[A Recurrent Colon Cancer Successfully Treated by Nivolumab plus Ipilimumab with On and Off for Preventing Exacerbation of Skin Disorders].

Here, we report a case in which nivolumab plus ipilimumab combination therapy was significantly effective for MSI-high recurrent colon cancer with acute exacerbation after 5-FU/L-OHP/CPT-11 treatment. At the end of 4 cycles of combination therapy, clinical CR was obtained on diagnostic imaging. At the end of the 2 cycles of transition from combination therapy to monotherapy, eosinophilia was observed in a quadratic function, and exacerbation of skin disorders was observed. Eosinophil counts normalized promptly after discontinuation of treatment, and skin disorders gradually improved. Two months after the discontinuation of treatment, monotherapy was restarted. After the resumption of treatment, an increase in eosinophils and worsening of skin symptoms were observed again, and stopped treatment. We report an interesting case in which immune checkpoint inhibiter were turned on and off according to eosinophil counts for preventing exacerbation of skin disorders, and for maintaining cancer remission by continuing immune checkpoint inhibitor treatment.

[Four cases of locally advanced colorectal cancer resected successfully after preoperative chemotherapy].

We describe four cases of locally advanced colorectal cancer resected successfully after preoperative chemotherapy conducted between April of 2007 and April of 2009. The average age of the patients was 66.3 years (range, 40-77 years). Because of tumor invasion into the surrounding organs, preoperative chemotherapy with FOLFOX4 was performed. The average number of courses of chemotherapy was 5.2 (range, 4-7). After chemotherapy, we were able to perform radical operations for all four cases. Histopathological examination of the tumor revealed Grade 3 in one case. There were no postoperative complications and no recurrences in any of the cases. We performed curative surgery after chemotherapy, and good results were obtained. Preoperative chemotherapy may be effective for avoiding excessive intervention surgeries such as total pelvic exenteration, preserving bladder and rectal functions, and for maintening QOL.