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Japanese Journal of Clinical Oncology Advance Access published online on June 20, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn046
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© The Author (2008). Published by Oxford University Press. All rights reserved

Metastatic Rectal Cancer Responding to Third-line Therapy Employing Bevacizumab After Failure of Oxaliplatin and Irinotecan: Case Report

Kohei Shitara*, Masaki Munakata, Osamu Muto and Yuh Sakata

Department of Medical Oncology, Misawa City Hospital, Misawa, Aomori, Japan

For reprints and all correspondence: Kohei Shitara, Department of Clinical Oncology, Aichi Cancer Center, 1-1 Kanakoden, Chikusa-ku Nagoya 464-8581, Japan. E-mail: kouheis0824{at}yahoo.co.jp

Received February 12, 2008; accepted May 18, 2008

A 61-year-old female with surgically treated rectal cancer that had metastasized to lung and lymph nodes was treated with bevacizumab (BV) plus 5-fluorouracil (5-FU) and leucovorin (LV) as third-line chemotherapy after treatment failures with infusional 5-FU, LV and oxaliplatin (FOLFOX regimen); and infusional 5-FU, LV and irinotecan (FOLFIRI regimen). After four cycles of treatment, a computed tomography scan revealed reduced sizes of the lung and lymph node metastases. Tumor response has still been maintained after six cycles of treatment, and the chemotherapeutic response was evaluated as partial response according to the Response Evaluation Criteria In Solid Tumor guidelines. Manageable toxicity included grade 2 hypertension, grade 1 epistaxis and grade 1 stomatitis. Although there are no clinical trial results supporting the use of BV-containing therapy as third-line chemotherapy for advanced colorectal cancer, BV plus 5-FU and LV was effective and feasible in our patient with colon cancer that had progressed after treatment with 5-FU, irinotecan and oxaliplatin.

Key Words: bevacizumab • third-line • colorectal cancer

* Present Address: Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan


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