Abstract
IntroductionTherapy comprising 5-fluorouracil, levofolinate, and oxaliplatin is currently the most common chemotherapy for colorectal cancer. We experienced a successful case of advanced colon cancer and recurrent breast cancer with 5-fluorouracil, levofolinate, and oxaliplatin therapy.Case presentationA 43-year-old Japanese woman who had already undergone surgery three times for bilateral breast cancer was admitted to our hospital for the treatment of advanced transverse colon cancer. Preoperative computed tomography demonstrated a swollen lymph node at her right upper clavicle, and fine-needle aspiration biopsy of the lymph node showed that it was a metastasis from the breast cancer. A laparoscopic-assisted colectomy was performed and the pathology demonstrated that the final stage was IIIC (T4aN2aM0, Union for International Cancer Control, 7th edition). The pathological findings and immunohistochemistry showed that the transverse colon tumor was not a metastatic lesion from the breast cancer, but was a de novo colon cancer. Chemotherapy was necessary for both the recurrent breast cancer and the Stage IIIC colon cancer. Therapy of 5-fluorouracil, levofolinate, and oxaliplatin was administered; the therapy included 5-fluorouracil, which is considered to be effective for both colon and breast cancer. After two courses of 5-fluorouracil, levofolinate, and oxaliplatin, the lymph node began to shrink and almost completely disappeared after eight courses of 5-fluorouracil, levofolinate, and oxaliplatin.ConclusionWe surmise that 5-fluorouracil, levofolinate, and oxaliplatin have the potential to provide a good response for tumors that are sensitive to fluorinated pyrimidine and platinum-containing anticancer drugs such as breast cancer.
Highlights
Therapy comprising 5-fluorouracil, levofolinate, and oxaliplatin is currently the most common chemotherapy for colorectal cancer
We surmise that 5-fluorouracil, levofolinate, and oxaliplatin have the potential to provide a good response for tumors that are sensitive to fluorinated pyrimidine and platinum-containing anticancer drugs such as breast cancer
We have experienced a successful case in which FOLFOX therapy, as postoperative adjuvant chemotherapy for locally advanced colon cancer, was effective for the upper cervical lymph node metastasis of a recurrent breast cancer
Summary
A combination therapy of three drugs, 5-fluorouracil (5FU), levofolinate (l-LV) and oxaliplatin (L-OHP; FOLFOX) plays an important role in chemotherapy for colon cancer [1]. Ax: Axillary lymphadenectomy, Bq: Quadrantectomy, Bt: Mastectomy, CEF: Cyclophosphamide + epirubicin + 5-fluorouracil, CK: Cytokeratin, ER: Estrogen receptor, FOLFOX: 5-fluorouracil, levofolinate, and oxaliplatin, HER2: Human epidermal growth factor receptor 2, LAC: Laparoscopic-assisted colectomy, Lt: Left, PR: Progesterone receptor, PTX: Paclitaxel, Rad: Postoperative radiation therapy, Rt: Right, Stage: TNM Classification Union for International Cancer Control 7th edition, TAM: Tamoxifen, T/C: Transverse colon, Tmab: Trastuzumab, UFT: Uracil-tegafur. As chemotherapy was required to treat both the recurrent breast cancer and the Stage IIIC colon cancer, FOLFOX regimen including 5FU was selected to treat both cancers, because 5FU had been approved for both cancers in Japan She was started on modified FOLFOX6 (5-FU, 400mg/m2 bolus infusion, followed by l-LV 200mg/m2 and L-OHP 85mg/m2 given concomitantly over 2 hours followed by 5 FU 2, 400mg/m2 continuous infusion over 46 hours). Cancer has not been observed 1.5 years after the colon cancer surgery and chemotherapy is ongoing
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