RT Book, Section A1 Chu, Edward A2 Katzung, Bertram G. A2 Vanderah, Todd W. SR Print(0) ID 1176470719 T1 Cancer Chemotherapy T2 Basic & Clinical Pharmacology, 15e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260452310 LK accesspharmacy.mhmedical.com/content.aspx?aid=1176470719 RD 2024/03/28 AB CASE STUDYA 55-year-old man presents with increasing fatigue, 15-pound weight loss, and a microcytic anemia. Colonoscopy identifies a mass in the ascending colon, and biopsy specimens reveal well-differentiated colorectal cancer (CRC). He undergoes surgical resection and is found to have high-risk stage III CRC with five positive lymph nodes. After surgery, he feels entirely well with no symptoms. Of note, he has no other illnesses. What is this patient’s overall prognosis? Based on his prognosis, what are the possible benefits of adjuvant chemotherapy? How long should he receive adjuvant chemotherapy? The patient receives a combination of 5-fluorouracil (5-FU), leucovorin, and oxaliplatin (FOLFOX) as adjuvant therapy. One week after receiving the first cycle of therapy, he experiences significant toxicity in the form of myelosuppression, diarrhea, and altered mental status. What is the most likely explanation for this increased toxicity? Is there any role for genetic testing to determine the etiology of the increased toxicity?