Toji Yuta, Takeuchi Shintaro, Ebihara Yuma, Kurashima Yo, Harada Kazuaki, Hayashi Mariko, Abe Hirotake, Wada Hideyuki, Yorinaga Satoko, Shichinohe Toshiaki, Tomaru Utano, Komatsu Yoshito, Hirano Satoshi
Department of Gastroenterological Surgery II, Division of Surgery, Faculty of Medicine, Hokkaido University, West-7, North-15, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
Department of Gastroenterology and Hepatology, Faculty of Medicine, Hokkaido University, West-7, North-15, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan.
Surg Case Rep. 2024 Aug 28;10(1):200. doi: 10.1186/s40792-024-02001-w.
Nivolumab with chemotherapy has been transformative for metastatic gastric cancer (GC). The potential of this regimen for local tumor control could be utilized for perioperative chemotherapy in locally advanced GC with bulky tumors or lymph node metastasis involving other organs.
Five patients with HER2-negative advanced GC were treated with nivolumab and oxaliplatin-based chemotherapy. All patients presented with clinical stage III or IVA GC with tumors in contact with either the pancreas or liver. Following chemotherapy, all tumors demonstrated shrinkage, allowing successful radical gastrectomies including four minimally invasive approach without postoperative complications. Four patients avoided combined resection of other organs.
Perioperative chemotherapy with nivolumab was effective for local disease control in this case series. This regimen could be a promising treatment approach for locally advanced GC; however, its survival benefits should be evaluated in clinical trials.
纳武利尤单抗联合化疗已改变了转移性胃癌（GC）的治疗格局。该方案在局部肿瘤控制方面的潜力可用于局部晚期GC伴大体积肿瘤或累及其他器官的淋巴结转移的围手术期化疗。
5例HER2阴性晚期GC患者接受了纳武利尤单抗和基于奥沙利铂的化疗。所有患者均表现为临床III期或IVA期GC，肿瘤与胰腺或肝脏相邻。化疗后，所有肿瘤均缩小，从而成功进行了根治性胃切除术，其中4例采用微创方法且无术后并发症。4例患者避免了其他器官的联合切除。
在本病例系列中，纳武利尤单抗围手术期化疗对局部疾病控制有效。该方案可能是局部晚期GC的一种有前景的治疗方法；然而，其生存获益应在临床试验中进行评估。
