Advanced Colorectal Cancer with Marwan G. Fakih, MD Case 2

Case Scenario 2:

• A 57-year old man presented for routine colonoscopy and was found to have a descending colon moderately differentiated adenocarcinoma. CEA pre-operatively was 6.
• Laparoscopic colectomy with colo-colonic anastomosis was performed. Final pathology showed a T3N2a (stage IIIb) lesion with 5/20 LNs positive. There was lymphovascular but no perineural invasion.
• Mutation testing revealed a KRAS mutation. The tumor was MSS.
• His ECOG performance status was 0.
• Following surgery, he was given adjuvant therapy with FOLFOX for 12 cycles with oxaliplatin help during the last two cycles because of grade 2 neuropathy.
• Six months later, follow-up imaging revealed recurrence and multiple metastatic hepatic lesions.
• The patient was started on FOLFIRI plus bevacizumab.