Willett CG, Duda DG, di Tomaso E, Boucher Y, Czito BG, Vujaskovic Z, Vlahovic G, Bendell J, Cohen KS, Hurwitz HI, Bentley R, Lauwers GY, Poleski M, Wong TZ, Paulson E, Ludwig KA, Jain RK. Complete pathological response to bevacizumab and chemoradiation in advanced rectal cancer.
ACTA ACUST UNITED AC 2007;
4:316-21. [PMID:
17464339 PMCID:
PMC2686127 DOI:
10.1038/ncponc0813]
[Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Accepted: 02/19/2007] [Indexed: 01/21/2023]
Abstract
BACKGROUND
Localized rectal cancer responds well to 5-fluorouracil and radiation-based regimens. A phase I-II trial is currently testing the efficacy of adding bevacizumab, a VEGF-specific antibody, to standard chemoradiotherapy. The case presented here is a complete pathological response seen in a patient with extensive and locally invasive carcinoma after receiving this combined treatment.
INVESTIGATIONS
Physical examination, rectal ultrasound, PET-CT scan, laboratory tests, proctoscopic examination, chest radiograph, rectal forcep biopsies with immunohistochemistry, and protein and flow cytometric analyses.
DIAGNOSIS
Large, invasive, ultrasound stage T4 carcinoma of the rectum, which was positive for survivin.
MANAGEMENT
One 2-week cycle of bevacizumab alone, followed by 3 cycles of bevacizumab with continuous 5-fluorouracil infusion, and external-beam radiation therapy given 5 days per week to the pelvis, abdominoperineal resection with posterior vaginectomy, hysterectomy and bilateral salpingo-oophorectomy.
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