Anal canal
cancer is a rare
tumor without clear treatment evidence in the metastatic setting. In terms of the bad prognosis of patients with metastatic
anal cancer, further therapeutic options are urgently needed. In this paper we present the case of a 64-year-old man suffering from undifferentiated
squamous cell carcinoma with liver
metastases. After progression on
cisplatin and
fluorouracil,
tumor tissue was analyzed with respect to anti-EGFR
therapy with
cetuximab. There was no KRAS mutation and the EGFR expression level in the
tumor tissue was 2+; ideal conditions for the
immunotherapy. Encouraged by these results we started a
therapy using FOLFIRI in combination with
cetuximab. Fortunately the patient showed a partial response after 6 cycles. On patient's preference we did a
therapy break of 6 weeks. Within this time period the disease was progressive indicating its aggressiveness. However, the same
immunotherapy was able to stabilize the disease for a further 3 months. The patient died 21 months after diagnosis because of
liver failure. Nevertheless, from our perspective the combination of FOLFIRI and
cetuximab is quite a promising therapeutic option for patients with metastatic
anal cancer. Potential predictive factors of the immunochemotherapy are discussed in this paper.