TITLE:
Case Report: Long-Term Survival in Patient with Cirrhosis of the Liver and Colon Cancer K-ras Wild-Type
AUTHORS:
Emiddio Barletta, Lucia Cannella, Vincenza Tinessa, Domenico Germano, Bruno Daniele
KEYWORDS:
K-ras Wild-Type Carcinoma, Metastatic Colorectal Cancer, Panitumumab, Anti-EGFR Treatment, Cirrhosis
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.3 No.6,
June
24,
2014
ABSTRACT: K-ras wild-type carcinoma
is a tumour that is sensitive to treatment with anti-cancer and anti-EGFR
drugs: the combination of Cetuximab and Panitumumab with chemotherapy
(Cetuximab) or as a single therapy (Panitumumab). Case Report: The clinical
case presented here refers to a 68-year-old patient who had been diagnosed
with adenocarcinoma of the recto sigmoid with pelvic recurrence three years
after surgery. The patient had a severe co-morbidity: correlated B-type liver
cirrhosis. First-line chemotherapy was begun with Oxaliplatin plus Capecitabine
(CAPOXI) following a relapse, and this continued for six months (six cycles),
when the treatment was interrupted because of the disease’s progression and
hematological and gastrointestinal toxicity. Following an assessment of the K-ras,
diagnosed as wild type, the patient was excluded from second-line chemotherapy
treatment because of decompensated cirrhosis and the persistence of thrombocytopenia
and leukopenia. The patient was put forward for biological treatment with an
anti-EGFR monoclonal antibody (Panitumumab). Panitumumab was administered at a
dosage of 6 mg/kg every 2 weeks for 17 months; the treatment was well
tolerated, despite the cirrhosis, and the main toxicity was the skin rash.
Conclusion: In patients with severe comorbidities such as cirrhosis of the
liver and K-ras wild-type carcinomas, therapy with a monoclonal antibody such
as Panitumumab is a treatment that is well tolerated, with few serious toxic
side-effects; it also offers advantages in terms of survival and clinical
benefits.