A Case of Resistance to Systemic Therapy in Hypermutation of Colorectal Cancer

Kana Tanaka, Yoshifumi Shimada, Yosuke Tajima, Saki Yamada, Shinnosuke Hotta, Mae Nakano, Masato Nakano, Hitoshi Kameyama, Kohei Miura, Hiroshi Ichikawa, Masayuki Nagahashi, Hitoshi Nogami, Satoshi Maruyama, Yasumasa Takii, Toshifumi Wakai

Research output: Contribution to journalArticlepeer-review


A 78-year-old man was admitted with diarrhea. Colonoscopy and computed tomography(CT)revealed rectal cancer with multiple liver metastases. Low anterior resection was performed for local control. After the operation, 5 courses of mFOLFOX6 plus bevacizumab chemotherapy were administered as first-line systemic therapy, but CT showed progressive disease with liver metastases. After the first-line systemic therapy, 2 courses of FOLFIRI plus bevacizumab chemotherapy were performed as second-line systemic therapy, but CT also revealed progressive disease with liver metastases. We retrospectively performed comprehensive genomic sequencing with a 415-gene panel and found that the patient had a hypermutation subtype. Interestingly, the panel also revealed that he had mismatch-repair(MMR)deficiency with MSH2 mutation, which is reported as a possible cause of resistance to 5-fluorouracil in colorectal cancer.

Original languageEnglish
Pages (from-to)2476-2478
Number of pages3
JournalGan to kagaku ryoho. Cancer & chemotherapy
Issue number13
Publication statusPublished - 01-12-2018

All Science Journal Classification (ASJC) codes

  • General Medicine


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