Posterior Reversible Encephalopathy Syndrome During Treatment with Aflibercept, 5-Fluorouracil, Leucovorin, and Irinotecan for Metastatic Colorectal Cancer
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Posterior reversible encephalopathy syndrome (PRES) is an urgent neurologic condition that is associated with white and gray matter vasogenic edema primarily in parietal and occipital lobes . Clinical features usually involve headache, altered mental status, seizures, and visual disturbances . Although PRES is generally a rare reversible condition, it is increasingly reported in the literature, especially in the setting of cancer patients treated with chemotherapy and antiangiogenic drugs targeting the vascular endothelial growth factor (VEGF) pathway.
The combination of aflibercept with 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI) has been approved for the treatment of patients with metastatic colorectal cancer (mCRC) after the failure of oxaliplatin-based chemotherapy to control the disease . To the best of our knowledge, no cases of PRES related to aflibercept-FOLFIRI can be found in the published literature.
We present the case of a 64-year-old...
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Informed consent was obtained from the patient for publication of this manuscript and any accompanying images.
Conflict of Interest
The authors declare that they have no competing interests.
- 2.Van Cutsem E, Tabernero J, Lakomy R, et al. Addition of aflibercept to fluorouracil, leucovorin, and irinotecan improves survival in a phase III randomized trial in patients with metastatic colorectal cancer previously treated with an oxaliplatin-based regimen. J Clin Oncol. 2012;30(28):3499–506. doi: 10.1200/JCO.2012.42.8201.CrossRefGoogle Scholar
- 7.Miaris N, Maltezou M, Papaxoinis G, et al. Posterior reversible encephalopathy syndrome with concurrent nephrotic syndrome in a patient treated with pazopanib for metastatic renal cell carcinoma: case report and review of the literature. Clin Genitourin Cancer. 2017; doi: 10.1016/j.clgc.2016.08.005.
- 10.How J, Blattner M, Fowler S, et al. Chemotherapy-associated posterior reversible encephalopathy syndrome: a case report and review of the literature. Neurologist 2016;21(6):112–7. doi: 10.1097/NRL.0000000000000105.
- 11.Myint ZW, Sen JM, Watts NL, et al. Reversible posterior leukoencephalopathy syndrome during regorafenib treatment: a case report and literature Review of reversible posterior leukoencephalopathy syndrome associated with multikinase inhibitors. Clin Colorectal Cancer. 2017;13(2):127–30. doi: 10.1016/j.clcc.2013.12.003.CrossRefGoogle Scholar
- 18.Chen H, Modiano MR, Neal JW, et al. A phase II multicentre study of ziv-aflibercept in combination with cisplatin and pemetrexed in patients with previously untreated advanced/metastatic non-squamous non-small cell lung cancer. Br J Cancer. 2014;110(3):602–8. doi: 10.1038/bjc.2013.735.CrossRefGoogle Scholar