内容紹介
Summary
Immunocheckpoint inhibitors including anti-PD-1 antibody have shown certain therapeutic effects on various cancer types. They have also attracted great attention as novel cancer treatment options in addition to surgical resection, chemotherapy, and radiation therapy. Herein, we report a case of gastric cancer that was successfully treated with conversion surgery after nivolumab treatment. The patient was 68 years old and male. Upper gastrointestinal endoscopy revealed a type 3 tumor in the antrum, and he was referred to our department for further examination. The gastric cancer was diagnosed as cT4aN2M0, cStage ⅢA, and he was administered SOX as the first-line and nab-PTX/RAM as the second-line treatment, which was also a PD. As the third-line treatment, nivolumab showed remarkable reduction of the tumor after initiation, and after 14 courses, conversion surgery was performed. The patient remains alive without recurrence.
要旨
抗PD-1抗体治療をはじめとする免疫チェックポイント阻害薬は多様な癌種に対して一定の治療効果を示し,外科的切除,化学療法,放射線療法に加え新たな癌治療として大きな注目を集めている。今回われわれは,nivolumabによる切除不能進行胃癌三次治療後にconversion surgeryを施行し得た1例を経験したので報告する。症例は68歳,男性。上部消化管内視鏡で前庭部に3型腫瘍を認めた。胃癌,cT4aN2(bulky N,切除不能)M0,cStage ⅢAの診断にて標準的一次,二次化学療法を施行するも,いずれもPDであった。三次治療としてnivolumabを開始後,腫瘍の著明な縮小を認め,14コース施行後conversion surgeryを施行し,R0切除を達成し得た。現在無再発生存中である。
目次
Immunocheckpoint inhibitors including anti-PD-1 antibody have shown certain therapeutic effects on various cancer types. They have also attracted great attention as novel cancer treatment options in addition to surgical resection, chemotherapy, and radiation therapy. Herein, we report a case of gastric cancer that was successfully treated with conversion surgery after nivolumab treatment. The patient was 68 years old and male. Upper gastrointestinal endoscopy revealed a type 3 tumor in the antrum, and he was referred to our department for further examination. The gastric cancer was diagnosed as cT4aN2M0, cStage ⅢA, and he was administered SOX as the first-line and nab-PTX/RAM as the second-line treatment, which was also a PD. As the third-line treatment, nivolumab showed remarkable reduction of the tumor after initiation, and after 14 courses, conversion surgery was performed. The patient remains alive without recurrence.
要旨
抗PD-1抗体治療をはじめとする免疫チェックポイント阻害薬は多様な癌種に対して一定の治療効果を示し,外科的切除,化学療法,放射線療法に加え新たな癌治療として大きな注目を集めている。今回われわれは,nivolumabによる切除不能進行胃癌三次治療後にconversion surgeryを施行し得た1例を経験したので報告する。症例は68歳,男性。上部消化管内視鏡で前庭部に3型腫瘍を認めた。胃癌,cT4aN2(bulky N,切除不能)M0,cStage ⅢAの診断にて標準的一次,二次化学療法を施行するも,いずれもPDであった。三次治療としてnivolumabを開始後,腫瘍の著明な縮小を認め,14コース施行後conversion surgeryを施行し,R0切除を達成し得た。現在無再発生存中である。