Primary Cancer

• Type: Colorectal adenocarcinoma
• Initial site: Colon
• Status: Primary tumor surgically removed

Metastatic Disease

• Current site: Liver (metastatic colorectal cancer)
• Disease nature: Systemic disease (metastatic, not localized)

Molecular Profile

• KRAS mutation: G12V
• MMR status: MSS / pMMR (microsatellite stable; mismatch repair proficient)

Clinical Implications

• KRAS G12V: EGFR inhibitors are not effective
• MSS / pMMR: Low likelihood of response to immunotherapy (checkpoint inhibitors)

Prior Chemotherapy

• Regimen: FOLFOX
• Duration: 12 cycles
• Outcome: Completed; later disease recurrence in liver

Current Chemotherapy

• Regimen: FOLFIRI
• Schedule: Every 14 days
• Cycle Pattern:
  • Day 0: ~5+ hour infusion, then 48-hour portable pump
  • Day 1–2: Peak fatigue, nausea, cognitive fog
  • Day 3+: Gradual recovery window