曲妥珠单抗-deruxtecan 在晚期胃癌伴脑转移患者中的疗效。
Efficacy of trastuzumab deruxtecan in an advanced gastric cancer patient with brain metastasis.
机构信息
Department of Medical Oncology, Nagoya Medical Center, Nagoya, Aichi, Japan.
Department of Medical Oncology, Nagoya Medical Center, Nagoya, Aichi, Japan.
出版信息
Curr Probl Cancer. 2021 Dec;45(6):100757. doi: 10.1016/j.currproblcancer.2021.100757. Epub 2021 Apr 18.
BACKGROUND
There is no clinical evidence supporting the effectiveness of trastuzumab deruxtecan (T-DXd) for treating advanced gastric cancer (AGC) with brain metastasis.
CASE REPORT
This is a case of a 65-year-old man with human epidermal growth factor-2 (HER2)-positive AGC. He was initially treated with capecitabine, cisplatin, and trastuzumab, followed by paclitaxel and ramucirumab, nivolumab, trifluridine and tipiracil, and irinotecan regimens in addition to radiation therapy for brain metastasis. The patient exhibited refractoriness to the standard regimen used for AGC and developed relapse of the brain metastasis after radiation accompanied by headache, nausea, and dizziness. In August 2020, following the approval of T-DXd for HER2-positive AGC, he received T-DXd therapy. After 5 cycles of T-DXd, contrast-enhanced computed tomography and magnetic resonance imaging demonstrated significant tumor shrinkage and improvement of symptoms.
CONCLUSION
T-DXd demonstrated effectiveness for the treatment of brain metastasis arising from HER2-positive AGC.
背景
目前尚无临床证据支持曲妥珠单抗-德鲁替康（T-DXd）治疗合并脑转移的晚期胃癌（AGC）的疗效。
病例报告
这例患者为 65 岁男性，患有 HER2 阳性 AGC。他最初接受卡培他滨、顺铂和曲妥珠单抗治疗，随后接受紫杉醇和雷莫芦单抗、纳武利尤单抗、替匹嘧啶和盐酸托泊替康以及伊立替康治疗，并联合脑转移放疗。该患者对 AGC 的标准方案耐药，并且在脑转移放疗后复发，伴有头痛、恶心和头晕。2020 年 8 月，T-DXd 获 HER2 阳性 AGC 适应证批准后，他开始接受 T-DXd 治疗。接受 5 个周期的 T-DXd 治疗后，增强 CT 和 MRI 显示肿瘤显著缩小，症状改善。
结论
T-DXd 对 HER2 阳性 AGC 脑转移的治疗有效。
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