ABSTRACT

Small bowel cancer is a very rare disease. It can be treated by surgery at early stages; however, there is no standard therapeutic strategy established for the treatment of unresectable and/or metastatic diseases.

Here we present a case of metastatic small bowel adenocarcinoma, which progressed after sequential treatment with XELOX (capecitabine and oxaliplatin), FOLFIRI (fluorouracil, leucovorin, and irinotecan), cetuximab, HER-2 targeted therapy and apatinib and was then effectively controlled by fruquintinib. Genetic testing showed wild-type KRAS/NRAS/BRAF, HER-2 amplification, and microsatellite stable. Then the patient started to receive fruquintinib and has already achieved a 6-month progression-free survival. Till Jun 2019, the treatment with fruquintinib is still ongoing and no severe adverse effect has been seen so far.

Although fruquintinib is not, at present, a standard therapeutic strategy recommended by the treatment guideline for advanced small bowel adenocarcinoma, the significant curative effect has been seen in our clinical practice.

 抽象的

小肠癌是一种非常罕见的疾病。早期可以通过手术治疗；然而，对于不可切除的和/或转移性疾病的治疗，还没有建立标准的治疗策略。

本文介绍一例转移性小肠腺癌，经 XELOX（卡培他滨和奥沙利铂）、FOLFIRI（氟尿嘧啶、亚叶酸和伊立替康）、西妥昔单抗、HER-2 靶向治疗和阿帕替尼序贯治疗后进展，随后经呋喹替尼有效控制。基因检测显示野生型 KRAS/NRAS/BRAF、HER-2 扩增和微卫星稳定。随后患者开始接受呋喹替尼治疗，并已实现 6 个月无进展生存。直至2019年6月，呋喹替尼的治疗仍在进行中，迄今尚未发现严重的不良反应。

虽然目前呋喹替尼还不是晚期小肠腺癌治疗指南推荐的标准治疗策略，但在我们的临床实践中已经看到了显着的疗效。