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From palliative to curative treatment - stage IV mucinous adenocarcinoma, successfully treated with metronomic capecitabine in combination with Bevacizumab and surgery- a case report

2015; BioMed Central; Volume: 15; Issue: 1 Linguagem: Inglês

10.1186/s12885-015-1908-3

1471-2407

Karolina Vernmark, Maria Albertsson, Bergþór Björnsson, Thomas Gasslander, Per Sandström, Xiao‐Feng Sun, Annika Holmqvist,

Colorectal and Anal Carcinomas

Mucinous adenocarcinoma (MAC) represents 6-19 % of all colorectal carcinoma. It is associated with poorer response to chemotherapy and chemoradiotherapy. A 27-year-old Swedish woman presented with stomach pain and weight loss, and was diagnosed with locally advanced MAC in the transverse colon as well as 3 liver metastases. Neoadjuvant treatment with fluorouracil, folinic acid and oxaliplatin (FLOX) failed due to several infections, pulmonary embolism and deteriorated performance status. The patient was therefore considered palliative. Palliative treatment with metronomic capecitabine 500 mg × 2 daily and bevacizumab every other week were initiated. After 4 months of treatment the tumors had regressed and the patient was able to undergo radical surgery, thereby changing the treatment intention from palliative to curative. No adjuvant chemotherapy was given. There were no signs of recurrence 9 months later. The role of the combination of metronomic capecitabine and bevacizumab in patients with MAC merits further investigation.