Key result
A 71-year-old normotensive woman with metastatic colorectal cancer developed posterior reversible encephalopathy syndrome (PRES) after two cycles of fruquintinib, which completely resolved upon discontinuation of the drug.
Why the study?
Does fruquintinib cause posterior reversible encephalopathy syndrome (PRES) in patients with metastatic colorectal cancer?
Case Report (n=1)
Does fruquintinib cause posterior reversible encephalopathy syndrome (PRES) in patients with metastatic colorectal cancer?
Fruquintinib can cause posterior reversible encephalopathy syndrome (PRES) even in the absence of hypertension, highlighting the need for prompt radiological evaluation and drug discontinuation upon acute neurological symptoms.
May warrant vigilance for PRES with fruquintinib even without hypertension; single case leaves open causality and incidence.
We report a rare case of posterior reversible encephalopathy syndrome (PRES) following fruquintinib treatment in a 71-year-old female with metastatic colorectal adenocarcinoma harbouring a KRAS G12D mutation. The patient had previously undergone multiple lines of chemotherapy and surgical resections with stable disease before receiving fruquintinib under compassionate access. After two cycles, she developed headaches and acute encephalopathy. MRI confirmed PRES without associated hypertension. Fruquintinib was discontinued, and the patient made a full neurological recovery. This case highlights a rare but significant toxicity of anti-vascular endothelial growth factor (VEGF) therapy in the colorectal cancer setting and underscores the importance of early radiological evaluation in suspected PRES.
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ElManfalouty et al. (2025) conducted a case report in Metastatic colorectal cancer (n=1). Fruquintinib was evaluated on Development of posterior reversible encephalopathy syndrome (PRES). A 71-year-old normotensive woman with metastatic colorectal cancer developed posterior reversible encephalopathy syndrome (PRES) after two cycles of fruquintinib, which completely resolved upon discontinuation of the drug.
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