Epidermal growth factor receptor inhibitor with fluorouracil, leucovorin, and irinotecan as an alternative treatment for advanced upper tract urothelial carcinoma: a case report

J Med Case Rep. 2016 Apr 18:10:98. doi: 10.1186/s13256-016-0879-6.

Abstract

Background: Currently, there is no standard salvage regimen after the failure of cisplatin-based chemotherapy for advanced urothelial carcinoma. The combination of epidermal growth factor receptor inhibitor with fluorouracil, leucovorin, and irinotecan was originally designed for the treatment of metastatic colorectal cancer. Until now, there have been no reports using this combination therapy in treating advanced upper tract urothelial carcinoma. To the best of our knowledge, this is the first report showing this possible treatment regimen for advanced upper tract urothelial carcinoma.

Case presentation: We report the case of a 90-year-old Chinese woman who was diagnosed with metastatic colorectal cancer and urothelial carcinoma of the bladder, ureter, and renal pelvis. The upper tract urothelial carcinoma was well controlled by the chemotherapy regimen for metastatic colorectal cancer. Considering her age, we used only laser ablation for the treatment of her urothelial carcinoma in combination with intravesical mitomycin C chemotherapy. Follow-up cystoscopy and ureterorenoscopy showed an unexpected regression of the upper tract urothelial tumor. Contrast-enhanced computed tomography also demonstrated the same results.

Conclusions: This novel regimen for the treatment of upper tract urothelial carcinoma may merit further investigation or evaluation in clinical trials.

Keywords: Chemotherapy; Epidermal growth factor receptor; Surgery; Target therapy; Upper tract urothelial carcinoma; Urothelial carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Cetuximab / administration & dosage
  • Colorectal Neoplasms / surgery
  • ErbB Receptors / antagonists & inhibitors
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Irinotecan
  • Leucovorin / administration & dosage
  • Neoplasm Metastasis
  • Neoplasms, Second Primary / drug therapy*
  • Urologic Neoplasms / drug therapy*

Substances

  • Irinotecan
  • ErbB Receptors
  • Cetuximab
  • Leucovorin
  • Fluorouracil
  • Camptothecin