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Journal of Medical Case Reports
Published in: Journal of Medical Case Reports 1/2019

Open Access 01-12-2019 | Computed Tomography | Case report

Strategy for treatment of stage IV human epidermal growth factor 2-positive gastric cancer: a case report

Authors: Masazumi Sakaguchi, Norihiro Shimoike, Shin Akagawa, Seiichiro Kanaya

Published in: Journal of Medical Case Reports | Issue 1/2019

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Abstract

Background

The prognosis of stage IV gastric cancer and human epidermal growth factor 2 (HER2)-positive gastric cancer is poor, although new drugs and regimens have been developed. We report a case of a patient with stage IV HER2-positive gastric cancer treated successfully by conversion therapy and trastuzumab.

Case presentation

The patient was a 73-year-old Japanese man diagnosed as L, type 3, circ, T4aNxCy1P1M1, stage IV (the Japanese classification of gastric carcinoma). The patient was treated with docetaxel, cisplatin, and TS-1 (DCS regimen). After two courses of the regimen, peritoneal dissemination disappeared, and peritoneal lavage cytology revealed no tumor cells in the abdominal cavity. Subsequently, he underwent laparoscopic distal gastrectomy with D1+. Pathological findings were ypT2(MP), ypN2(3/15), ypP0, ypCY0, M0, ypstage II. He received TS-1 as an adjuvant chemotherapy, but he had peritoneal recurrence. The original gastric cancer was HER2-positive. We therefore treated him with TS-1 with trastuzumab. This regimen was quite effective and achieved a complete response. After complete response, we switched the patient to trastuzumab monotherapy. He had no evidence of recurrence for 6 years, 3 months after surgery.

Conclusion

DCS regimen, R0 resection, and adjuvant chemotherapy with trastuzumab can be a powerful strategy for stage IV HER2-positive gastric cancer.
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Metadata
Title
Strategy for treatment of stage IV human epidermal growth factor 2-positive gastric cancer: a case report
Authors
Masazumi Sakaguchi
Norihiro Shimoike
Shin Akagawa
Seiichiro Kanaya
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2019
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-019-2001-3

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