Irinotecan: 37 Real Stories

Severe immune thrombocytopenia during treatment for metastatic colon cancer

Patient Info: Anonymized, Female, 50s | Stage IV

Biomarkers: KRAS-mutated; microsatellite stable; BRAF-wild type.

Metastatic Site: bilateral ovaries; pelvis; peritoneum; mesenteric…

After multiple metastatic recurrences and treatment changes, she died from progressive colon cancer; oxaliplatin had been permanently stopped after antibody-confirmed immune thrombocytopenia.

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Bilateral adrenal bleeding during bevacizumab treatment for metastatic colon cancer

Patient Info: Anonymized, Male, 50s | Stage IV

Biomarkers: RAS-mutant; BRAF-wild type; microsatellite stable.

Metastatic Site: peritoneum; liver; lung

Despite multiple systemic and local treatments, his metastatic colon cancer progressed in the liver and peritoneum, and he died from disease progression in November 2018.

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Ramucirumab and paclitaxel for metastatic gastric cancer in a patient receiving hemodialysis

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-negative

Metastatic Site: liver, distant lymph nodes

After about 16 months of disease control on paclitaxel plus ramucirumab, multiple liver metastases and distant lymph nodes progressed. Third-line irinotecan was stopped after severe toxicity, and supportive care followed.

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Stage IV Colorectal Cancer: Lee's Survivor Story

Patient Info: Lee Jones, Male, 50s | Stage IV

Metastatic Site: Liver

As of February 2021, Lee reported no evidence of colon cancer since 2011 after treatment for Stage IV colon cancer with liver metastases, recurrence, chemotherapy, colon surgery, and liver surgery.

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Emergency Repair of a Long-Term Perineal Hernia After Rectal Cancer Surgery

Patient Info: Anonymized, Female, 70+ | Stage IV

Metastatic Site: lungs

She lived with metastatic rectal cancer and received community palliative care after becoming too frail for further chemotherapy.

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Colon Cancer With an MLH1 Deletion and Lynch Syndrome

Patient Info: Anonymized, Male, Under 40 | Stage III

Biomarkers: dMMR with loss of MLH1 and PMS2. Familial MLH1 c.1057_1060delGCTG frameshift deletion identified; its clinical significance had not previously been reported.

The colon cancer progressed rapidly despite postoperative and second-line therapy, and he died from multiple organ failure one week after pembrolizumab was started.

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Sjögren syndrome during nivolumab treatment for HER2-positive metastatic gastric cancer

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: liver, lungs, adrenal gland

One year after nivolumab was stopped, the shrinkage of lung metastases was maintained and the adrenal metastasis remained unchanged, although severe dry-mouth symptoms from treatment-related Sjögren syndrome persisted.

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Graves disease during nivolumab treatment for HER2-positive metastatic gastric cancer

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: liver, brain

After progression through several treatment lines and development of brain metastasis, he died 4 months after evaluation for nivolumab-associated Graves disease, more than 1.5 years after his Stage IV gastric-cancer diagnosis.

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More than 10 years living with relapsing extensive-stage small cell lung cancer

Patient Info: Anonymized, Male, 60s | Stage IV

Biomarkers: Chromogranin-positive.

Metastatic Site: pleura; pancreas; left kidney and perinephric region

After five treatment lines and several metastatic relapses over more than 10 years, his latest irinotecan and carboplatin course produced another partial response and he was doing well at the last follow-up.

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Metastatic Colon Cancer With Painful Skin Fissures During Cetuximab

Patient Info: Anonymized, Male, 60s | Stage IV

Biomarkers: KRAS unmutated

Metastatic Site: lungs|pericardium|mediastinal lymph nodes

He died not long after cetuximab was stopped following cancer progression.

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Metastatic Colorectal Cancer Treated With S-1 After 5-FU Cardiotoxicity

Patient Info: Anonymized, male, 60s

Biomarkers: RAS-mutant

After progression in the liver despite prior systemic and liver-directed treatment, he started S-1, oxaliplatin and bevacizumab; the first cycle caused no cardiac complication and treatment continued as an outpatient.

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ERBB2-Mutated Stage III Lung Cancer With Liver Recurrence and Multiple Lines of Therapy

Patient Info: Anonymized, female, 60s | Stage IV

Biomarkers: ERBB2 exon 20 insertion

Metastatic Site: liver

After 6 months of disease control on vinorelbine plus trastuzumab, the cancer progressed in all sites and she chose hospice care.

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Sigmoid colon cancer with later inguinal lymph-node metastasis: surgery, FOLFOX, FOLFIRI, and cetuximab

Patient Info: Anonymized, Male, 60s | Stage IV

Biomarkers: CEA was elevated at diagnosis and recurrence. Metastatic lymph node was CK20 positive/CK7 negative; EGFR mutation status not reported.

Metastatic Site: left inguinal lymph node

Apparently disease-free 8 months after surgical removal of the left inguinal lymph-node metastasis followed by FOLFIRI plus cetuximab.

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