Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
권호 표지

A Case of Partial Response with Trastuzumab Based Treatment in Advanced Gastric Cancer with Multiple Metastasis

다발성 전이가 동반된 위암 환자에서 Trastuzumab 치료로 부분 관해를 보인 1례

  • Seo Hee Lee (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Hyun Yong Jeong (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Hee Seok Moon (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Jae Kyu Sung (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Sun Hyun Kang (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Ju Seok Kim (Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine)
  • 이서희 (충남대학교 의과대학 내과학교실, 소화기내과) ;
  • 정현용 (충남대학교 의과대학 내과학교실, 소화기내과) ;
  • 문희석 (충남대학교 의과대학 내과학교실, 소화기내과) ;
  • 성재규 (충남대학교 의과대학 내과학교실, 소화기내과) ;
  • 강선형 (충남대학교 의과대학 내과학교실, 소화기내과) ;
  • 김주석 (충남대학교 의과대학 내과학교실, 소화기내과)
  • Received : 2017.12.04
  • Accepted : 2017.12.11
  • Published : 2017.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

A 38-year-old man presented with abdominal discomfort and was diagnosed as type 3 advanced gastric cancer with multiple liver and lung metastases (Stage IV). Endoscopic forcep biopsy revealed moderately differentiated adenocarcinoma, which stained positive HER2 (Human epidermal growth factor receptor) on immunohistochemistry. We started chemotherapy with FP (5-Fluorouracil plus Cisplatin) plus trastuzumab. After 6 cycles of FP plus trastuzumab chemotherapy, there were partial response in the liver, lung and lymph nodes metastasis. Especially, metastatic lung lesions showed remarkable improvement. Chemotherapy with FP plus trastuzamab was effective for HER2 positive advanced cancer with multiple liver and lung metastases. Through active research on target therapy about advanced gastric cancer, we expect to improve the survival rate and quality of life of patients with advanced gastric cancer who can not undergo curative resection.

ToGA 연구 결과를 바탕으로 하여, HER2 강양성을 보이는 진행성 위암의 경우에는 Trastuzumab을 기존의 항암제에 병합하여 치료하였을 때 더 좋은 반응과 생존율 향상을 기대할 수 있겠다. 이에 저자들은 HER2 강양성을 보이는 간과 폐와 림프절 전이 등 다발성 전이가 있는 진행성 위암 환자에서 Trastuzumab과 5-Fluorouracil (5-FU)과 Cisplatin 병합 항암요법을 함께 사용하여 큰 부작용 없이 간과 폐, 림프절에 다발성 전이 병변들의 크기가 감소하여 부분 관해를 보인 환자의 증례를 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Wagner AD, Unverzagt S, Grothe W, et al. Chemotherapy for advanced gastric cancer. Cochrane Database Syst Rev 2010;3:CD004064.
  2. Gravalos C, Jimeno A. HER2 in gastric cancer: a new prognostic factor and a novel therapeutic target. Ann Oncol 2008;19:1523-1529
  3. Sliwkowski MX, Lofgren JA, Lewis GD, et al. Non clinical studies addressing the mechanism of action of trastuzumab (Herceptin). Semin Oncol 1999;26:60-70.
  4. Cuello M, Ettenberg SA, Clark AS, et al. Down-regulation of the erbB-2 receptor by trastuzumab (herceptin) enhances tumor necrosis factor-related apoptosis inducing ligand-mediated apoptosis in breast and ovarian cancer cell lines that overexpress erbB-2. Cancer Res 2001;61:4892-4900.
  5. Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastrooesophageal junction cancer (ToGA): a phase 3, open-label, randomized controlled trial. The Lancet 2010;376:687-697.
  6. Kim JW, Kim HP, Im SA, et al. The growth inhibitory effect of lapatinib, a dual inhibitor of EGFR and HER2 tyrosine kinase, in gastric cancer cell lines. Cancer Lett 2008;272:296-306.
  7. Hecht JE, Bang YJ, Qin S, et al. Lapatinib in combination with capecitabine plus aoxaliplatin (CapeOx) in HER2-Ppositive advanced or metastatic gastric, esophageal or gastroesophageal adenocarcinoma (AC): the TRIO-013/LOGiC Trial. J Clin Oncol 2013;31(Suppl): LBA4001.
  8. Satoh T, Xu RH, Chung HC, et al. Lapatinib plus paclitaxel versus paclitaxel alone in the second-line treatment of HER2-amplified advanced gastric cancer in Asian populations: TyTAN - a randomized, phase III study. J Clin Oncol 2014;32:2039-2049.
  9. Franklin MC, Carey KD, Vajdos FF, Leahy DJ, de Vos AM, Sliwkowski MX. Insights into ErbB signaling from the structure of the ErbB2-pertuzumab complex. Cancer Cell. 2004;5:317-328.
  10. Yamashita-Kashima Y, Iijima S, Yorozu K, et al. Pertuzumab in combination with trastuzumab shows significantly enhanced antitumor activity in HER2-positive human gastric cancer xenograft models. Clin Cancer Res 2011;17:5060-5070.
  11. Oh DY, Bang YJ. Pertuzumab in Gastointestinal Cancer. Expert Opin Biol Ther. 2015.
  12. Fuchs CS, Tomasek J, Yong CJ, et al. REGARD Trial Investigators. Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet 2014;383:31-39.
  13. Park JH, Lee SI. A case of long term survival of gastric cancer on trastuzumab based treatment. Journal of Digestive Cancer Reports 2015;31:39-41.