Metastatic urachal carcinoma treated with trifluridine/tipiracil and bevacizumab: a case report

A 53-year-old man with a tumorous lesion at the bladder apex was diagnosed with an unresectable urachal carcinoma. After 10 cycles of combined therapy with 5-fluorouracil, leucovorin, and oxaliplatin, a combination of trifluridine/tipiracil and bevacizumab was initiated as second-line chemotherapy. Despite requiring a switch to bevacizumab monotherapy after the sixth cycle due to hematological toxicity, this regimen effectively controlled the disease for 16 cycles. It resulted in a progression-free survival of 17 months. To the best of our knowledge, this is the first report documenting the use of trifluridine/tipiracil and bevacizumab combination therapy for urachal carcinoma. While the observed disease control was notable in this patient, further accumulation of clinical experience and careful evaluation are warranted before generalizing the efficacy of this regimen in this rare malignancy.