Arvind Dasari, MD, MS, explains how to sequence radioligand therapy, cabozantinib, and everolimus in well-differentiated neuroendocrine tumors.
|Videos|February 20, 2019
A 75-Year-Old Man With Right-Sided mCRC
A 75-Year-Old Man With Right-Sided mCRC
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Case: A 75-Year-Old ManWithRight-Sided mCRC
Initial presentation
- A 75-year-old Caucasian man presented to his PCP with rectal bleeding, fatigue, weight loss, and constipation
Clinical workup
- Colonoscopy: fungating mass in the ascending colon
- Biopsy: invasive, poorly differentiated adenocarcinoma
- Imaging: CT scan of the chest/abdomen/pelvis showed multiple small liver lesions including a 3-cm mass in right lobe
- Molecular testing on tissue biopsy:
- KRAS, RAS, andBRAFWT
- Microsatellite-stable
- ECOG PS 1
Treatment
- Patient underwent a diverting colostomy without complication
- He was started on FOLFOX and bevacizumab
- Follow up imaging at 3, 6, and 9 months showed a partial response
- He was continued on bevacizumab and underwent capecitabine maintenance
- Imaging at 12 months showed 2 new liver lesions (1.2 cm and 3.4 cm)
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