Stage IV gastric cancer with gastric outlet obstruction treated with a stent

Patient Info: Anonymized, female, 70+ | Stage IV

Metastatic Site: para-aortic lymph nodes

The second stent allowed her to continue eating solid food. She died from progressive gastric cancer 3 months after the repeat stent procedure.

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Young man with hereditary diffuse gastric cancer and a CDH1 mutation

Patient Info: Anonymized, male, Under 40 | Stage IV

Biomarkers: CDH1 c.639G>A nonsense mutation, decreased E-cadherin expression

His health deteriorated rapidly and he died 4 months after the Stage IV diagnosis without receiving anticancer treatment.

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Rapidly progressive AFP-producing gastric cancer with widespread metastases and severe blood-clotting complications

Patient Info: Anonymized, male, 50s | Stage IV

Biomarkers: AFP-positive

Metastatic Site: liver, lymph nodes, bone, muscle, subcutaneous tissue

He died shortly after presentation from a massive brain hemorrhage in the setting of disseminated intravascular coagulation, before systemic anticancer treatment could be started.

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Ramucirumab and paclitaxel for metastatic gastric cancer in a patient receiving hemodialysis

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-negative

Metastatic Site: liver, distant lymph nodes

After about 16 months of disease control on paclitaxel plus ramucirumab, multiple liver metastases and distant lymph nodes progressed. Third-line irinotecan was stopped after severe toxicity, and supportive care followed.

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Hemodialysis used to manage 5-FU toxicity during treatment of Stage IV gastric cancer

Patient Info: Anonymized, male, 70+ | Stage IV

Metastatic Site: para-aortic lymph nodes, meninges

After a partial response to 7 cycles of chemotherapy, carcinomatous meningitis developed. Treatment was stopped, best supportive care was started, and he died 2 months later.

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Sjögren syndrome during nivolumab treatment for HER2-positive metastatic gastric cancer

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: liver, lungs, adrenal gland

One year after nivolumab was stopped, the shrinkage of lung metastases was maintained and the adrenal metastasis remained unchanged, although severe dry-mouth symptoms from treatment-related Sjögren syndrome persisted.

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Dural metastasis causing seizures after treatment for signet-ring gastric cancer

Patient Info: Anonymized, female, Under 40 | Stage IV

Metastatic Site: dura mater

She died 16 days after hospital admission for neurologic symptoms, roughly 8 months after the original gastric-cancer diagnosis, following rapid deterioration from diffuse dural metastatic disease.

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Five years recurrence-free after surgery for a solitary splenic metastasis from gastric cancer

Patient Info: Anonymized, male, 70+ | Stage IV

Metastatic Site: spleen

He remained well without recurrence for 5 years after splenectomy for the solitary gastric-cancer metastasis.

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Graves disease during nivolumab treatment for HER2-positive metastatic gastric cancer

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: liver, brain

After progression through several treatment lines and development of brain metastasis, he died 4 months after evaluation for nivolumab-associated Graves disease, more than 1.5 years after his Stage IV gastric-cancer diagnosis.

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Cutaneous lymphatic spread after Stage III gastric cancer with signet-ring cells

Patient Info: Anonymized, female, 70+ | Stage IV

Metastatic Site: bone, distant lymph nodes, skin

After metastatic spread to bone, distant lymph nodes and skin, she developed respiratory failure and died despite palliative treatment.

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Nivolumab-related IgA kidney disease during treatment for Stage IV gastric cancer

Patient Info: Anonymized, male, 70+ | Stage IV

The gastric tumor regrew while nivolumab was withheld. Kidney function improved with steroids, but recurrent pneumonia and poor performance status prevented immunotherapy from restarting.

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Gastric adenocarcinoma with a rare choriocarcinoma component and rapid liver and lung spread

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-positive

Metastatic Site: liver, lung

Rapid liver and lung metastatic progression caused bleeding from a liver metastasis. He declined further treatment and died from hemorrhagic shock 18 days after his final discharge.

