Effectiveness of Pembrolizumab as Second Line Therapy for Metastatic Colon Cancer in an Elderly Patient

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  • Nakamura Ayano
    Department of Surgery, Chikugo City Hospital Department of Surgery, Kurume University School of Medicine
  • Nakano Masahiko
    Department of Surgery, Chikugo City Hospital Department of Surgery, Kurume University School of Medicine
  • Hirakawa Yusuke
    Department of Surgery, Chikugo City Hospital Department of Surgery, Kurume University School of Medicine
  • Katsumoto Mitsuru
    Department of Surgery, Chikugo City Hospital Department of Surgery, Kurume University School of Medicine
  • Nakayama Hitomi
    Department of Endocrinology and Metabolism, Chikugo City Hospital
  • Oshima Koichi
    Department of Pathology, Kurume University School of Medicine
  • Akagi Yoshito
    Department of Surgery, Kurume University School of Medicine

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  • 2次治療にpembrolizmabが著効した高齢者大腸癌切除後再発の1例

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Abstract

<p>In the super-aging society in Japan, the number of elderly patients with colorectal cancer is increasing. In recent years, therapeutic developments have produced various treatments for colorectal cancer, and immune checkpoint inhibitors have emerged. in addition to anticancer drugs and molecular-targeted drugs. We report the case of an elderly patient with colorectal cancer in whom FOLFOXIRI+BEV and pembrolizumab therapy were effective. The patient was an 87-year-old woman with ascending colon cancer who underwent laparoscopic right hemicolectomy. At 4 months after surgery, a recurrent lesion was detected in the right abdominal wall. At this time, we decided to administer FOLFOXIRI+BEV as 1st line chemotherapy. After initiation of treatment, the sizes of the tumors diminished. However, after 14 courses of chemotherapy, the main tumor grew and CT showed new lesions on the abdominal wall. At 18 months after surgery, the chemotherapy was changed to immunotherapy with pembrolizumab because MSI-H was diagnosed based on examination of the resected specimen. The tumors then decreased in size. After 27 courses of immunotherapy, the patient presented to our hospital with fatigue, dyspnea, and other symptoms. The cause was considered to be an immune-related adverse event. After their treatment, the symptoms improved and the patient was able to continue immunotherapy. Thereafter, the patient remained in partial response.</p>

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