Complete pathological response of colorectal liver metastases after chemotherapy and bevacizumab treatment: a case report

Abstract

The vast majority of colorectal cancer patients who present with liver metastases are not initially candidates for hepatic resection. Although the combination of systemic chemotherapy and liver surgery can convert a significant proportion of patients from a palliative situation to a potentially curative situation, the majority of initially unresectable liver metastases do not respond sufficiently to initial chemotherapy to become resectable. More recently the addition of biologic agents (bevacizumab or cetuximab) to cytotoxic chemotherapy has increased the rate of tumor response, suggesting that the addition of these agents could improve resectability rate. Here we report the clinical case of a complete pathological response (pCR) in a 67-year-old male affected by metastatic colorectal cancer, with initially unresectable liver metastases, after treatment with chemotherapy and bevacizumab.

Predictors of a true complete response among disappearing liver metastases from colorectal cancer after chemotherapy

“…The incidence of DLMs and true CRs may be different in the era of biologics: Recent studies have demonstrated improved response rates and higher complete resection (R0) rates in patients who receive a combination of cytotoxic chemotherapy and cetuximab or bevacizumab. 12 A strength of the current study, unlike the study by Benoist et al, 5 is that it included both patients who underwent surgical exploration and those who were followed clinically. It is important to note that the true CR rate was similar among DLMs that were followed clinically and those that were resected (62% vs 72%, respectively), suggesting that these represent similar phenomena.…”