A multiple metastatic colon cancer patient with extra-long survival and acquired BRAF mutation: case report and literature review

For colorectal cancer patients, metastasis is a major cause of high mortality and short survival. Precision medicine has led to significant advances in targeted therapy and immunotherapy in the treatment of colorectal cancer, providing more options for patients with mCRC and eventually improving their prognosis. However, the use of these drugs is limited by pre-existing intrinsic resistance mechanisms or the ability of cancer cells to acquire resistance. This report presents a colorectal cancer patient who survived 12 years. After the first palliative resection for descending colon cancer, this patient had experienced local recurrence, splenic and diaphragmatic metastases, splenic fossa and incisional implant metastases, renal metastases, and liver metastases. The patient underwent five surgical resection procedures and benefited from surgery combined with chemotherapy. The disease was initially controlled with first-line treatment when the patient developed liver metastases. After the metastases progressed, next-generation sequencing (NGS) revealed the patient's acquired genomic alternation, BRAF V600E. This case highlights the importance of combining local and systemic therapy and the need to be aware of acquired genomic alternations.