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Stage IV Gastric Cancer: Faye's Patient Story

Patient Info: Faye Hood, female, 70+ | Stage IV

After surgery and heated intraperitoneal chemotherapy, Faye recovered, returned to exercise and completed a half-marathon 1 year later.

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Gastric cancer with an unexpected appendix metastasis

Patient Info: Anonymized, female, 50s | Stage IV

Metastatic Site: appendix

PET/CT at 6, 12 and 18 months showed no recurrence, giving at least 18 months with no evidence of disease after treatment.

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Clival skull-base metastasis during treatment for Stage IV gastric cancer

Patient Info: Anonymized, male, 70+ | Stage IV

Biomarkers: HER2-negative

Metastatic Site: peritoneum, cervical lymph nodes, pelvic bone, lungs,…

At publication he was alive on fourth-line treatment, with no disease progression for 6 months after the clival metastasis was treated and with sustained improvement in his cranial-nerve symptoms.

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Severe reversible neurologic toxicity after apatinib for metastatic gastric cancer

Patient Info: Anonymized, male, 50s | Stage IV

Metastatic Site: bone, adrenal glands

At follow-up in April 2019, he was alive and independent about 7 years after his Stage IV diagnosis, with apatinib permanently stopped after the neurologic toxicity.

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Stage IV gastric cancer presenting with chylothorax and lymphedema

Patient Info: Anonymized, female, 40s | Stage IV

Biomarkers: HER2-negative

Metastatic Site: distant lymph nodes, pleura, peritoneum

She died 6 months after the Stage IV gastric-cancer diagnosis despite chemotherapy and repeated treatment of the malignant pleural effusions.

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Reversible Heart Dysfunction After FLOT Chemotherapy for Gastric Cancer

Patient Info: Anonymized, Female, 50s | Stage IV

Her speech recovered within hours and heart function returned to an ejection fraction of 65% within 1 week. Gastric-cancer treatment continued with carboplatin and paclitaxel.

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Primary gastric squamous cell carcinoma with early chest metastases

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-negative

Metastatic Site: lungs, distant lymph nodes

Twelve months after chemotherapy began, the metastatic chest lesions had not progressed and showed minor regression.

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Gastric Choriocarcinoma With Adenocarcinoma and Rapid Liver Metastases After Surgery

Patient Info: Anonymized, female, 70+ | Stage IV

Biomarkers: β-hCG positive; serum β-hCG 972.1 mIU/mL after diagnosis

Metastatic Site: liver

Multiple liver metastases appeared 2 months after discharge, and she died from hepatic failure 5 months after surgery.

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Stage IV gastric cancer complicated by paraneoplastic dermatomyositis during nivolumab treatment

Patient Info: Anonymized, male, 70+ | Stage IV

Metastatic Site: liver, lung, abdominal cavity

He died from rapidly worsening gastric cancer 142 days after the first nivolumab dose, roughly 14 months after his April 2017 diagnosis.

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Mixed adenocarcinoma-neuroendocrine gastric cancer progressing after multiple treatments

Patient Info: Anonymized, male, 60s | Stage IV

Biomarkers: HER2-negative

Metastatic Site: liver

After progression through several treatments and development of liver metastasis, he was taking apatinib at the latest update.

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Metastatic gastric cancer with suspected spread to an extraocular muscle

Patient Info: Anonymized, female, 50s | Stage IV

Metastatic Site: ovary, mesentery, neck subcutaneous tissue, thoracic…

She died 3 months after the eye presentation, more than 2 years after the gastric-cancer diagnosis.

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Mucinous gastric cancer presenting with an iris metastasis

Patient Info: Anonymized, female, 70+ | Stage IV

Metastatic Site: iris, peritoneum, para-aortic and mesenteric lymph…

She died of aspiration pneumonia 8 months after presentation. Autopsy confirmed persistent invasive gastric cancer with metastatic spread.

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