Challenges in the adjuvant chemotherapy of a patient with colorectal cancer with impaired drug metabolism due to multiple single nucleotide polymorphisms (SNPs).

e13658 Background: Adjuvant chemotherapy for stage III colorectal cancer is a standard procedure and utilizes two classical drugs: a fluoropyrimidine derivative and the oxaliplatin, in different regimens: XELOX, mFOLFOX6, and recently, FLOX. Single nucleotide polymorphism have been involved in different patterns of toxicities but these findings have not been addressed in clinical trials. Methods: We studied the SNPs involved in the metabolism of fluoropyrimidines and oxaliplatin of a 52 years old lady with a pT3N2M0 colorectal grade II adenocarcinoma, with unusual toxicity to the chemotherapy regimens After one clinical oncologist had given her XELOX with oxaliplatin IV for one infusion only. The patient got very sick, and despite calcium and magnesium, there were acute and subsequent peripheral neurotoxicities, swallowing difficulties, cold hypersensitivity, diplopia, grade 3 fatigue, and grade 2 diarrhea concomitant to the use of oral antibiotics and grade 3 cough. With three more infusions of mFOLFOX6 ...