Naslov
Efficacy and safety of antivascular drug after anti-EGFR ; aflibercept after panitumumab, a clinical case

Autori
Jurčić, Petra

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Libri Oncologici : Croatian Journal of Oncology, Vol.45 No.Supplement 1 Srpanj 2017. / - , 2017, 55-55

Skup
1st Regional Congress of Medical Oncology and 1st Regional Congress of Oncology Pharmacy

Mjesto i datum
Dubrovnik, Hrvatska, 04.05.2017. - 07.05.2017

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
ulcerative colitis-associated cancer ; aflibercept ; arterial hypertension

Sažetak
A 40-year-old male with a negative family history of cancer and longstanding extensive ulcerative colitis, who was treated with mesalazine, was referred in July 2016 for a regular follow-up colonoscopy. A stenotic cancer in the hepatic flexure was detected with the histological finding of poorly differentiated adenocarcinoma. Comprehensive whole-body imaging revealed the multiple bilobar liver metastases and the absence of pulmonary and bone metastases. The patient underwent right hemicolectomy. The definitive pathological investigation confirmed the previous histological findings, pT4a (focal perforation of serosa) R0 pN2 [4/56] pM1[hep] pL1, pV1, pPn0, G3, wild-type RAS. The perioperative upper-extremity deep venous thrombosis was treated as a paraneoplastic feature. The patient was assigned to mFOLFOX6 and panitumumab as the first-line treatment protocol. During this treatment, the patient developed papulopustular rash of the face and the trunk grade 2 NCI-CTCAE v.4.0. Additional mutation screening revealed the presence of PIK3CA mutation in exon 9 (E542K) and the absence of BRAF mutations in primary cancer and lymph node metastases. A daily 100 mg dose of acetylsalicylic acid was added to standard therapy. After four cycles, the increment of serum markers (CEA, CA19-9) was noticed. Computed tomography scan of the abdomen revealed progression in size of liver metastases. Due to liver-limited disease, the multidisciplinary tumor board did not exclude the possibility of resection. Consequently, FOLFIRI and aflibercept were introduced in January 2017. After two cycles, the serum markers were in significant decrease. After four cycles, the values of serum markers were halved. The abdominal computed tomography scan findings suggested a constant size of liver metastases but with central necrosis. Due to the omitted unacceptable gastrointestinal toxicity, it was decided to continue with the same line for the next four cycles. After the fifth cycle, the asymptomatic arterial hypertension second-degree NCI-CTCAE v.4.0 occurred. Nevertheless, it was kept under control with antihypertensive. The next appointment for diagnostic imaging and laboratory test is scheduled for May 2017.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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