title: [A Patient with HER2-Positive Stage IV Advanced Gastric Cancer Who Received Chemotherapy with Trastuzumab plus XP Followed by Conversion Surgery].
abstract: A 68-year-old man presented with type 3 advanced gastric cancer(Circ, tub2>por, HER2 score 3)in the antrum, with skip lesions in the duodenum. The tumor was cT4aN2M1(DUO)CY0, cStage IV . An XP plus trastuzumab regimen(1,000mg/m2 capecitabine[Xeloda®]twice a day on days 1-14, 80mg/m2 CDDP on day 1, 8 mg/m2 trastuzumab on day 1[second course- 6mg/m2])was administered every 3 weeks and repeated for 6 courses without severe adverse events. After 6 courses, the primary tumor and metastatic lymph nodes shrank by 31.7%(a PR according to the RECISTcriteria ), and open distal gastrectomy, D3 lymphadenectomy, and Roux-en-Y reconstruction(ante colic)were performed as conversion surgery(R0). During the administration of adjuvant chemotherapy with S-1, para-aortic, mediastinum, left supraclavicular fossa, and cervical lymph node recurrence developed. Four courses of weekly PTX plus trastuzumab as first-line chemotherapy and 11 courses of biweekly CPT-11 plus CDDP as second-line chemotherapy were administered. Because of prolonged adverse events such as Grade 3 diarrhea, the patient refused continuation of chemotherapy. The patient died 24 months after the start of preoperative chemotherapy.
authors.affiliation: Dept. of Surgery, National Hospital Organization Osaka National Hospital.
authors.forename: Kei
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Sakae
authors.initials: S
authors.lastname: Maeda
authors.forename: Mamoru
authors.initials: M
authors.lastname: Uemura
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyake
authors.forename: Naoki
authors.initials: N
authors.lastname: Hama
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Hideyasu
authors.initials: H
authors.lastname: Omiya
authors.forename: Michihiko
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.forename: Koji
authors.initials: K
authors.lastname: Takami
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069287:Capecitabine / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D013274:Stomach Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D000068878:Trastuzumab / Q000008:administration & dosage
chemical_list: D000069287:Capecitabine; D002945:Cisplatin; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human