Complete response in Stage IV gastric cancer after chemotherapy, immunotherapy, and surgery

This gastric cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Adenocarcinoma
Biomarkers
HER2-negative; MSS; PD-L1 high (CPS ≥70)
Sex
Male
Spread to
liver
Treatment
chemotherapy, immunotherapy and surgery
Outcome
Cancer-Free / NED

Treatment course, step by step

  1. He received 4 cycles of S-1 plus oxaliplatin with nivolumab, and both the stomach tumor and liver metastasis shrank markedly.
  2. He then underwent distal gastrectomy with lymph-node removal and partial liver surgery.
  3. Pathology found no remaining cancer.

What happened, in summary

A 64-year-old man sought care for upper abdominal pain. Endoscopy found a stomach tumor, and biopsy confirmed moderately differentiated gastric adenocarcinoma. Imaging also showed a 6 cm liver metastasis and several enlarged regional lymph nodes, making the disease Stage IV.

Tumor testing later showed HER2-negative, microsatellite-stable disease with very high PD-L1 expression. He received 4 cycles of S-1 plus oxaliplatin chemotherapy together with nivolumab. After treatment, the stomach tumor had become almost scar-like, while the liver metastasis and enlarged lymph nodes had also shrunk markedly.

With this strong response, he underwent distal gastrectomy with lymph-node removal and partial liver surgery. Examination of the surgical specimens found no viable cancer in the stomach, lymph nodes, or liver metastasis, representing a complete pathologic response.

He recovered from surgery without major complications and remained free of recurrence for 3 years and 3 months.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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