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首页> 外文期刊>Balkan journal of medical genetics: BJMG >Impact of genetics on neoadjuvant therapy with complete pathological response in metastatic colorectal cancer: Case report and review of the literature
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Impact of genetics on neoadjuvant therapy with complete pathological response in metastatic colorectal cancer: Case report and review of the literature

机译：遗传对转移结直肠癌完全病理应答的新辅助治疗的影响 - 案例报告与文学审查

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Treatment of colorectal metastatic cancer is still challenging, despite recent improvements in chemotherapy. A genetic cancer profile, such as the KRAS (Kirsten rat sarcoma) gene status, plays a key role in individualized tailored therapy. Molecular targeted therapy added to neo-adjuvant chemotherapy can achieve a better pathological response and prolong survival. Pathological complete response of colorectal cancer stage IV is rare. A 47-year-old female patient presented with rectal adenocarcinoma and three liver metastases (cT3d/4, N2, Ml). After seven cycles of Bevacizumab and CAPOX in neoadjuvant setting, we noted more than 70.0% regression of metastases and complete regression of the primary tumor. We performed low anterior resection of rectum and synchronous subsegmental resection of S3, because the other two lesions were not detectable. Pathology revealed complete response of the primary and also secondary tumors. After 8 months, diagnostic tests did not show any sign of recurrence and the remaining liver lesions disappeared. Colorectal cancer is a heterogeneous disease and it is necessary to identify patients who are at-risk of recurrence and suitable for neoadjuvant therapy. Genetic biomarkers play an important role in metastatic colorectal cancer treatment. Because of the mutated KRAS gene, Bevacizumab was added to cytotoxic therapy achieving a complete pathological response of primary tumor and metastasis. This case is unique because all reported cases with similar results, described staged surgery and one of reverse staged surgery, but with similar results. This neoadjuvant therapy has extraordinary results for colorectal cancer stage IV and can help disease-free and long-term survival.
机译：尽管最近的化疗改善，但结直肠转移性癌症的治疗仍然具有挑战性。遗传癌细胞概况，例如KRA（Kirsten大鼠肉瘤）基因状况，在个性化量身定制的疗法中起着关键作用。添加到新辅助化疗中的分子靶向疗法可以达到更好的病理反应和延长存活。结肠直肠癌阶段IV的病理完全反应是罕见的。一名47岁的女性患者呈现直肠腺癌和三种肝转移（CT3D / 4，N2，ML）。经过七个贝伐单抗和Capox在Neoadjuvant设置后，我们注意到了超过70.0％的转移回归并完全回归原发性肿瘤。我们对S3进行了直肠直肠和同步分段切除的低前切除术，因为其他两个病变是不可检测的。病理学揭示了初级和中学肿瘤的完全反应。 8个月后，诊断测试没有显示任何复发迹象，剩余的肝脏病变消失了。结肠直肠癌是一种异质疾病，有必要鉴定患者，患者患有复发性，适合新辅助治疗。遗传生物标志物在转移性结肠直肠癌治疗中发挥着重要作用。由于突变的KRA基因，将Bevacizumab添加到达到原发性肿瘤和转移的完全病理响应的细胞毒性疗法中。这种情况是独一无二的，因为所有报告的患者具有相似的结果，描述了分阶段手术和逆转术手术之一，但具有类似的结果。这种Neoadjuvant疗法对结肠直肠癌阶段IV具有非凡的结果，可以帮助无病和长期存活。

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