We present the case of a 53-year-old male with metastatic rectal cancer who was treatment resistant to FOLFOX and FOLFOXIRI. Due to a Kirsten rat sarcoma viral oncogene homolog () mutation, regorafenib was given in the third line setting. Surprisingly, the patient had a prolonged partial response that lasted 27 months. Mutational status was extensively evaluated to identify potential alterations that might play a role as predictive markers for this unusual event. A poorly characterized but nontransforming mutation in Fms-like tyrosine kinase 4 () was present in the tumor. Prior to and at the time of clinical progression, we found amplification of fibroblast growth factor receptor 1 ( epidermal growth factor receptor , loss of the mutation, and gain of proto-oncogene receptor tyrosine kinase G961S suggesting potential roles in acquired resistance.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593691 | PMC |
| http://dx.doi.org/10.18632/oncotarget.18357 | DOI Listing |
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