An Improvement of Exertional Dyspnea by the Reintroduction of Anti-EGFR Antibody in Patients with Metastatic Rectal Cancer Who Developed Cancerous Lymphangiopathy - A Case Report

Sep 21, 2026

Reexposure to anti-EGFR antibodies, including rechallenge or reintroduction after treatment discontinuation, has drawn attention in metastatic colorectal cancer. A case describes a 68-year-old man with metastatic rectal cancer who developed cancerous lymphangiopathy and respiratory failure after multiple lines of therapy and prior skin toxicity. After reintroduction of irinotecan plus cetuximab, discontinued earlier due to acneiform eruptions, dyspnea and performance status improved dramatically within two months. The report concludes that reintroduction may be a useful option for selected patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Introduction

Reexposure to anti-EGFR antibodies

Case Report

Patient history and prior treatments

Reintroduction of irinotecan plus cetuximab

Conclusion

Case Reports in Oncology | Case Rep Oncol 2024;17:511–516 | | | --- | --- | | DOI: 10.1159/000538235
Received: January 4, 2024
Accepted: January 29, 2024
Published online: March 28, 2024 | © 2024 The Author(s) .
Published by S. Karger AG, Basel [www.karger.com/cro](www.karger.com/cro) | This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ([http://www.karger.com/Services/OpenAccessLicense](http://www.karger.com/Services/OpenAccessLicense)). Usage and distribution for commercial purposes requires written permission. Case Report An Improvement of Exertional Dyspnea by the Reintroduction of Anti-EGFR Antibody in Patients with Metastatic Rectal Cancer Who Developed Cancerous Lymphangiopathy: A Case Report Masatsune Shibutania Hideki Tandaa Tatsunari Fukuoka a Hiroaki Kasashimaa Shinichiro Kashiwagi b Kiyoshi Maeda a a Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan; b Department of Breast Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan Keywords Anti-EGFR antibody · Cetuximab · Reintroduction · Colorectal cancer Abstract Introduction: Reexposure to anti-EGFR antibodies, such as a reintroduction or rechallenge with anti-EGFR antibodies, has attracted much attention in the ﬁeld of metastatic colorectal cancer. A reintroduction of anti-EGFR antibodies often shows good therapeutic outcomes, as most patients eligible for such reintroduction discontinued treatment due to adverse events despite a good treatment response during front-line treatment. We herein report a case demonstrating an improvement in exertional dyspnea after the reintroduction of anti-EGFR antibody in a patient with metastatic rectal cancer who developed cancerous lymphangiopathy. Case Presentation: A 68-year-old man who had undergone curative surgery for stage IIIB rectal cancer was diagnosed with multiple lung metastases. During the late-line treatment, respiratory failure developed because of multiple lung metastases and cancerous lymphangiopathy. Two months after the initiation of irinotecan + cetuximab, which had been discontinued due to acneiform eruptions despite a good treatment response as a ﬁrst-line treatment, his dyspnea and performance status dramatically improved. Correspondence to: Masatsune Shibutani, [fbxbj429](fbxbj429@ ybb. ne.jp)[@](fbxbj429@ ybb. ne.jp)[ ybb. ne.jp](fbxbj429@ ybb. ne.jp) Case Reports in Oncology Case Rep Oncol 2024;17:511–516 512 | DOI: 10.1159/000538235 | © 2024 The Author(s) . Published by S. Karger AG, Basel [www.karger.com/cro](www.karger.com/cro) | | --- | --- | Shibutani et al.: Reintroduction of Anti-EGFR Antibody Conclusion: This case indicates that the reintroduction of anti-EGFR antibody to patients who have discontinued anti-EGFR antibody due to skin toxicity despite a good treatment response is a very useful treatment option for metastatic colorectal cancer. © 2024 The Author(s) . Published by S. KargerAG, Basel Introduction Reexposure to anti-EGFR antibodies has attracted considerable attention for the treatment of metastatic colorectal cancer (mCRC) . Reexposure includes a rechallenge after the acquisition of resistance to anti-EGFR antibodies and reintroduction after discontinuation due to severe adverse events or according to the patient’s wishes, and both have shown good therapeutic outcomes [1] . In particular, a reintroduction has shown far better therapeutic outcomes than a rechallenge, as most patients eligible for reintroduction discontinued treatment due to adverse events despite a good treatment response during the front-line treatment [2] . A rechallenge with anti-EGFR antibodies is not an established treatment strategy, as there is no evidence based on the results of large prospective randomized trials. However, some phase 2 studies have shown relatively good therapeutic outcomes for a recha

FAQs

What clinical issue did the patient experience in this case report?

The patient developed exertional dyspnea and respiratory failure associated with multiple lung metastases and cancerous lymphangiopathy.

Why was cetuximab initially discontinued during front-line treatment?

Cetuximab was stopped due to acneiform eruptions despite an initial good treatment response.

What treatment was used after reintroduction, and what was the outcome?

Irinotecan plus cetuximab was reintroduced; within about two months, the patient’s dyspnea and performance status improved dramatically.

Sep 21, 2026

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