Abstract

A 69-year-old British gentleman with a good performance status, who runs a charity for animals (important), presented to the Gastroenterology outpatient department at the Bahrain Specialist Hospital (June 2016) with complaints of vague abdominal discomfort, bloating sensation, tiredness, and a recent change in the bowel habits. Endoscopy revealed a rectosigmoid colon mass, and the biopsy confirmed an invasive adenocarcinoma. The elderly man received six cycles of combination chemotherapy with oxaliplatin and capecitabine (until January 2017); however, the disease progressed, and he had liver metastases. A total mesenteric excision along with metastasectomy of the liver lesions was performed (February 2017); and a follow-up positron emission tomography–computed tomography (PET-CT) image showed a progressive disease with multiple lesions in both lobes of the liver as well as local recurrence. He was depressed and wanted to know further options; and so, was started on injection panitumumab 6 mg/kg administered every 21 days. After four doses of the therapy, PET-CT showed complete resolution of the local recurrence and partial resolution of the liver lesions. The patient, then resumed his activities with a good performance status and the therapy with panitumumab will be continued until either, disease progression or severe side effects are observed. The case illustrates the effectiveness of panitumumab in metastatic colorectal carcinoma, which has progressed on standard chemotherapy regimen.

Keywords: Metastatic colorectal cancer (mCRC), response rate therapy, biotherapy, epithelial growth factor receptor, panitumumab.