Successful Treatment of a Hemodialysis Patient Using MFOLFOX-6/Bevacuzumab

Abstract

Introduction: The number of dialysis patients increases each year. Studies have shown that the incidence of malignant tumors is increasing. The number of patients on dialysis due to malignant tumors is expected to rise. Although combination treatment with 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and bevacizumab (BV) is standard for unresectable colorectal cancer, a standard treatment has not yet been established for dialysis patients.We here report on the treatment of dialysis patients with mFOLFOX-6/BV. Subject: A 70-year-old male had received maintenance dialysis treatment since January 2012 for diabetic nephropathy. On April 13, sigmoidectomy was performed for sigmoid colon cancer resulting from synchronous liver metastases. On May 28, mFOLFOX-6/BV therapy was initiated. Various reports on the subject influenced the dosage. A 47% dosage was initially administered, increasing to 65% by fourth course, with a 2-week interval. Dialysis was performed 1 h after urinary 1-hyfroxypyrene measurement. The only side effect was Grade 1 nausea. Computed tomography demonstrated 50% tumor shrinkage after twelfth course, and this combination treatment was continued. Discussion: Fifteen studies have examined FOLFOX treatment in dialysis patients, with FOLFOX and BV in three. Except for cases of cerebral hemorrhage of unknown cause, no serious adverse event has been reported in patients receiving this treatment. Of the nine cases in which FOLFOX/BV was determined to be effective, partial response was observed in two, stable disease in three, and progressive disease in four. FOLFOX/BV therapy may be effective for dialysis patients.