Zhang HQ, Huang CZ, Wu JY, Wang ZL, Shao Y, Fu Z. PD-1 inhibitor in combination with fruquintinib therapy for initial unresectable colorectal cancer: A case report. World J Clin Cases 2022; 10(14): 4669-4675 [PMID: 35663084 DOI: 10.12998/wjcc.v10.i14.4669]
Corresponding Author of This Article
Zan Fu, MD, Chief Doctor, Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. fuzan1971@njmu.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hong-Qiang Zhang, Chang-Zhi Huang, Jing-Yu Wu, Zhen-Ling Wang, Yu Shao, Zan Fu, Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Author contributions: Zhang HQ designed the writing ideas and wrote the manuscript; Huang CZ participated in the operation of the patient as an assistant and made important modifications to the manuscript; Wu JY, Wang ZL, and Shao Y collected patient's data and followed the patient; Fu Z performed the surgery and developed the patient's treatment plan; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zan Fu, MD, Chief Doctor, Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China. fuzan1971@njmu.edu.cn
Received: January 9, 2022 Peer-review started: January 9, 2022 First decision: February 21, 2022 Revised: March 3, 2022 Accepted: March 27, 2022 Article in press: March 27, 2022 Published online: May 16, 2022 Processing time: 123 Days and 20.4 Hours
Abstract
BACKGROUND
PD-1 inhibitors in combination with fruquintinib have not previously been reported as neoadjuvant therapy for patients with colorectal cancer. In this case report, the combination of a PD-1 inhibitor and fruquintinib demonstrated good efficacy in patients with MSI-H colorectal cancer.
CASE SUMMARY
The patient was a young man in his 30s who had MSI-H type colon cancer. The patient underwent four cycles of neoadjuvant therapy with a PD-1 inhibitor combined with fruquintinib before surgery, resulting in regression of the mass and a successful surgery.
CONCLUSION
Some patients with colorectal cancer have the MSI-H type, and the first-line chemotherapy regimen is not effective. However, PD-1 monoclonal antibody immunotherapy has a good therapeutic effect, which can be improved by combination therapy with fruquintinib. We recommend that patients with a history of colon or rectal cancer receive universal MSI testing; then, neoadjuvant therapy should be used.
Core Tip: A 30-year-old man was diagnosed with microsatellite unstable colon cancer. Prior to his surgical treatment, he was treated with a neoadjuvant regimen of PD1 inhibitors in combination with fruquintinib. This neoadjuvant regimen is rarely used; however, this patient had a good outcome. Subsequently, we performed a laparoscopic radical resection of his right colon cancer, which revealed no microscopic tumour cells. The patient was in good condition after the surgical treatment.
