What is it about?
We present the rare case of a 73-year-old man, who diagnosed stage IV gastric cancer with liver metastasis, effectively treated with conversion surgery (CS) after nivolumab monotherapy as a third-line chemotherapy. Twelve courses of capecitabine, cisplatin, and trastuzumab were administered as the first-line treatment, 25 courses of paclitaxel plus ramucirumab were administered as the second-line treatment. After 31 courses of nivolumab monotherapy as the third-line treatment, CT showed that the primary tumor shrank with no liver metastasis or ascites. Diagnostic laparoscopy was performed with no peritoneal dissemination (P0), and the peritoneal lavage cytology was negative (CY0). CS was performed with total gastrectomy and D2 lymph node dissection (R0 resection). The patient did not show recurrence for 9 months after CS.
Featured Image
Photo by Dominik Lange on Unsplash
Why is it important?
CS is often performed when first-line chemotherapy is effective, there are few reports of conversion surgery after nivolumab monotherapy. Although the response rate of nivolumab monotherapy is not high, it is effective after the third-line chemotherapy in some cases. Thus, long-term survival and the number of patients undergoing CS after nivolumab as third-line chemotherapy are expected to increase in the future.
Perspectives
Although the response rate of nivolumab monotherapy is not high, it is extremely effective in some patients, as in this case. It is suggested that determining the optimal timing and indications of conversion surgery may lead to improved prognosis for patients.
Hayato Watanabe
Yokohama City University
Read the Original
This page is a summary of: Successful Conversion Surgery for Stage IV Gastric Cancer after Nivolumab Monotherapy as Third-Line Chemotherapy, Case Reports in Gastroenterology, June 2021, Karger Publishers,
DOI: 10.1159/000514396.
You can read the full text:
Contributors
The following have contributed to this page
