KRAS-Mutated Metastatic CRC

Case: A 38-year Old Woman WithKRAS-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 forKRASexon 2 codon 12 mutation
  • Negative forNRAS,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