Department of Integrated Traditional Chinese Medicine and Western Medicine, West China Hospital of Sichuan University, Chengdu, China.
Department of Integrated Traditional Chinese Medicine and Western Medicine, West China Hospital of Sichuan University, Chengdu, China. Email:
Ann Palliat Med. 2021 Jan;10(1):803-809. doi: 10.21037/apm-20-2572.
We report a rare case of gastric cancer with liver metastasis in a patient whose condition improved with the combination use of lenvatinib and camrelizumab. A 53-year-old man was admitted to hospital for abdominal pain. After an enhanced CT scan of his abdomen, it was found that he had multiple liver occupancy. Gastroscopic biopsies and liver biopsies supported the clinical diagnosis of stage IV gastric cancer. Next-generation sequencing technology (NGS) testing indicated that the tumor mutational burden (TMB) of the liver tissue and stomach tissue samples were high. The patient first received transcatheter arterial chemoembolization (TACE) treatment on August 30, 2018. The patient later received combined lenvatinib (8 mg, daily) anti-angiogenic therapy and camrelizumab (200 mg, every 2 weeks) immunotherapy. Three months following treatment, the patient's abdominal pain was relieved and his weight was increased. Regular reexamination of CT showed that the metastases of the liver continued to shrink. The curative effect was evaluated as partial response (PR). After 11 months of treatment, gastroscopy showed that the lesions of gastric tumors disappeared. At present, 14 months since the initial treatment, there is no clinical evidence of disease progression, and the current overall survival time is 14 months. Moreover, the quality of life of the patient was good and there were no obvious adverse drug reactions. This suggests that immunotherapy combined with antiangiogenic therapy has a synergistic effect on tumor and can play a better anti-tumor effect.
我们报告了一例罕见的胃肝转移癌病例，该患者联合使用仑伐替尼和卡瑞利珠单抗后病情得到改善。一名 53 岁男性因腹痛住院。腹部增强 CT 扫描发现他有多发性肝占位。胃镜活检和肝活检支持 IV 期胃癌的临床诊断。下一代测序技术 (NGS) 检测表明肝组织和胃组织样本的肿瘤突变负担 (TMB) 较高。该患者于 2018 年 8 月 30 日首次接受经导管肝动脉化疗栓塞术 (TACE) 治疗。随后，该患者接受了仑伐替尼（8mg，每日）联合卡瑞利珠单抗（200mg，每 2 周）免疫治疗。治疗 3 个月后，患者腹痛缓解，体重增加。定期复查 CT 显示肝转移继续缩小。疗效评估为部分缓解 (PR)。治疗 11 个月后，胃镜显示胃肿瘤的病变消失。目前，从初始治疗开始已经过去了 14 个月，没有疾病进展的临床证据，目前的总生存时间为 14 个月。此外，患者的生活质量良好，没有明显的药物不良反应。这表明免疫治疗联合抗血管生成治疗对肿瘤具有协同作用，可以发挥更好的抗肿瘤作用。
