Long-Term Complete Response to Trastuzumab Deruxtecan in a Case of Unresectable Gastric Cancer

Abstract Introduction: Trastuzumab deruxtecan (T-Dxd) has been approved for the treatment of HER2-positive gastric cancer. However, there are only a limited number of cases of gastric cancer where a long-term complete response (CR) has been maintained. Consequently, we report a case of gastric cance...

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Published in:Case reports in oncology 2024-01, Vol.17 (1), p.463-470
Main Authors: Yamane, Hiroaki, Sugiyama, Yoichi, Komo, Toshiaki, Shibata, Kosuke, Tazaki, Tatsuya, Koyama, Mohei, Sasaki, Masaru
Format: Article
Language:English
Subjects:
Anemia
Anorexia
Ascites
Biopsy
Breast cancer
Cancer therapies
Case Report
Case reports
Chemokines
Chemotherapy
Cytotoxicity
Drug dosages
Endoscopy
Gastric cancer
her2-positive gastric cancer
Lymphatic system
Medical prognosis
Metastasis
Monoclonal antibodies
Neutropenia
Targeted cancer therapy
Tomography
trastuzumab deruxtecan
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Summary:Abstract Introduction: Trastuzumab deruxtecan (T-Dxd) has been approved for the treatment of HER2-positive gastric cancer. However, there are only a limited number of cases of gastric cancer where a long-term complete response (CR) has been maintained. Consequently, we report a case of gastric cancer in which long-term CR was maintained. Case Presentation: A woman in her late 60s underwent a gastrointestinal endoscopy, which revealed a type 2 lesion with ulceration in the lesser curvature of the vestibule, and a biopsy, which revealed an adenocarcinoma. Computed tomography (CT) revealed wall thickening of the gastric antecubital region, metastatic liver tumor, and extra-regional lymph node metastasis; a diagnosis of T4a, N3a, M1 (H, LYN), and cStage IVB (HER2 3+) was confirmed. Trastuzumab, oxaliplatin, and S-1 were administered initially. After 9 months, ascites appeared, and progressive disease was diagnosed. Paclitaxel and ramucirumab were started as second-line treatments but discontinued owing to neutropenia and increasing ascites. Third-line treatment with T-Dxd was initiated, and 11 months later, CT showed the disappearance of metastases. Even after 31 months, the CR was maintained. Conclusion: To the best of our knowledge, this is one of the few cases in which long-term CR was maintained with third-line T-Dxd treatment. Treatment strategies for patients with gastric cancer to achieve long-term CR require careful consideration.
ISSN:1662-6575
1662-6575
DOI:10.1159/000537845