Prolonged multimodal disease control with trifluridine/tipiracil plus bevacizumab in KRAS-mutant metastatic rectal cancer: a case report.

Anticancer DrugsJun 16, 2026 (epub)
Case ReportOncology (Medical)

Onur Alkan, Ahmet Başgöze, İsmail Nazli

✦ AI-curated · Sources linked

Case in brief

A 57-year-old man with KRAS G13D-mutant, liver-dominant metastatic rectal adenocarcinoma had recurrent coronary vasospasm associated with fluoropyrimidines, precluding 5-fluorouracil and capecitabine. Following multimodal first-line treatment and regorafenib, he received trifluridine/tipiracil plus bevacizumab, alongside liver-directed treatments for oligoprogressive disease. The combined approach provided approximately 16.6 months of disease control, with manageable hematological toxicity and preserved performance status.

What made this case unusual

Disease control was prolonged despite the inability to use 5-fluorouracil or capecitabine, with systemic trifluridine/tipiracil plus bevacizumab integrated with focal liver treatment for oligoprogression.

Diagnostic / clinical pearl

In this case, recurrent fluoropyrimidine-associated coronary vasospasm constrained systemic options; trifluridine/tipiracil plus bevacizumab with liver-directed treatment was feasible and achieved prolonged disease control.

Source

PubMed · PMID 42307975

Published in Anticancer Drugs. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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