[A Case of HER-2 Positive Advanced Gastric Cancer Responding to Capecitabine＋Cisplatin＋Trastuzumab Chemotherapy].
A 67-year-old woman was referred to our hospital for type 1 gastric cancer. We diagnosed the patient with advanced gastric cancer (tub2>por, HER2-positive), and the clinical findings were T4aN1M1 (lung), Stage Ⅳ. The patient had cancer cachexia. As first-line chemotherapy, a regimen consisting of capecitabine (X) (1,600 mg/m2/day, days 1-14), cisplatin (P) (60 mg/m2/day, day 1), and trastuzumab (H) (8 mg/kg/day>6 mg/kg/day, day 1) was administered every 3 weeks and repeated 6 times. After receiving 6 courses, the patient's general condition and cancer cachexia symptoms improved. The size of the primary lesion significantly decreased, and lung metastasis was not visible on a PET scan. Simultaneously, a new 0-Ⅱc tumor was detected in the cardia, and a biopsy revealed a malignant lymphoma. Total gastrectomy and D2 lymph node dissection without splenectomy were performed. The final diagnosis was T4aN0M0. After treatment, the tumor was histologically evaluated as Grade 1b, and the remnant cancer cells were found to be HER2-negative (loss of HER2). The patient has been alive for 5 months and is receiving adjuvant chemotherapy comprising capecitabine and trastuzumab. Following chemotherapy containing trastuzumab, the patient with cachexia who was diagnosed with unresectable HER2-positive advanced gastric cancer showed improvement in the cachexia symptoms and the disappearance of lung metastasis.
Dept. of Gastrointestinal surgery, Kanagawa Cancer Center.
Kenki
K
Segami
Tsutomu
T
Sato
Taiichi
T
Kawabe
Shigeya
S
Hayashi
Yosuke
Y
Makuuchi
Takashi
T
Oshima
Yasushi
Y
Rino
Munetaka
M
Masuda
Takashi
T
Ogata
Haruhiko
H
Cho
Takaki
T
Yoshikawa
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002100:Cachexia / Q000209:etiology; D000069287:Capecitabine / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005743:Gastrectomy; D006801:Humans; D020360:Neoadjuvant Therapy; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D013274:Stomach Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000068878:Trastuzumab / Q000008:administration & dosage; D016896:Treatment Outcome
D000069287:Capecitabine; D002945:Cisplatin; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human