Murata Yoriko, Matsuura Tetsuya, Kanoshima Kenji, Kuwabara Hiroki, Fuyuki Akiko, Tomeno Wataru, Taniguchi Reo, Uchiyama Takashi, Kuriyama Hitoshi, Hata Yasuo
Division of Gastroenterology, Chigasaki Municipal Hospital.
Gan To Kagaku Ryoho. 2013 Jul;40(7):933-6.
A 67-year-old woman was diagnosed as having advanced gastric cancer(poorly differentiated adenocarcinoma)with multiple liver metastases. She had received combined S-1 plus cisplatin chemotherapy as first-line treatment and weekly paclitaxel chemotherapy as second-line treatment, however, both had eventually proved ineffective. Because the gastric cancer was HER2-positive, she was treated with trastuzumab plus capecitabine plus cisplatin(XP)chemotherapy as third-line treatment. The primary lesion and liver metastatic lesions were confirmed to show remarkable regression. The ToGA trial revealed increased efficacy of trastuzumab in first-line treatment of cancers showing high expression levels of the HER2- protein. This case suggested the increased efficacy of trastuzumab in third-line treatment. Neutropenia and hand foot syndrome of grade 2 were all reported adverse events. She could receive trastuzumab plus XP chemotherapy safely by dose reduction or dormancy temporarily of capecitabine.
一名67岁女性被诊断为晚期胃癌（低分化腺癌）伴多发肝转移。她接受了S-1联合顺铂化疗作为一线治疗，以及每周一次的紫杉醇化疗作为二线治疗，但最终均证明无效。由于该胃癌为HER2阳性，她接受了曲妥珠单抗联合卡培他滨加顺铂（XP）化疗作为三线治疗。原发灶和肝转移灶均证实有显著消退。ToGA试验显示，曲妥珠单抗在HER2蛋白高表达癌症的一线治疗中疗效增加。该病例提示曲妥珠单抗在三线治疗中疗效增加。中性粒细胞减少和2级手足综合征均为报告的不良事件。通过减少卡培他滨剂量或暂时停药，她能够安全地接受曲妥珠单抗联合XP化疗。
