What happened, in summary

A 65-year-old man was diagnosed with unresectable gastric cancer involving the lower stomach with peritoneal spread. He began FOLFOX chemotherapy, but the primary tumor progressed after three months and caused nausea and vomiting from gastric outlet obstruction. An uncovered metal stent was placed to reopen the narrowed outlet.

He then received weekly paclitaxel plus ramucirumab. Three months later, he again developed nausea and vomiting. Imaging showed that the stent had fractured and a segment had migrated into the small bowel, causing obstruction. Surgeons removed the migrated stent segment and created a jejunostomy. A month later, the stoma was closed and a gastrojejunostomy was created. By two months after the emergency surgery, he could eat solid food without intravenous fluids and chemotherapy was restarted.

When the gastric cancer progressed again, he received nivolumab. He later transitioned to palliative care and died 10 months after the emergency surgery.