Abstract
The standard third-line treatment of metastatic colorectal cancer (mCRC) includes the small-molecule anti-vascular drugs (Regofenib and Fruquintinib) and the chemotherapy drug trifluridine and tipiracil hydrochloride (TAS-102). There is no standard treatment for mCRC if the third-line treatment failed. Therefore, it is a pressing need to develop new therapeutic approaches to improve the survival of patients who developed drug resistance to the third-line treatment. In this study, we report a case of mCRC with RAS/BRAF wild-type, who was successfully treated using cetuximab in combination with fruquintinib after resistance to chemotherapy, bevacizumab, cetuximab and regorafenib. This patient responded to this combination regimen. Then, we discuss the mechanisms of action of this combination. Furthermore, we introduce the clinical trials on the combination regimens of anti-EGFR with anti-vascular monoclonal antibodies. Finally, we discuss the clinical explorations of using combination of anti-EGFR with small-molecule anti-VEGF drugs and their potential benefits. The clinical effects of small-molecule anti-vascular drugs in combination with anti-EGFR in the treatment of CRC warrant further explored.
Highlights
Therapeutic regimens for metastatic colorectal cancer include chemotherapy and targeted therapy
Hear we report a case of advanced CRC who is RAS/BRAF wild-type and developed drug resistance to the previous therapy
The aim of this study is to present the mechanisms of action and clinical applications of anti-EGFR combined with anti-VEGF drugs, and discuss the potential benefits of this combination
Summary
Therapeutic regimens for metastatic colorectal cancer (mCRC) include chemotherapy and targeted therapy. For patients with RAS/BRAF wild-type who have not used the anti-EGFR drug, cetuximab in combination with irinotecan can be selected [2,3,4,5,6]. Because TAS-102 is not approved in China, from January 30 to August 6, 2020, this patient received 11 cycles of cetuximab, 500 mg/m [2] biweekly, in combination with fruquintinib, 5 mg once daily for the first 3 weeks of each 4 weeks as the fifth-line therapy.
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