演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

進行再発大腸癌に対する後方ラインでのFOLFIRI+Ramucirumabの使用経験

演題番号 : P19-6

[筆頭演者]
演者)池谷 哲郎:1 
[共同演者]
村橋 邦康:1、瀬良 知央:1、城月 順子:1、澤田 鉄二:1

1:大阪掖済会病院・外科

 

Introduction: FOLFIRI plus ramucirumab(Rmab) is recommended as a second-line therapy for the treatment of colorectal cancer. Herein we report a case in which FOLFIRI plus Rmab was effective as a seventh-line therapy.Case: A 60-year-old man underwent abdominoperineal resection for advanced rectal cancer with multiple liver metastases. The pathological diagnosis was Rb, type 3, tub1, pT3, ly2, v3, INFb, int, N2, and the tumor was RAS wild-type. After surgery, chemotherapy with XELOX was initiated. A total of 11 courses of the regimen were administered until progressive disease (PD). Subsequently, he received 4 courses of FOLFIRI and 27 courses of panitumab monotherapy until PD. Then, 17 courses of FOLFOX plus bevacizumab(Bmab) were administered, but the regimen was changed due to enlargement of the liver metastases and development of lung metastasis. Subsequently, he underwent 6 courses of regorafenib and 2 courses of TAS-102, but both treatment regimens were discontinued due to adverse drug reactions. 4 years had elapsed since the surgery, and all key drugs, except for Rmab, had been used. We decided to introduce FOLFIRI plus Rmab because his general condition was relatively good. It was possible to administer a total of 20 courses of this regimen for 10 months until baseline PD was confirmed. Finally, the patient has survived for 5 years and 9 months, to date, since the surgery.Discussion:Bmab is an anti-VEGF-A monoclonal antibody, whereas Rmab is an anti-VEGFR-2 monoclonal antibody that directly binds to the receptor and blocks the angiogenesis. A higher antitumor effect can be expected by using angiogenesis inhibitors with different mechanisms of action. This case suggested that disease control may be achieved by using FOLFIRI plus Rmab as a later-line therapy, if the patient's general condition can tolerate further treatment even after long-term treatment with Bmab or treatment failure and if an attempt to use all available key drugs is made.

キーワード

臓器別:大腸・小腸

手法別:化学療法

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