内容紹介
Summary
According to the REGARD and RAINBOW trials, ramucirumab(RAM)was introduced as second-line therapy for advanced or metastatic gastric cancer. Endoscopic metallic stent placement and angiogenesis inhibitor administration carry the risk of gastrointestinal perforation. The outcomes of patients who undergo endoscopic placement of metallic stents during RAM treatment have not yet been fully assessed. A 60's man was diagnosed with advanced esophagogastric junction cancer(por)with Virchow's lymph node metastases. His tumor was classified as cT4a(SE), N1(#1), M1, stage Ⅳ. He received chemotherapy, but the size of the primary tumor and metastases increased. After stenting for gastric outlet obstruction, he received a paclitaxel(PTX)plus RAM regimen as third-line treatment. Because of CTCAE Grade 2 peripheral neuropathy, PTX was discontinued after 10 courses. For 11 months, tumor control without adverse events was maintained. The patient was then switched to CPT-11 as fourth-line treatment.
要旨
進行再発胃癌に対する二次治療として,ramucirumab(RAM)の有効性が証明された。RAMは血管新生を阻害することから創傷治癒遅延が懸念され,ステント留置を行った症例でのRAM投与の安全性については一定の見解が得られていない。症例は60歳台,男性。食道胃接合部癌(por),T4a(SE),N1(#1),M1,stage Ⅳに対し化学療法後にPDとなり,食道ステントを留置した。三次治療としてRAM/paclitaxel(PTX)を開始した。末【梢】神経障害(Grade 2)にて10コース目よりRAM単剤で計11か月の間,QOLを低下させることなく治療を継続でき,また四次治療としてCPT-11への移行も可能であった。
目次
According to the REGARD and RAINBOW trials, ramucirumab(RAM)was introduced as second-line therapy for advanced or metastatic gastric cancer. Endoscopic metallic stent placement and angiogenesis inhibitor administration carry the risk of gastrointestinal perforation. The outcomes of patients who undergo endoscopic placement of metallic stents during RAM treatment have not yet been fully assessed. A 60's man was diagnosed with advanced esophagogastric junction cancer(por)with Virchow's lymph node metastases. His tumor was classified as cT4a(SE), N1(#1), M1, stage Ⅳ. He received chemotherapy, but the size of the primary tumor and metastases increased. After stenting for gastric outlet obstruction, he received a paclitaxel(PTX)plus RAM regimen as third-line treatment. Because of CTCAE Grade 2 peripheral neuropathy, PTX was discontinued after 10 courses. For 11 months, tumor control without adverse events was maintained. The patient was then switched to CPT-11 as fourth-line treatment.
要旨
進行再発胃癌に対する二次治療として,ramucirumab(RAM)の有効性が証明された。RAMは血管新生を阻害することから創傷治癒遅延が懸念され,ステント留置を行った症例でのRAM投与の安全性については一定の見解が得られていない。症例は60歳台,男性。食道胃接合部癌(por),T4a(SE),N1(#1),M1,stage Ⅳに対し化学療法後にPDとなり,食道ステントを留置した。三次治療としてRAM/paclitaxel(PTX)を開始した。末【梢】神経障害(Grade 2)にて10コース目よりRAM単剤で計11か月の間,QOLを低下させることなく治療を継続でき,また四次治療としてCPT-11への移行も可能であった。