PMC8728007_01
(A-C): Baseline thoracic CT showing multiple metastases bilaterally (June 2021).
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Patient's performance status was 2 at that time, he weighed 64 kg and suffered from paroxysmal dry cough, pain in the upper right abdominal area due to his hepatic disease that was well-controlled with opioids, and episodes of incomplete intestinal obstruction associated with a large peritoneal metastasis laying in contact with the bowel as well as with signs of localized PD in the large intestine ( Figures 1A-C ,  2A, B ).
(A, B): Baseline abdominal CT showing multiple hepatic metastases (June 2021).
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Patient's performance status was 2 at that time, he weighed 64 kg and suffered from paroxysmal dry cough, pain in the upper right abdominal area due to his hepatic disease that was well-controlled with opioids, and episodes of incomplete intestinal obstruction associated with a large peritoneal metastasis laying in contact with the bowel as well as with signs of localized PD in the large intestine ( Figures 1A-C ,  2A, B ).
Variability of tumor markers over time.
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His tumor markers started to decrease rapidly from the 1st course (Ca19-9: 390 U/ml and CEA: 127 U/ml on the 15th of June from baseline 800 U/ml and 127 U/ml, respectively on the 1st of June) ( Figure 3 ).
Variability of liver function tests (LFTs) over time.
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His liver function tests (LFTs), that were somewhat affected during pembrolizumab - regorafenib treatment also started to decrease ( Figure 4 ), and he managed to gain 4kgs in August 2021.
Comparison of CT scans via RECIST v.1.1 criteria. na, not applicable.
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Imaging reevaluation after the 6th course revealed SD according to Response Criteria for Solid Tumors (RECIST) version 1.1 ( Figure 5 ) in the pulmonary ( Figures 6A-C ), as well as in the abdominal disease ( Figures 7A, B ), while tumor markers continued to decrease.
(A-C): Thoracic CT after the completion of 6 treatment courses, showing SD in the lung (August 2021).
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Imaging reevaluation after the 6th course revealed SD according to Response Criteria for Solid Tumors (RECIST) version 1.1 ( Figure 5 ) in the pulmonary ( Figures 6A-C ), as well as in the abdominal disease ( Figures 7A, B ), while tumor markers continued to decrease.
(A, B): Abdominal CT after the completion of 6 treatment courses, showing SD in the liver (August 2021).
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Imaging reevaluation after the 6th course revealed SD according to Response Criteria for Solid Tumors (RECIST) version 1.1 ( Figure 5 ) in the pulmonary ( Figures 6A-C ), as well as in the abdominal disease ( Figures 7A, B ), while tumor markers continued to decrease.