PMC7649345_01
Treatment process after post-operative relapse. PFS, progression-free survival; FOLFIRI, irinotecan, leucovorin, and fluorouracil; Bev, bevacizumab; PD, progressive disease; SD, stable disease; PR, partial response; mos, months.
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Figure 1 shows the entire treatment process, and Figure 2 shows the corresponding changes in the lung lesions during treatment on computed tomography (CT) scan.
(A) Initial lung metastases were revealed by CT (2014-11). (B) The best efficacy achieved by the combination of FOLFIRI (irinotecan, leucovorin, and fluorouracil) and cetuximab was stable disease (SD) (2015-6). (C) CT (2015-9) demonstrated progressive disease (PD) in the lung metastases when first-line chemotherapy failed. (D) The SD status (2016-6) achieved by apatinib had not been changed until a cerebellum metastasis (images unavailable) was found in October 2016. (E) CT (2017-3) showed that the lung lesions had markedly shrunken in size 4 months after trastuzumab and lapatinib. (F) After 6 months of trastuzumab and lapatinib treatment as third-line therapy, CT (2017-5) suggested new lung metastases. (G) CT scans revealed PR after treatment of raltitrexed plus TS-1 plus bevacizumab for 4 months. (H) CT scans (2018-9) showed PD in pulmonary metastatic lesions again. (I) Regimen of TAS-102 and bevacizumab failed after 3 cycles. (J) CT scans (2019-1) revealed that lung lesions are increased and enlarged significantly after treatment with pembrolizumab for 3 cycles. (K) The number and size of pulmonary metastases considerably decreased after the treatment of single pyrotinib for 6 months. (L) CT scan (2019-10) showed PD in the lung lesions again. (M) CT scan demonstrated SD of the lung lesions after the treatment of pyrotinib plus cetuximab for 4 months.
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Figure 1 shows the entire treatment process, and Figure 2 shows the corresponding changes in the lung lesions during treatment on computed tomography (CT) scan. Confirmed partial response (PR) was observed during CT re-examination in August 2019, with impressive reductions in both the numbers and size of the lung lesions (Figure 2K). On February 6, 2020, the CT scan demonstrated SD of the lung lesions (Figure 2M), and the patient had a Karnofsky score of 80 and a QOL (quality of life) score of 51.