AI Article Synopsis
- Hepatoid adenocarcinoma of the stomach (HAS) is a rare and aggressive form of gastric cancer with a poor prognosis; however, this case demonstrates a complete response following a novel chemo-immunotherapy approach.
- A 48-year-old woman diagnosed with HAS underwent a treatment regimen of oxaliplatin, S-1, and the PD-1 inhibitor terelizumab, leading to a significant reduction in tumor markers and size.
- The patient achieved a pathologic complete response after surgery, with no signs of recurrence after one year, suggesting this combined treatment could be a promising option for HAS, even in cases with negative PD-L1 expression.
Article Abstract
Background: Hepatoid adenocarcinoma of the stomach (HAS) is a highly malignant subtype of gastric carcinoma with specific clinicopathological features and extremely poor prognosis. We present an exceedingly rare case of complete response after chemo-immunotherapy.
Case Description: A 48-year-old woman with highly elevated serum alpha-fetoprotein (AFP) level was found to have HAS verified by pathological examination based on gastroscopy. Computed tomography scan was done and TNM staging of the tumor was T4aN3aMx. Programmed cell death ligand-1 (PD-L1) immunohistochemistry was performed, revealing a negative PD-L1 expression. Chemo-immunotherapy including oxaliplatin plus S-1 and PD-1 inhibitor terelizumab was given to this patient for 2 months until the serum AFP level decreased from 748.5 to 12.9 ng/mL and the tumor shrank. D2 radical gastrectomy was then performed and histopathology of the resected specimen revealed that the cancerous cells had disappeared. Pathologic complete response (pCR) was achieved and no evidence of recurrence has been found after 1 year of follow-up.
Conclusions: We, for the first time, reported an HAS patient with negative PD-L1 expression who achieved pCR from the combined chemotherapy and immunotherapy. Although no consensus has been reached regarding the therapy, it might provide a potential effective management strategy for HAS patient.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10098014 | PMC |
| http://dx.doi.org/10.3389/fsurg.2023.1133335 | DOI Listing |
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