Departments of Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, Shandong, China.
World J Surg Oncol. 2022 Sep 8;20(1):289. doi: 10.1186/s12957-022-02751-7.
Alpha‑fetoprotein-producing gastric cancer (AFPGC) is a rare type of gastric cancer with a high rate of metastasis and poor prognosis. Despite substantial progress in the treatment of many solid tumors, there are no reports of the safety and effectiveness of immune checkpoint inhibitors in combination with antiangiogenesis agents for AFPGC patients who have proficient mismatch repair.
We describe a 69-year-old man who was diagnosed with metastatic AFPGC. After progression to chemotherapy resistance, tislelizumab combined with apatinib was administered, although the patient's gastroscopic pathology showed proficient mismatch repair. After three cycles of therapy, partial remission (reduced by 56%) was obtained, and the quality of life improved significantly. Surprisingly, after more than 1 year of continuous application of the combination treatment regimen, both the primary and metastatic tumors in this patient eventually disappeared, which obtained complete remission without surgery. The patient has had a progression-free survival of more than 24 months and is still continuing to benefit.
This case is the first example of effective treatment of AFPGC with tislelizumab combined with apatinib. The outcomes of this case suggest a highly effective and tolerable therapeutic strategy for microsatellite-stabilized AFPGC.
甲胎蛋白阳性胃癌（AFPGC）是一种罕见的胃癌类型，转移率高，预后差。尽管许多实体瘤的治疗取得了重大进展，但免疫检查点抑制剂联合抗血管生成药物治疗错配修复功能完整的 AFPGC 患者的安全性和有效性尚无报道。
我们描述了一位 69 岁男性，被诊断为转移性 AFPGC。在对化疗耐药后，给予替雷利珠单抗联合阿帕替尼治疗，尽管患者的胃镜病理显示错配修复功能完整。治疗三个周期后，获得部分缓解（减少 56%），生活质量显著改善。令人惊讶的是，在联合治疗方案持续应用 1 年多后，该患者的原发和转移肿瘤最终消失，无需手术即获得完全缓解。患者无进展生存期超过 24 个月，且仍在持续获益。
本例是替雷利珠单抗联合阿帕替尼治疗 AFPGC 有效的首例病例。该病例结果提示对于微卫星稳定的 AFPGC 是一种高效且耐受良好的治疗策略。
