Complete response to capecitabine in a frail, elderly patient with metastatic colorectal cancer: A case report

Abstract

The clinical management of frail, elderly patients affected by colorectal cancer (CRC) remains a subject of debate. The present study reports the case of an elderly man with metastatic CRC (mCRC) who was successfully treated with capecitabine. The patient survived for 29 months, thus highlighting its potential activity in terms of obtaining a complete response and high efficacy. A 77-year-old man presented with adenocarcinoma of the rectum with multiple and synchronous liver metastases, in addition to several comorbidities. The patient received single-agent capecitabine chemotherapy (825 mg/mq twice a day) on days 1-14 of a 21-day cycle. Following 12 cycles of well-tolerated therapy, a computed tomography scan revealed a complete response with no evidence of liver metastases. An overall survival of 29 months was documented, and the patient eventually succumbed to a diabetes-related complication. In compromised patients with mCRC, reduced-dose capecitabine is an excellent therapeutic option due to its positive safety profile, activity and efficacy.

Keywords: advanced disease; capecitabine; colorectal cancer; complete response; frail elderly patient.

Figure 1.

Contrast-enhanced computed tomography scan performed in May 2008 showing evidence of multiple, isodense, solid nodules in the left and right liver lobes.

Figure 2.

Contrast-enhanced computed tomography scan performed in January 2009 showing a reduction of >75% in the number and size of the multiple, solid lesions evidenced in each liver lobe in previous examinations.

Figure 3.

Contrast-enhanced computed tomography scan performed in June 2009 showing a complete response with no evidence of liver metastases.

Figure 4.

Contrast-enhanced computed tomography scan performed in July 2010 confirming a complete response and no evidence of liver metastases.