title: Molecular-targeted therapy for chemotherapy-refractory gastric cancer: a case report and literature review.
abstract: The prognosis of advanced gastric cancer (AGC) remains poor despite therapeutic advances in recent decades. Several recent positive phase III trials established the efficacy of second-line chemotherapy for metastatic gastric cancer in prolonging overall survival. However, malnutrition and poor performance of AGC in late stages usually preclude such patients from intensive treatment. Many targeted-therapies failed to show a significant survival benefit in AGC, but have regained attention after the positive result of ramucirumab was announced last year. Among all targeted agents, only trastuzumab, a monoclonal antibody against Human epidermal growth factor receptor-2 (HER2) protein, has been proven as having survival benefit by addition to first-line chemotherapy. Herein we reported a patient who benefited from adding trastuzumab to the same second-line combination chemotherapy (paclitaxel, 5-fluorouracil, and leucovorin) upon progression of bulky liver metastases. At least five months of progression-free survival were achieved without any additional toxicity. We also reviewed literature of molecularly-targeted therapy for chemotherapy-refractory gastric cancer, including several large phase III trials (REGARD, GRANITE-1, EXPAND, and REAL-3) published in 2013-2014.
authors: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan, R.O.C.
authors: Hung-Yang
authors: HY
authors: Kuo
authors: Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan, R.O.C. Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan, R.O.C. khyeh@ntu.edu.tw.
authors: Kun-Huei
authors: KH
authors: Yeh
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D006801:Humans; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000068878:Trastuzumab
keywords: Gastric cancer; chemotherapy; ramucirimab; refractory; targeted therapy; trastuzumab