Emergence of KRAS p.G13D mutation and acquired resistance to cetuximab in colorectal cancer with vulvar metastasis
| Autor: | Qiang, Weiguang, Wu, Qinqin, Ni, Xuefeng, Zhang, Chu, Zhao, Jiemin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Organoplatinum Compounds
Vulvar Neoplasms Rectal Neoplasms acquired resistance Leucovorin KRAS mutation Cetuximab colorectal cancer Adenocarcinoma Middle Aged digestive system diseases Proto-Oncogene Proteins p21(ras) Antineoplastic Agents Immunological Fatal Outcome Drug Resistance Neoplasm Antineoplastic Combined Chemotherapy Protocols Mutation Humans Female Clinical Case Report Fluorouracil neoplasms Research Article vulvar metastasis |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Rationale: Vulvar metastasis of colorectal cancer (CRC) and acquired resistance to cetuximab is a very rare phenomenon. To our knowledge, few cases have been reported in the English literatures. Patient concerns: A 55-year-old woman was diagnosed as adenocarcinoma of the rectum and the primary tumor was detected to be Kirsten-RAS (KRAS) wild type. Diagnoses: The patient was diagnosed with rectal adenocarcinoma by colonoscopy. Positron emission tomography/computed tomography (PET-CT) revealed multiple lymph node and bone metastases. Interventions: The patient received a first-line course of palliative chemotherapy with FOLFOX combined with cetuximab. Outcomes: After an initial response, acquired resistance to cetuximab occurred and vulvar metastasis was established by a second biopsy. Further molecular analysis showed that the KRAS mutation was detected in plasma samples and tumor tissues. Lessons: Vulvar metastasis from CRC is relatively rare and indicates a poor prognosis. Routine physical examinations of cutaneous and subcutaneous may facilitate early detection of metastases and timely intervention of medical technology. Moreover, combining serial tumor biopsy, liquid biopsy, and radiologic imaging could help to define mechanisms of drug resistance and to guide selection of therapeutic strategies. |
| Databáze: | OpenAIRE |
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