Gastric cancer treatment during hemodialysis after liver recurrence

This gastric cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Adenocarcinoma
Biomarkers
HER2-negative
Sex
Male
Spread to
liver|peritoneum
Treatment
surgery, chemotherapy, immunotherapy and targeted therapy
Outcome
Setback / Progression

Treatment course, step by step

  1. He underwent distal gastrectomy for Stage I gastric cancer.
  2. After liver recurrence, he received nivolumab with FOLFOX while continuing hemodialysis.
  3. When peritoneal progression developed, treatment changed to ramucirumab plus albumin-bound paclitaxel.
  4. Systemic treatment was stopped because of severe fatigue and loss of appetite, and he later transferred to hospice.

What happened, in summary

A 65-year-old man receiving hemodialysis for kidney disease was diagnosed with gastric cancer in 2022. He underwent distal gastrectomy, and the cancer was initially classified as Stage I.

During surveillance in October 2023, imaging found 3 new lesions in the liver. A biopsy confirmed that these represented recurrent gastric cancer rather than his separate skin tumor. The recurrence made the gastric cancer Stage IV. Testing showed that the tumor was HER2-negative.

He began nivolumab together with FOLFOX chemotherapy while continuing regular hemodialysis. His treatment was adjusted several times because of fatigue, appetite loss, and blood-count changes. After 6 cycles, the liver lesions were stable or slightly smaller, but abdominal fluid increased and the clinical picture indicated progression in the peritoneum.

Treatment was changed to ramucirumab plus albumin-bound paclitaxel. He later found systemic treatment increasingly difficult because of severe fatigue and loss of appetite. Chemotherapy was stopped in August 2024, and he transferred to hospice in October 2024.

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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