Division of Medical Oncology and Hematology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
J Hematol Oncol. 2010 Sep 9;3:31. doi: 10.1186/1756-8722-3-31.
We report a 49-year-old Chinese male with locally advanced gastric adenocarcinoma achieving pathological complete response after neoadjuvant chemotherapy with trastuzumab-containing regimen. He underwent esophagogastroduodenoscopy in September 2009, which revealed a 2-cm gastric ulcer on the lesser curvature proximal to angularis. Biopsy of gastric ulcer showed moderately differentiated adenocarcinoma with overexpression of human epidermal growth factor receptor 2 (HER2) by immunohistochemistry and fluorescence in situ hybridization. Further workups with endoscopic ultrasound, computed tomography and positron emission tomography staged his cancer as T3N1M0. He received 3 cycles of neoadjuvant chemotherapy consisting of trastuzumab, oxaliplatin, docetaxel and capecitabine without severe toxicities except grade 2 diarrhea near the completion of cycle 3 requiring discontinuation of capecitabine. Afterwards, he received total gastrectomy with extended D2 lymph node dissections showing pathological complete response. He went on to receive 3 more cycles of chemotherapy postoperatively. The role of trastuzumab as a part of perioperative therapy in gastric cancer overexpressing HER2 is worth further investigation.
我们报告了一例局部晚期胃腺癌患者，在接受曲妥珠单抗为基础的新辅助化疗后达到病理完全缓解。患者于 2009 年 9 月接受了食管胃十二指肠镜检查，发现角切迹附近小弯侧有 2cm 的胃溃疡。胃溃疡活检显示中分化腺癌，免疫组化和荧光原位杂交显示人表皮生长因子受体 2（HER2）过表达。进一步的内镜超声、计算机断层扫描和正电子发射断层扫描检查将其癌症分期为 T3N1M0。他接受了 3 个周期的新辅助化疗，包括曲妥珠单抗、奥沙利铂、多西他赛和卡培他滨，除了第 3 个周期接近完成时出现 2 级腹泻，需要停用卡培他滨外，没有严重的毒性反应。之后，他接受了全胃切除术和扩大的 D2 淋巴结清扫术，显示病理完全缓解。他随后接受了 3 个周期的术后化疗。曲妥珠单抗作为过表达 HER2 的胃癌围手术期治疗的一部分的作用值得进一步研究。
