Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2024; 16(2): 557-562
Published online Feb 15, 2024. doi: 10.4251/wjgo.v16.i2.557
Anti-EGFR antibody monotherapy for colorectal cancer with severe hyperbilirubinemia: A case report
Toshiaki Tsurui, Yuya Hirasawa, Yutaro Kubota, Kiyoshi Yoshimura, Takuya Tsunoda
Toshiaki Tsurui, Yuya Hirasawa, Yutaro Kubota, Kiyoshi Yoshimura, Takuya Tsunoda, Department of Medical Oncology, Showa University, Tokyo 1428555, Japan
Kiyoshi Yoshimura, Department of Clinical Immuno Oncology, Clinical Research Institute of Clinical Pharmacology and Therapeutics, Showa University, Tokyo 1578577, Japan
Author contributions: Tsurui T designed the case report and drafted the manuscript; Hirasawa Y coordinated the study; Kubota Y revised the manuscript; Yoshimura K organized the manuscript; Tsunoda T supervised the manuscript; all authors have read and approve the final manuscript.
Informed consent statement: Written informed consent for medical treatment was obtained from the patient.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Toshiaki Tsurui, MD, Doctor, Department of Medical Oncology, Showa University, No. 1-5-8, Hatanodai, Shinagawa, Tokyo 1428555, Japan.
Received: October 25, 2023
Peer-review started: October 25, 2023
First decision: November 30, 2023
Revised: December 13, 2023
Accepted: January 11, 2024
Article in press: January 11, 2024
Published online: February 15, 2024

Hyperbilirubinemia with hepatic metastases is a common complication and a poor prognostic factor for colorectal cancer (CRC). Effective drainage is often impossible before initiating systemic chemotherapy, owing to the liver’s diffuse metastatic involvement. Moreover, an appropriate chemotherapeutic approach for the treatment of hyperbilirubinemia is currently unavailable.


The patient, a man in his 50s, presented with progressive fatigue and severe jaundice. Computed tomography revealed multiple hepatic masses with thickened walls in the sigmoid colon, which was pathologically confirmed as a well-differentiated adenocarcinoma. No RAS or BRAF mutations were detected. The Eastern Cooperative Oncology Group (ECOG) performance status (PS) score was 2. Biliary drainage was impossible due to the absence of a dilated bile duct, and panitumumab monotherapy was promptly initiated. Subsequently, the bilirubin level decreased and then normalized, and the patient’s PS improved to zero ECOG score after four cycles of therapy without significant adverse events.


Anti-EGFR antibody monotherapy is a safe and effective treatment for RAS wild-type CRC and hepatic metastases with severe hyperbilirubinemia.

Keywords: Colorectal neoplasms, Panitumumab, Chemotherapy, Hyperbilirubinemia, Jaundice, Case report

Core Tip: We report the case of a patient with colorectal cancer and severe hyperbilirubinemia who was successfully treated with anti-EGFR antibody monotherapy. As this approach is safe and potentially lifesaving, it should be considered as a treatment option for hyperbilirubinemia due to hepatic metastases when biliary drainage is impossible.