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中华结直肠疾病电子杂志 ›› 2023, Vol. 12 ›› Issue (05) : 431 -435. doi: 10.3877/cma.j.issn.2095-3224.2023.05.011

病例报道

信迪利单抗联合索凡替尼后线治疗MSS型BRAF突变的转移性结肠癌:个案报道并文献复习
陈润芝, 杨东梅, 徐慧婷()   
  1. 430079 武汉,华中科技大学附属湖北省肿瘤医院腹部内科
  • 收稿日期:2023-05-08 出版日期:2023-10-25
  • 通信作者: 徐慧婷
  • 基金资助:
    湖北省自然科学基金青年项目(2021CFB267)

PD-1 combined with surufatinib for the treatment of metastatic colon cancer with microsatellite stability and BRAF V600E mutation: A case report and review

Runzhi Chen, Dongmei Yang, Huiting Xu()   

  1. Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, China
  • Received:2023-05-08 Published:2023-10-25
  • Corresponding author: Huiting Xu
引用本文:

陈润芝, 杨东梅, 徐慧婷. 信迪利单抗联合索凡替尼后线治疗MSS型BRAF突变的转移性结肠癌:个案报道并文献复习[J]. 中华结直肠疾病电子杂志, 2023, 12(05): 431-435.

Runzhi Chen, Dongmei Yang, Huiting Xu. PD-1 combined with surufatinib for the treatment of metastatic colon cancer with microsatellite stability and BRAF V600E mutation: A case report and review[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(05): 431-435.

BRAF基因在转移性结直肠癌中的突变率约12%,其中,90%为BRAF V600E突变。常规治疗有效率低,预后差。现报道1例微卫星稳定型(MSS)BRAF V600E突变的晚期结肠癌患者,一线接受BEV+FOLFOXIRI,三线瑞戈非尼靶向治疗后疾病进展,四线接受信迪利单抗联合索凡替尼治疗后获得部分缓解(PR)。

BRAF mutation is found in approximately 12% of metastatic colorectal cancer (mCRC), with 90% mutation caused by V600E mutation, which has limited response to conventional therapies and poor prognosis. Here we present a case of an advanced colon cancer patient with BRAF V600E mutation. After a failed therapy with Bevacizumab and FOLFOXIRI, the disease progressed rapidly in the third-line treatment with Regorafenib. Then the patient was initiated on a regimen of sintilimab blockade and Surufatinib which had achieved partial response (PR).

图1 一线治疗期间肿瘤标志物的变化
图2 术后辅助治疗期间肿瘤标志物的变化
图3 2022-07-15的PET-CT提示:腹盆腔腹膜、系膜见多发条片状影及结节影,代谢增高,考虑腹膜、系膜转移
图4 腹部增强CT。4A:三线治疗基线;4B:四线治疗基线(肾上腺新发转移,腹膜转移进展);4C:四线治疗期间;4D:四线治疗最佳疗效
图5 患者治疗时间轴
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