HER2过表达/扩增是各种类型癌症的普遍驱动因素,包括胃癌(GC)。HER2阳性转移性胃癌患者的选择有限,特别是那些对HER2抗体曲妥珠单抗联合化疗的标准治疗无反应的患者.先前的研究表明,PD-1抑制剂与放射疗法和粒细胞巨噬细胞集落刺激因子(PRaG方案)联合使用可能会增强化疗耐药转移性实体瘤患者的抗肿瘤作用。在这个案例研究中,我们提出了HER2阳性和PD-L1阴性胃腺癌患者的潜在治疗策略.即使在手术和多种曲妥珠单抗加化疗治疗后,患者仍显示出快速的肿瘤进展。为了解决这个问题,我们采用了一种名为RC48的新型抗HER2抗体与PRaG方案治疗(PRaG3.0)联用.患者在两个治疗周期后表现出阳性反应,并实现了6.5个月的无进展生存时间。这个案例突出了四种联合疗法治疗难治性,多器官,HER2阳性,PD-L1阴性转移性胃癌。此外,靶向双病灶的不同放射剂量对增强肿瘤免疫治疗至关重要.
HER2 overexpression/amplification is a prevalent driver in various types of cancer, including gastric cancer (GC). Limited options are available for patients with HER2-positive metastatic gastric cancer, particularly those who do not respond to the standard therapy of HER2 antibody trastuzumab combined with chemotherapy. Previous research suggests that combining a PD-1 inhibitor with radiotherapy and granulocyte macrophage-colony stimulating factor (PRaG regimen) may enhance the antitumor effects in patients with chemotherapy-resistant metastatic solid tumors. In this
case study, we presented a potential treatment strategy of a patient having HER2-positive and PD-L1-negative gastric adenocarcinoma. The patient showed rapid tumor progression even after surgery and multiple trastuzumab plus chemotherapy treatments. To address this, we employed a novel anti-HER2 antibody called RC48 in combination with PRaG regimen therapy (PRaG3.0). The patient demonstrated a positive response after two treatment cycles and achieved a progression-free survival time of 6.5 months. This
case highlights the potential of four-combination therapies for treating refractory, multiorgan, HER2-positive, PD-L1-negative metastatic gastric cancer. Additionally, varying radiation doses in targeting dual foci is critical to enhance tumor immunotherapy.