Supplementary Material for: Long-Term 5-Year Response to Pembrolizumab, Bevacizumab, and Capecitabine Regimen in a Metastatic Colon Cancer Patient with MSI-High and KRAS Mutation- Case Report

With an estimated 1.88 million new cases and 0.92 million deaths in 2020, colorectal cancer accounts for nearly one-tenth of all new cancer and cancer-related deaths worldwide. Nearly half of the patients of colorectal cancer are diagnosed with metastatic or inoperable disease with a very dismal 5-year survival rate. Chemotherapy, targeted therapy, and immunotherapy have been used to treat metastatic disease, either alone or in combination. We present a case of recurrent metastatic colon carcinoma with KRAS exon 2 mutation and high microsatellite instability that was treated with a combination regimen of bevacizumab, capecitabine oral chemotherapy, and pembrolizumab immunotherapy. At nearly 5 years of treatment, the patient is alive with good performance status, and improved quality of life owing to a favorable response to the molecular profiling-based treatment approach.

2020年，结直肠癌(colorectal cancer)预估新增188万例、死亡92万例，约占全球新增癌症病例与癌症相关死亡总例数的十分之一。近半数结直肠癌患者确诊时已发生转移或无法手术，5年生存率极低。化疗、靶向治疗与免疫疗法已被单独或联合应用于转移性疾病的治疗。本文报告1例携带KRAS基因2号外显子突变且微卫星高度不稳定(high microsatellite instability)的复发性转移性结肠癌病例，该患者接受贝伐珠单抗、卡培他滨口服化疗联合帕博利珠单抗免疫疗法的联合方案治疗。经近5年的治疗后，患者仍存活且体能状态良好，得益于基于分子分型的治疗方案带来的良好应答，其生活质量得到显著改善。