A Case of HER2 Positive Gastric Cancer That Was Highly Responsive to Fifth-Line Chemotherapy with Trastuzumab

• Published in: Gan to kagaku ryoho Vol. 48; no. 13; p. 1646
• Main Authors: Sato, Hideaki, Ii, Takayuki, Hotchi, Shota, Goh, KengWee, Rikiyama, Naoki, Sato, Ami, Akishige, Naoki, Kokumai, Takashi, Aoki, Yasutaka, Kikuchi, Daisuke, Yamanami, Hideaki
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-12-2021
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Gastrectomy; Humans; Male; Nivolumab - therapeutic use; Stomach Neoplasms - drug therapy; Stomach Neoplasms - surgery; Trastuzumab - therapeutic use
• ISSN: 0385-0684

A 76-year-old male underwent distal gastrectomy for gastric cancer and pathological findings showed Stage Ⅳ(T4a, N3a, M1, H0, P0, CY1)with HER2 positivity. He received chemotherapy with S-1 and oxaliplatin(SOX)plus trastuzumab and no disease progression was shown. However, because of Grade 3 adverse skin effects to S-1, he could not continue with the regimen. He switched to a regimen of ramucirumab plus paclitaxel, followed by nivolumab, and later irinotecan. However, the disease progressed and multiple lung metastases as well as a left adrenal metastasis appeared. Fifth-line chemotherapy with trastuzumab was administered. After 4 courses, the lung metastases reduced and the left adrenal metastasis shrank from 46 mm to 33 mm. These results were consistent with a partial response on the Response Evaluation Criteria in Solid Tumors. In addition, CEA and CA19-9 also decreased significantly. Unfortunately, after 10 courses, the patient's disease progressed.