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Epidermal growth factor receptor inhibitor with fluorouracil, leucovorin, and irinotecan as an alternative treatment for advanced upper tract urothelial carcinoma: a case report.

Lu YM, Chien TM, Lin CH, Chai CY, Huang CN - J Med Case Rep (2016)

Bottom Line: The combination of epidermal growth factor receptor inhibitor with fluorouracil, leucovorin, and irinotecan was originally designed for the treatment of metastatic colorectal cancer.Follow-up cystoscopy and ureterorenoscopy showed an unexpected regression of the upper tract urothelial tumor.Contrast-enhanced computed tomography also demonstrated the same results.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Kaohsiung Medical University Hospital, No. 100, Tz-You 1st Road, Kaohsiung, 807, Taiwan.

ABSTRACT

Background: Currently, there is no standard salvage regimen after the failure of cisplatin-based chemotherapy for advanced urothelial carcinoma. The combination of epidermal growth factor receptor inhibitor with fluorouracil, leucovorin, and irinotecan was originally designed for the treatment of metastatic colorectal cancer. Until now, there have been no reports using this combination therapy in treating advanced upper tract urothelial carcinoma. To the best of our knowledge, this is the first report showing this possible treatment regimen for advanced upper tract urothelial carcinoma.

Case presentation: We report the case of a 90-year-old Chinese woman who was diagnosed with metastatic colorectal cancer and urothelial carcinoma of the bladder, ureter, and renal pelvis. The upper tract urothelial carcinoma was well controlled by the chemotherapy regimen for metastatic colorectal cancer. Considering her age, we used only laser ablation for the treatment of her urothelial carcinoma in combination with intravesical mitomycin C chemotherapy. Follow-up cystoscopy and ureterorenoscopy showed an unexpected regression of the upper tract urothelial tumor. Contrast-enhanced computed tomography also demonstrated the same results.

Conclusions: This novel regimen for the treatment of upper tract urothelial carcinoma may merit further investigation or evaluation in clinical trials.

No MeSH data available.


Related in: MedlinePlus

Cystoscopy (a–c) shows that the bladder tumor had shrunk. The three pictures were taken over the course of the treatment
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Fig1: Cystoscopy (a–c) shows that the bladder tumor had shrunk. The three pictures were taken over the course of the treatment

Mentions: Analysis of codons 12 and 13 of the KRAS gene in the excised colorectal cancer tissues revealed that they were mutation-negative (wild type) (Additional file 1 to 3 : Figure S1 to S3 and Additional file 4). Therefore, nine cycles of adjuvant chemotherapy was initiated with cetuximab (Erbitux; Bristol-Myers Squibb, Princeton, NJ, USA) and fluorouracil, leucovorin, and irinotecan (FOLFIRI) for the treatment of the metastatic colorectal cancer. As for the urothelial carcinoma of the bladder, intravesical mitomycin C therapy was administered five times. Our patient tolerated the chemotherapy well. Cystoscopy, ureterorenoscopy, and urine cytology examinations were performed every 3 months. The size of the bladder tumor became smaller (Fig. 1). Surprisingly, a repeat contrast-enhanced abdominal CT showed shrinkage of the renal pelvis tumor (Fig. 2), and her hematuria also improved.Fig. 1


Epidermal growth factor receptor inhibitor with fluorouracil, leucovorin, and irinotecan as an alternative treatment for advanced upper tract urothelial carcinoma: a case report.

Lu YM, Chien TM, Lin CH, Chai CY, Huang CN - J Med Case Rep (2016)

Cystoscopy (a–c) shows that the bladder tumor had shrunk. The three pictures were taken over the course of the treatment
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4835853&req=5

Fig1: Cystoscopy (a–c) shows that the bladder tumor had shrunk. The three pictures were taken over the course of the treatment
Mentions: Analysis of codons 12 and 13 of the KRAS gene in the excised colorectal cancer tissues revealed that they were mutation-negative (wild type) (Additional file 1 to 3 : Figure S1 to S3 and Additional file 4). Therefore, nine cycles of adjuvant chemotherapy was initiated with cetuximab (Erbitux; Bristol-Myers Squibb, Princeton, NJ, USA) and fluorouracil, leucovorin, and irinotecan (FOLFIRI) for the treatment of the metastatic colorectal cancer. As for the urothelial carcinoma of the bladder, intravesical mitomycin C therapy was administered five times. Our patient tolerated the chemotherapy well. Cystoscopy, ureterorenoscopy, and urine cytology examinations were performed every 3 months. The size of the bladder tumor became smaller (Fig. 1). Surprisingly, a repeat contrast-enhanced abdominal CT showed shrinkage of the renal pelvis tumor (Fig. 2), and her hematuria also improved.Fig. 1

Bottom Line: The combination of epidermal growth factor receptor inhibitor with fluorouracil, leucovorin, and irinotecan was originally designed for the treatment of metastatic colorectal cancer.Follow-up cystoscopy and ureterorenoscopy showed an unexpected regression of the upper tract urothelial tumor.Contrast-enhanced computed tomography also demonstrated the same results.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Kaohsiung Medical University Hospital, No. 100, Tz-You 1st Road, Kaohsiung, 807, Taiwan.

ABSTRACT

Background: Currently, there is no standard salvage regimen after the failure of cisplatin-based chemotherapy for advanced urothelial carcinoma. The combination of epidermal growth factor receptor inhibitor with fluorouracil, leucovorin, and irinotecan was originally designed for the treatment of metastatic colorectal cancer. Until now, there have been no reports using this combination therapy in treating advanced upper tract urothelial carcinoma. To the best of our knowledge, this is the first report showing this possible treatment regimen for advanced upper tract urothelial carcinoma.

Case presentation: We report the case of a 90-year-old Chinese woman who was diagnosed with metastatic colorectal cancer and urothelial carcinoma of the bladder, ureter, and renal pelvis. The upper tract urothelial carcinoma was well controlled by the chemotherapy regimen for metastatic colorectal cancer. Considering her age, we used only laser ablation for the treatment of her urothelial carcinoma in combination with intravesical mitomycin C chemotherapy. Follow-up cystoscopy and ureterorenoscopy showed an unexpected regression of the upper tract urothelial tumor. Contrast-enhanced computed tomography also demonstrated the same results.

Conclusions: This novel regimen for the treatment of upper tract urothelial carcinoma may merit further investigation or evaluation in clinical trials.

No MeSH data available.


Related in: MedlinePlus