A Case of Metastatic Colorectal Cancer with Brain Metastasis Treated with Combined TFTD and Bevacizumab Therapy

• Published in: Gan to kagaku ryoho Vol. 45; no. 2; p. 318
• Main Authors: Takano, Jin, Matsuhashi, Nobuhisa, Takahashi, Takao, Tanahashi, Toshiyuki, Matsui, Satoshi, Imai, Hisashi, Tanaka, Yoshihiro, Yamaguchi, Kazuya, Yoshida, Kazuhiro
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.02.2018
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab - administration & dosage; Brain Neoplasms - drug therapy; Brain Neoplasms - secondary; Colonic Neoplasms - drug therapy; Colonic Neoplasms - pathology; Colonic Neoplasms - surgery; Female; Humans; Pyrrolidines - administration & dosage; Thymine - administration & dosage; Trifluridine - administration & dosage
• ISSN: 0385-0684

A woman in her 70s was confirmed as presenting with multiple liver and lung metastases from transverse colon cancer. After undergoing resection of the primary lesion, partial response(PR)was achieved after undergoing the first regimen (sLV5FU2 and bevacizumab[Bmab]); therefore, partial hepatectomy was performed. Adjuvant chemotherapy was administered for 7 months, but liver metastasis recurrence, multiple lung metastases, and brain metastasis were confirmed. As the brain metastasis was a single lesion and was accompanied by symptoms, resection of the lesion was performed. Treatment with regorafenib was initiated, but Grade 3 severe erythema multiforme was detected, and the treatment had to be discontinued. Therefore, combined TFTD and Bmab therapy was initiated as the third regimen. Liver and lung metastases were maintained as stable disease(SD), and the treatment was continued for approximately 1 year together with stereotaxic radiation therapy for the newbrain metastatic lesion. The utility of combined TFTD and Bmab therapy has been reported in a phase II trial, and it has also been indicated that Bmab is effective for reducing brain edema. As this treatment was effective in this case, we will report on it together with a discussion of the literature.