title: Surgical resection of advanced gastric cancer following trastuzumab/oxaliplatin/capecitabine combination therapy.
abstract: Late-stage gastric adenocarcinoma patients have a poor prognosis because of high recurrence rates. To improve long-term outcomes, perioperative chemotherapies are combined with surgery. Human epidermal growth factor receptor 2 (HER2) overexpression had been noted in gastric cancer; therefore, trastuzumab has been used occasionally in this setting. A 63-year-old male Chinese patient, who was diagnosed with adenocarcinoma in the gastric antrum, as well as lymph node metastases along the left gastric and hepatic artery, and left adrenal area, was admitted to our hospital. HER2 expression was positive, and cluster amplification was detected in a fluorescence in situ hybridization assay. The patient received three cycles of a neoadjuvant trastuzumab/oxaliplatin /capecitabine regimen. He subsequently underwent distal gastrectomy, D2+ lymphadenectomy, left adrenalectomy, cholecystectomy and Billroth II anastomosis. Treatment was continued with another five postoperative cycles of the same medication and trastuzumab application for 1 year. No recurrence has been observed 18 mo after the operation. Trastuzumab as perioperative and adjuvant medication, in combination with oxaliplatin and capecitabine for a HER2-overexpressing advanced gastric adenocarcinoma, led to recurrence-free survival of at least 18 mo after surgery.
authors.affiliation: Cai-Xia Dong, Xian-Yun Ye, Xiao-Fen Li, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University College of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Cai-Xia
authors.initials: CX
authors.lastname: Dong
authors.affiliation: Cai-Xia Dong, Xian-Yun Ye, Xiao-Fen Li, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University College of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Jian-Fei
authors.initials: JF
authors.lastname: Fu
authors.affiliation: Cai-Xia Dong, Xian-Yun Ye, Xiao-Fen Li, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University College of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Xian-Yun
authors.initials: XY
authors.lastname: Ye
authors.affiliation: Cai-Xia Dong, Xian-Yun Ye, Xiao-Fen Li, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University College of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Xiao-Fen
authors.initials: XF
authors.lastname: Li
authors.affiliation: Cai-Xia Dong, Xian-Yun Ye, Xiao-Fen Li, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University College of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Xian
authors.initials: X
authors.lastname: Zhong
authors.affiliation: Cai-Xia Dong, Xian-Yun Ye, Xiao-Fen Li, Ying Yuan, Department of Medical Oncology, 2 Hospital of Zhejiang University College of Medicine, Hangzhou 310009, Zhejiang Province, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D002681:China; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004334:Drug Administration Schedule; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D005743:Gastrectomy; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000037:antagonists & inhibitors / Q000235:genetics / Q000378:metabolism; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D000068878:Trastuzumab; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000069287:Capecitabine; D003841:Deoxycytidine; D005472:Fluorouracil; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Capecitabine; Gastric adenocarcinoma; Neoadjuvant medication; Oxaliplatin; Trastuzumab