLFOX4
April 2018
- 24 months later, the patient complained of mild abdominal distension and his stools were pencil-shaped with some presence of blood
- PET/CT scan showed widespread small liver lesions
- CEA; 14.7 mg/L
- Biopsy was CK2-positive
- Molecular testing; allRAS&BRAFWT
- ECOG PS 1
- Patient began treatment with FOLFIRI + bevacizumab
February 2019
- PET/CT scan showed evidence of new liver lesions and a 2-cm mass in the right lung
- CEA; 31.7 mg/L
- Patient started on regorafenib 80 mg/day
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