The Second Hospital and Clinical Medical School, Lanzhou University, Lanzhou, China.
Gansu Provincial Key Laboratory of Environmental Oncology, The Second Hospital and Clinical Medical School, Lanzhou, China.
Front Immunol. 2024 Jul 12;15:1410284. doi: 10.3389/fimmu.2024.1410284. eCollection 2024.
Gastric cancer is highly prevalent in China, yet early diagnosis and overall survival rates are low. The primary treatment strategy is comprehensive therapy centered on surgery. Studies indicate that neoadjuvant chemotherapy can enhance radical resection rates and extend survival in locally advanced gastric cancer. Combining VEGFR inhibitors with chemotherapy improves efficacy in digestive system tumors, while PD-1/PD-L1 inhibitors combined with anti-angiogenesis agents or chemotherapy show synergistic effects. This report presents a case of gastric adenocarcinoma (cT3N1M0) treated with SOX, apatinib mesylate, and camrelizumab as neoadjuvant therapy, followed by D2 distal gastrectomy and postoperative adjuvant therapy with the same regimen. The patient completed all treatment cycles successfully. Post-neoadjuvant therapy, only focal residual cancer cells were found in the lamina propria (pT1a). During postoperative adjuvant therapy follow-up, gastroscopic biopsy indicated a pathological complete response with no recurrence or metastasis. The patient primarily experienced dyspepsia, oropharyngeal pain, capillary proliferation, mild bone marrow suppression, nausea, and vomiting as side effects. Therefore, SOX combined with apatinib mesylate and camrelizumab shows promise for treating resectable locally advanced gastric cancer.
胃癌在中国高发，但早期诊断率和总生存率均较低。其主要治疗策略是以手术为中心的综合治疗。研究表明，新辅助化疗可以提高局部晚期胃癌的根治性切除率并延长生存时间。VEGFR 抑制剂联合化疗可提高消化系统肿瘤的疗效，而 PD-1/PD-L1 抑制剂联合抗血管生成药物或化疗则显示出协同作用。本报告介绍了一例胃腺癌（cT3N1M0）患者接受 SOX、甲磺酸阿帕替尼和卡瑞利珠单抗新辅助治疗，随后行 D2 远端胃切除术，并采用相同方案进行术后辅助治疗。患者成功完成了所有治疗周期。新辅助治疗后，仅在固有层发现局灶性残留癌细胞（pT1a）。在术后辅助治疗随访期间，胃镜活检显示完全病理缓解，无复发或转移。患者主要经历了消化不良、口咽疼痛、毛细血管增生、骨髓抑制轻度、恶心和呕吐等不良反应。因此，SOX 联合甲磺酸阿帕替尼和卡瑞利珠单抗有望治疗可切除的局部晚期胃癌。
