Significant response from fruquintinib plus anti-PD-1 immunotherapy for microsatellite stable metastatic colorectal cancer with liver and lung metastasis in the third line: A case report

Research Square (Research Square)(2023)

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摘要
Abstract Background: The treatment in patients with metastatic colorectal cancer (mCRC) has limited options. About 90% of CRC patients with mismatch repair proficient/microsatellite stable (pMMR/MSS) tumors, were almost unresponsive to PD-1 antibody treatment. This report shows that a patient with pMMR/MSS mCRC achieved significant response from tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor (VEGFR) family (VEGFR-1,2,3) (fruquintinib) plus anti-PD-1 immunotherapy in the third line, providing a reference for the treatment of some MSS mCRC patients. Case presentation: This case described a 65-year-old male with CRC who was diagnosed with pT4aN2bM0, IIIC and pMMR/MSS after curative surgery in August, 2018. Subsequently, he received adjuvant chemotherapy(FOLFOX for 5 cycles), first-line treatment(pelvic radiation plus capecitabine) and second-line treatment(TOMIRIplus cetuximab for 2 cycles), but lung, liver, and pelvic cavity metastases worsened in October 2019. Thus, he began receiving the fruquintinib plus PD-1 inhibitor(FP) regimen as third-line treatment and after three cycles, the size of the lung lesions was significantly reduced and evaluated as partial response(PR), while the liver and pelvic cavity lesions remained stable. As of December 2021, he had received a total of 33 courses of FP regimen. On February 17, 2022, the liver lesions were progressed. In brief, he achieved a long progression-free survival(PFS) of 28 months and overall survival(OS) of 40 months from the third-line treatment. Additionally, the patient tolerated the combined treatment. Conclusions: Fruquintinib combined with immunotherapy exerted good therapeutic effects with safety, and may bring more clinical benefits to MSS mCRC patients, especially with lung metastasis.
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stable metastatic colorectal cancer,colorectal cancer,lung metastasis,fruquintinib
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