Molecular-targeted therapy for chemotherapy-refractory gastric cancer: A case report and literature review
Journal
Anticancer Research
Journal Volume
34
Journal Issue
7
Pages
3695-3699
Date Issued
2014
Author(s)
Abstract
The prognosis of advanced gastric cancer (AGC) remains poor despite therapeutic advances in recent decades. Several recent positive phase III trials established the efficacy of second-line chemotherapy for metastatic gastric cancer in prolonging overall survival. However, malnutrition and poor performance of AGC in late stages usually preclude such patients from intensive treatment. Many targeted-therapies failed to show a significant survival benefit in AGC, but have regained attention after the positive result of ramucirumab was announced last year. Among all targeted agents, only trastuzumab, a monoclonal antibody against Human epidermal growth factor receptor-2 (HER2) protein, has been proven as having survival benefit by addition to first-line chemotherapy. Herein we reported a patient who benefited from adding trastuzumab to the same second-line combination chemotherapy (paclitaxel, 5-fluorouracil, and leucovorin) upon progression of bulky liver metastases. At least five months of progression-free survival were achieved without any additional toxicity. We also reviewed literature of molecularly-targeted therapy for chemotherapy-refractory gastric cancer, including several large phase III trials (REGARD, GRANITE-1, EXPAND, and REAL-3) published in 2013-2014.
SDGs
Other Subjects
cisplatin; epidermal growth factor receptor 2; everolimus; fluorouracil; folinic acid; paclitaxel; ramucirumab; trastuzumab; antineoplastic agent; monoclonal antibody; trastuzumab; abdominal distension; adult; Article; cancer chemotherapy; cancer staging; cancer survival; case report; combination chemotherapy; computer assisted tomography; deterioration; disease course; disease duration; distant metastasis; drug megadose; epigastric pain; gastrointestinal endoscopy; gastrointestinal hemorrhage; human; liver metastasis; low drug dose; lymphadenopathy; male; molecularly targeted therapy; multiple cycle treatment; multiple organ failure; phase 3 clinical trial (topic); progression free survival; Roux Y anastomosis; salvage therapy; stomach cancer; total stomach resection; treatment response; tumor volume; adenocarcinoma; article; chemotherapy; disease free survival; drug resistance; middle aged; molecularly targeted therapy; pathology; ramucirimab; randomized controlled trial (topic); refractory; stomach cancer; stomach tumor; targeted therapy; chemotherapy; Gastric cancer; ramucirimab; refractory; targeted therapy; trastuzumab; Adenocarcinoma; Antibodies, Monoclonal, Humanized; Antineoplastic Combined Chemotherapy Protocols; Clinical Trials, Phase III as Topic; Disease-Free Survival; Drug Resistance, Neoplasm; Humans; Male; Middle Aged; Molecular Targeted Therapy; Neoplasm Staging; Randomized Controlled Trials as Topic; Stomach Neoplasms
Publisher
International Institute of Anticancer Research
Type
journal article