Multimodality Treatment of a Colorectal Cancer Stage IV Patient with FOLFOX-4, Bevacizumab, Rigvir Oncolytic Virus, and Surgery

Abstract

Colorectal cancer is one of the most commonly diagnosed cancers worldwide. The treatment consists of surgical resection, systemic chemotherapy, and new biological agents. One more recently emerging treatment option is oncolytic virotherapy. Although the use of the new treatment methods shows improved overall and progression-free survival, in general, even with the new treatments, mortality remains high and combinations of treatments should be sought to treat patients with colorectal cancer. Here we report a stage IV colorectal cancer patient who received multimodality treatment including bevacizumab, FOLFOX-4, surgery, and the oncolytic virus Rigvir. The patient shows complete pathological remission and remains stable 7.7 years after initial diagnosis. The possible benefits of combining Rigvir oncolytic virus and bevacizumab should be investigated since in vitro research suggests that anti-angiogenesis agents improve viral distribution by altering the microenvironment of the tumor.

Developing Picornaviruses for Cancer Therapy

“…At the time of publication, the patient’s condition has been stable for 3.9 years, with scans showing minimal residual metastasis [101]. Another study documented Rigvir treatment of a stage IV poorly-differentiated rectal adenocarcinoma, with a 5-year survival rate of 5% [102]. The patient was first treated with 11 injections of Rigvir in combination with eight infusions with folinic acid-fluorouracil-oxiplatin (FOLFOX-4) and four infusions of bevacizumab.…”

“…Post-surgery, the patient was given four final infusions of FOLFOX-4. Computerised Topography (CT) scans six years following the initial diagnosis showed cystic bodies on the liver, spleen, and kidneys, as well as fibrotic changes in the lungs, consistent with a complete response to therapy [102].…”

Comment on McCarthy, C.; et al. Developing Picornaviruses for Cancer Therapy. Cancers 2019, 11, 685

“…The patient was first treated with 11 injections of Rigvir in combination with eight infusions with folinic acid-fluorouracil-oxiplatin (FOLFOX-4) and four infusions of bevacizumab." However, the patient was first treated with FOLFOX-4 and bevacizumab, and in addition with Rigvir [8].…”

“…However, the registered mode of administration of Rigvir is intramuscular [ 2 , 3 , 4 , 5 , 6 , 7 , 8 ].…”

“…However, the patient was first treated with FOLFOX-4 and bevacizumab, and in addition with Rigvir [ 8 ].…”