AI Article Synopsis
- Immunotherapy has become a standard treatment for certain advanced gastric cancers, but its effectiveness in resectable cases is still uncertain.
- A case study is presented where a man with resectable gastric cancer, characterized as microsatellite stable but positive for PD-L1 and Epstein-Barr Virus, received neoadjuvant treatment with pembrolizumab and capecitabine, largely due to the challenges posed by the COVID-19 pandemic.
- The patient experienced a complete response with no signs of disease afterward, suggesting that combining immunotherapy and chemotherapy could be a promising approach for treating resectable gastric cancer and highlighting the need for more research in this area.
Article Abstract
Immunotherapy has been established as a standard in select molecular subgroups of treatment-refractory advanced gastric cancer. However, its role in resectable gastric cancer where perioperative systemic therapy is the standard remains unclear. We present a case of a man who was diagnosed with resectable gastric cancer that was microsatellite stable but programmed death-ligand 1 (PD-L1) and Epstein-Barr Virus (EBV)-positive. Given extenuating circumstances of the SARS-CoV-2 pandemic, preferences to limit exposure to the healthcare setting, and the unique tumor molecular features, neoadjuvant pembrolizumab and capecitabine was pursued after multidisciplinary discussion. He was able to achieve a complete response to this neoadjuvant regimen with no further signs of radiographic or pathologic disease on follow-up. We highlight a dramatic response to this novel approach that represents among the first cases to support a potentially viable neoadjuvant chemoimmunotherapy strategy to resectable gastric cancer. In select patients, perioperative immunotherapy-based therapy may constitute a promising strategy in resectable gastric cancer and warrants further investigation.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256116 | PMC |
| http://dx.doi.org/10.21037/acr-21-11 | DOI Listing |
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