Two Case Reports of Resensitization to Previous Chemotherapy with the Novel Hypoxia-Activated Hypomethylating Anticancer Agent RRx-001 in Metastatic Colorectal Cancer Patients
A 66-year-old male with unresectable mCRC was treated with the FOLFOX therapy as first-line chemotherapy and with FOLFIRI combined with cetuximab upon progression after first-line therapy. Although the patient achieved a response to this regimen, the course was complicated by a persistent grade 2/3 skin rash. After 6 months on the second-line regimen, his disease again progressed, and the patient entered into the RRx-001 phase-1 clinical trial, receiving RRx-001 at 83 mg/m2 once weekly, which he tolerated well. His disease stabilized for 6 months before progressing again (fig. , fig. ). In the interval between stopping RRx-001 and restarting treatment (approx. 40 days), his disease progressed significantly, suggesting that RRx-001 had suppressed tumor growth even after he met the criteria for progression. Given the lack of other effective options, he was rechallenged with FOLFIRI, resulting in moderate tumor shrinkage after only 4 weeks and improvement of symptoms. The treatment of this patient is currently ongoing.