ONCAlert | Upfront Therapy for mRCC
Colorectal Cancer Case Studies

Case Studies: KRAS-Mutated Metastatic CRC

Cathy Eng, MD, FACP, discusses her impressions of the case of a young patient with left-sided KRAS-mutant colorectal cancer and provides recommendations for treating patients such as the woman in this case with a chemotherapy plus bevacizumab regimen.

KRAS-Mutated Metastatic CRC

Case: A 38-year Old Woman With KRAS-Mutated mCRC

Initial presentation

  • A 38-year old woman was referred to gastroenterology after experiencing several bouts of bloody diarrhea
  • PMH: unremarkable
  • PE: unremarkable

Clinical workup

  • Colonoscopy: suspicious sigmoid mass, partial obstruction
  • Biopsy: poorly differentiated adenocarcinoma
  • Imaging: CT scan of the chest/abdomen/pelvis revealed multiple small bilateral liver metastases
  • Molecular testing on tissue biopsy:
    • Positive for KRAS exon 2 codon 12 mutation
    • Negative for NRAS, BRAF
    • Microsatellite-stable
  • Diagnosis: stage IV colorectal cancer
  • ECOG PS 0

Treatment

  • She underwent laparoscopic sigmoid resection
  • She was initiated on treatment with FOLFOX + bevacizumab; well-tolerated
  • Follow-up imaging at 3 and 6 months showed a partial response
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