Nishida Kentaro, Yagi Hisashi, Mizumoto Rie, Haeno Masahiro, Mori Souichiro, Nomura Masatoshi, Yasuyama Akinobu, Yoshikawa Yukihiro, Sueda Toshinori, Matsumura Tae, Koga Chikato, Miyagaki Hiromichi, Tei Mitsuyoshi, Tsujie Masanori, Akamaru Yusuke
Dept. of Surgery, Osaka Rosai Hospital.
Gan To Kagaku Ryoho. 2023 Mar;50(3):343-345.
A 61-year-old male was diagnosed with unresectable advanced gastric cancer(cT4b[SI; panc], N+, M0, cStage ⅣA). However he was administered S-1 plus oxaliplatin as a primary treatment and ramucirumab plus paclitaxel as a secondary treatment, the primary tumor and lymph nodes were enlarged. We judged PD and switched to the third-line treatment with nivolumab. After starting nivolumab, both the primary tumor and the lymph nodes shrank, and the PET-CT scan after 24 courses showed no FDG accumulation in the primary tumor or lymph nodes, so we judged the response as CR. The patient requested discontinuation of nivolumab, and nivolumab administration was stopped. Twenty months later after nivolumab administration was discontinued, CT scan showed re-growth of the primary tumor, and nivolumab administration was resumed. After resumption, he received 22 courses of nivolumab for 10 months with maintenance of SD.
一名61岁男性被诊断为不可切除的晚期胃癌（cT4b[SI；全层]，N+，M0，c期ⅣA）。然而，他接受了S-1联合奥沙利铂作为一线治疗，以及雷莫西尤单抗联合紫杉醇作为二线治疗，原发肿瘤和淋巴结仍有增大。我们判定为疾病进展（PD），并改用纳武利尤单抗进行三线治疗。开始使用纳武利尤单抗后，原发肿瘤和淋巴结均缩小，24个疗程后的PET-CT扫描显示原发肿瘤或淋巴结无FDG聚集，因此我们判定反应为完全缓解（CR）。患者要求停用纳武利尤单抗，遂停止给药。在停用纳武利尤单抗20个月后，CT扫描显示原发肿瘤复发，于是恢复使用纳武利尤单抗。恢复用药后，他接受了22个疗程的纳武利尤单抗治疗，持续10个月，病情维持稳定（SD）。
