A Case of Colon Cancer with Liver Metastases Succesfully Treated with Re-administration of Panitumumab and Aggressive Surgery

Abstract

A 61-year-old man with sigmoid colon cancer and multiple liver metastases (KRAS wild type) was treated with resections of the sigmoid colon and a part of the liver, followed by chemotherapy with FOLFIRI or IRIS therapy in combination with panitumumab (Pmab) for 15 months. After an imaging CR and drug withdrawal, liver metastases reappeared 6 months later. Pmab/IRIS or Pmab/FOLFIRI therapy was resumed, and 7 months later partial hepatectomy was performed. Four months after the second surgery, metastases appeared near the IVC in the liver S7. Chemotherapy with SOX, FOLFIRI, or ISIS therapy in combination with Pmab was performed, that was effective for 2 years and 3 months. Afterwards, the tumor had come to grow rapidly, so resection of the liver combined with parts of the IVC wall was performed. Five months later, solitary lung metastasis appeared and was resected. Further two months later, multiple metastases to the lungs, bone, and adrenal glands appeared. Then, we tried to rechallenge Pmab alone chemotherapy, resulting in marked shrinkage of the metastases. The patient has been treated with Pmab alone for 2 years and 10 months with gradually increasing intervals and is still alive and well 9 years after the initial diagnosis. We present a patient with sigmoid colon cancer with liver metastases who survives for 9 years with aggressive resection and Pmab rechallenge.