Recovery from severe liver injury during Stage III gastric cancer treatment

What happened, in summary

A 76-year-old man was diagnosed with Stage III gastric adenocarcinoma in March 2023 after several months of upper abdominal discomfort. Imaging and endoscopy showed a tumor involving the upper stomach, and biopsy confirmed cancer.

In April 2023, he underwent total gastrectomy with lymph-node removal. The surgical findings confirmed Stage III disease. He then received SOX chemotherapy. For his second treatment cycle, he joined a clinical trial and received camrelizumab immunotherapy together with SOX.

About 20 days later, he developed severe jaundice and liver failure linked to the immunotherapy. His anticancer medicines were stopped while doctors treated the liver injury with steroids, immunosuppressive treatment, liver-protective medicines, and artificial liver support. His liver function gradually improved and returned to the normal range over the following months.

Camrelizumab and oxaliplatin were permanently discontinued. After recovery, he completed 1 year of S-1 chemotherapy. Follow-up imaging showed no recurrence, and his tumor markers remained stable. At the last follow-up in August 2025, his liver function was still normal and there was no evidence that the gastric cancer had returned.