Tajima Koichiro, Shimodate Yuichi, Mouri Hirokazu, Nagahisa Yoshio, Nishina Shinichi, Mizuno Motowo
Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Japan.
Department of Surgery, Kurashiki Central Hospital, Japan.
Intern Med. 2025;64(5):717-723. doi: 10.2169/internalmedicine.3585-24. Epub 2025 Mar 1.
A 77-year-old man with large-cell gastric neuroendocrine carcinoma underwent palliative total gastrectomy after 10 cycles of carboplatin and etoposide chemotherapy for severe tumor bleeding. Despite a histological grade 0 therapeutic effect, the remnant lesions were treated with paclitaxel and ramucirumab, but progression occurred after two cycles. Nivolumab monotherapy was then initiated, resulting in complete remission after three cycles. Nivolumab was discontinued because of immune-related psoriasis, but complete remission persisted for at least 16 months. This is the first reported case of nivolumab monotherapy achieving complete remission in gastric neuroendocrine carcinoma with the patient surviving 28 months.
一名77岁的大细胞胃神经内分泌癌男性患者,因严重肿瘤出血在接受10个周期的卡铂和依托泊苷化疗后接受了姑息性全胃切除术。尽管组织学疗效为0级,但残余病灶接受了紫杉醇和雷莫西尤单抗治疗,但两个周期后病情进展。随后开始使用纳武单抗单药治疗,三个周期后实现完全缓解。由于免疫相关的银屑病,纳武单抗停药,但完全缓解持续了至少16个月。这是首例报道的纳武单抗单药治疗在胃神经内分泌癌中实现完全缓解且患者存活28个月的病例。