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Complete response with fluorouracil and irinotecan with a BRAFV600E and EGFR inhibitor in BRAF-mutated metastatic colorectal cancer: a case report

Authors Wang Z, Dai WP, Zang YS

Received 19 July 2018

Accepted for publication 5 December 2018

Published 8 January 2019 Volume 2019:12 Pages 443—447

DOI https://doi.org/10.2147/OTT.S180845

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Leo Jen-Liang Su


Zhan Wang*, Wei-Ping Dai*, Yuan-Sheng Zang

Department of Medical Oncology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China

*These authors contributed equally to this work

Background: Patients with BRAF (v-Raf murine sarcoma viral oncogene homolog B) V600E-mutated metastatic colorectal cancer (mCRC) have a poor prognosis. The Southwest Oncology Group (SWOG) 1406 study evaluated the efficacy of vemurafenib in combination with irinotecan and cetuximab for simultaneous inhibition of epidermal growth factor receptor (EGFR) and BRAF in patients with BRAFV600E-mutated mCRC. Although the combination achieved higher progression-free survival (PFS) and disease control rates (DCRs), there was no complete response (CR) for the drug combination. In this case report, we report the complete recession of metastasis in a patient treated with irinotecan, cetuximab, vemurafenib, and 5-fluorouracil.
Case presentation: A 44-year-old male patient with hepatitis B was diagnosed with right-sided colon adenocarcinoma. He was treated with capecitabine plus oxaliplatin as postoperative adjuvant chemotherapy for eight cycles with a disease-free survival (DFS) of 1 year before the emergence of peritoneal and pelvic metastases. BRAFV600E mutation was positive and chemotherapy included 12 courses of 5-fluorouracil, vemurafenib, irinotecan, and cetuximab. Complete response with recession of metastases was observed.
Conclusion: The combination of fluorouracil and irinotecan with a BRAFV600E and EGFR inhibitor may have synergistic action, leading to recession of secondary metastases in patients with BRAFV600E-mutated colorectal cancer.

Keywords: mCRC, BRAFV600E mutation, fluorouracil, vemurafenib, irinotecan, cetuximab

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