Resection of hepatic metastasis after 5-fluorouracil and cofactor for colon cancer

Hepatic metastases are common in colorectal cancer. However, only a small percentage of patients are candidates for resection. Neoadjuvant chemotherapy is used to downstage tumors so surgical resection becomes a viable option. We present a case of resection of hepatic metastasis from an 85-year-old patient with metastatic colorectal cancer after treatment with 5-Fluorouracil and 5,10-methylenetetrafolate (CoFactor), an analog of leucovorin, in a Phase II Clinical Trial. CoFactor was developed as a more active replacement of leucovorin to potentially allow reduced dosing of 5-FU. This could potentially be associated with diminished side effects. 5-Fluorouracil with leucovorin or CoFactor could represent another alternative for neoadjuvant chemotherapy prior to resection in metastatic colorectal cancer and warrants further studies, especially in elderly patients.