Effect of preoperative chemotherapy combined with immunotherapy in a colorectal cancer patient with KRAS mutation
10.3969/j.issn.1674-8115.2025.09.018
- VernacularTitle:1例KRAS突变的结直肠癌患者术前接受化疗联合免疫治疗的效果报道
- Author:
Yi JIANG
1
;
Chenhao HUANG
1
;
Zhiliang LI
1
;
Junwei WU
1
;
Ren ZHAO
1
;
Tao ZHANG
1
Author Information
1. 上海交通大学医学院附属瑞金医院普外科,上海 200025
- Publication Type:Journal Article
- Keywords:
colorectal cancer(CRC);
neoadjuvant therapy;
KRAS mutation;
microsatellite stability(MSS)
- From:
Journal of Shanghai Jiaotong University(Medical Science)
2025;45(9):1256-1260
- CountryChina
- Language:Chinese
-
Abstract:
Colorectal cancer(CRC),a highly prevalent malignant tumor worldwide,has shown a continuously increasing incidence,particularly with the rise of early-onset CRC in young populations.Neoadjuvant therapy,as an important strategy for locally advanced CRC,shows significant potential to downstage tumors,improve radical surgical cure rates,and enhance prognosis.In this paper,a 39-year-old male patient with sigmoid colon adenocarcinoma at clinical stage cT4aN2aM0(stage ⅢC)is reported.Genetic testing revealed a mutation in the oncogene KRAS(G13D)and microsatellite stability(MSS).The patient also had significantly elevated carcinoembryonic antigen(CEA),lymph node metastasis,and suspected pelvic implant nodules,with a high risk of invasiveness and potential peritoneal metastasis.Because he had a refractory subtype of CRC with poor response to traditional immunotherapy,the patient was treated with neoadjuvant therapy,comprising CapeOx regimen(capecitabine+oxaliplatin),followed sequentially by sluzumab;after 6 treatment cycles,the tumor shrank significantly,and laparoscopic radical sigmoid colon resection was successfully performed,with no residual(ypT0N0)confirmed by postoperative pathology.This case suggests that for patients with KRAS-mutated MSS CRC resistant to traditional immunotherapy,a combination of CapeOx chemotherapy followed by programmed death-1(PD-1)inhibitors may induce a deep pathological response and provide translational treatment opportunities for locally advanced patients.However,the universality and long-term benefits of this treatment regimen still require further longitudinal studies and clinical follow-up.
