Metastatic colorectal cancer that have been previously treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, anti-VEGF therapy, and, in the event the tumor is KRAS wild-type, anti-EGFR therapy [2, 3]. In the international, multicenter, randomized, double-blind, placebo-controlled phase III Correct trial, regorafenib (compared with placebo) increased the general survival of sufferers with metastatic colorectal cancer who had progressed right after all standard therapies [4]. The case report presented herein is of a patient that we enrolled in to the Right study, and for whom therapy with regorafenib permitted stabilization of his metastatic illness over 2 years, for the duration of which time the patient remained asymptomatic.Calmodulin Protein MedChemExpress Case ReportIn November 2008, a 63-year-old male patient presented with an intestinal obstruction on a computed tomography (CT) scan and was subsequently diagnosed, soon after resection of the principal tumor, using a KRAS-mutated (exon 2, codon 12) adenocarcinoma on the rectum at 8 cm in the anal verge. An emergency discharge stoma was performed, and ten days later the patient underwent a low anterior resection using a coloanal anastomosis and a defunctioning loop ileostomy. Pathology diagnosis was of a well-differentiated adenocarcinoma infiltrating to the intestinal serosa. Longitudinal surgical margins have been healthier (R0). There were no lymph node metastases (0/16). A chest CT scan didn’t show any distant metastatic lesions. From December 15, 2008 to June 15, 2009, the patient received adjuvant chemotherapy comprising 5 cycles of 5-fluorouracil (5-FU), leucovorin, and oxaliplatin (FOLFOX4 regimen). In January 2010, even though the patient was asymptomatic, radiological assessment (chest CT) detected the presence of lung lesions: a left decrease lobe mass of 31 mm, 2 nodules connected together with the ideal upper lobe (11 and 9 mm), along with a left upper lobe nodule (12 mm). The lesions had been found to be hypermetabolic by positron emission tomography/CT.CD19 Protein Storage & Stability Bronchoscopy with endobronchial biopsy with the left reduce lobe mass confirmed the presence of a colorectal adenocarcinoma metastasis, which on DNA analysis was shown to possess a KRAS mutation (exon 2, codon 12) and to possess a microsatellite steady status. At this time, blood carcinoembryonic antigen (CEA) levels had been as higher as eight.2 /L. From February 17 to April four, 2010, the patient received first-line palliative chemotherapy comprising 5-FU, leucovorin, and irinotecan (FOLFIRI regimen) combined with VEGF-targeted therapy (bevacizumab). Radiological assessment performed just after six cycles of remedy showed a slight enhance within the size with the lung nodules, while the patient remained asymptomatic.PMID:23546012 It was decided that the patient really should undergo clinical and biological surveillance. A gradual elevation in CEA levels was observed from August 2010 to January 2011 (CEA levels elevated from 14.0 /L in July 2010 to 30.3 /L in November 2010).Case Rep Oncol 2017;10:1029sirtuininhibitor034 DOI: ten.1159/000484401 sirtuininhibitor2017 The Author(s). Published by S. Karger AG, Basel www.karger/croAmram et al.: Long-Term Survival with Regorafenib in KRAS-Mutated Metastatic Rectal CancerIn January 2011, a brand new radiological assessment demonstrated progression in the patient’s metastatic lung lesions; the biggest lesion was recorded inside the reduce left lobe of 60 sirtuininhibitor45 mm (24 sirtuininhibitor41 mm in August 2010). The patient was then integrated in the Right study and randomly assigned towards the regorafenib.