■曲妥珠单抗deruxtecan(T-Dxd)已被批准用于治疗HER2阳性胃癌。然而,只有有限数量的胃癌病例能够维持长期完全缓解(CR).因此,我们报道一例长期CR维持的胃癌.
■一名60多岁的妇女接受了胃肠内窥镜检查,显示2型病变,前庭的小曲率有溃疡,还有活检,显示腺癌.计算机断层扫描(CT)显示胃前肘区域的壁增厚,转移性肝肿瘤,和区域外淋巴结转移;T4a的诊断,N3a,M1(H,LYN),并且证实了c阶段IVB(HER23+)。曲妥珠单抗,奥沙利铂,和S-1最初给药。9个月后,出现腹水,并诊断出进行性疾病。紫杉醇和雷莫西单抗开始作为二线治疗,但由于中性粒细胞减少和腹水增加而停止治疗。开始使用T-Dxd进行三线治疗,11个月后,CT显示转移灶消失。即使在31个月后,CR得以维持。
■据我们所知,这是少数三线T-Dxd治疗维持长期CR的病例之一.胃癌患者实现长期CR的治疗策略需要仔细考虑。
UNASSIGNED: Trastuzumab deruxtecan (T-Dxd) has been approved for the treatment of HER2-positive gastric cancer. However, there are only a limited number of cases of gastric cancer where a long-term complete response (CR) has been maintained. Consequently, we report a
case of gastric cancer in which long-term CR was maintained.
UNASSIGNED: A woman in her late 60s underwent a gastrointestinal endoscopy, which revealed a type 2 lesion with ulceration in the lesser curvature of the vestibule, and a biopsy, which revealed an adenocarcinoma. Computed tomography (CT) revealed wall thickening of the gastric antecubital region, metastatic liver tumor, and extra-regional lymph node metastasis; a diagnosis of T4a, N3a, M1 (H, LYN), and cStage IVB (HER2 3+) was confirmed. Trastuzumab, oxaliplatin, and S-1 were administered initially. After 9 months, ascites appeared, and progressive disease was diagnosed. Paclitaxel and ramucirumab were started as second-line treatments but discontinued owing to neutropenia and increasing ascites. Third-line treatment with T-Dxd was initiated, and 11 months later, CT showed the disappearance of metastases. Even after 31 months, the CR was maintained.
UNASSIGNED: To the best of our knowledge, this is one of the few cases in which long-term CR was maintained with third-line T-Dxd treatment. Treatment strategies for patients with gastric cancer to achieve long-term CR require careful consideration.