Frontiers in Oncology (Feb 2023)
Unexpected curative effect of PD-1 inhibitor in gastric cancer with brain metastasis: A case report
- Qijun Wang,
- Qijun Wang,
- Qijun Wang,
- Qijun Wang,
- Qijun Wang,
- Zhewei Shen,
- Zhewei Shen,
- Zhewei Shen,
- Zhewei Shen,
- Zhewei Shen,
- Mengxi Ge,
- Jie Xu,
- Xin Zhang,
- Xin Zhang,
- Xin Zhang,
- Xin Zhang,
- Xin Zhang,
- Wei Zhu,
- Wei Zhu,
- Wei Zhu,
- Wei Zhu,
- Wei Zhu,
- Jie Liu,
- Wei Hua,
- Wei Hua,
- Wei Hua,
- Wei Hua,
- Wei Hua,
- Ying Mao,
- Ying Mao,
- Ying Mao,
- Ying Mao,
- Ying Mao
Affiliations
- Qijun Wang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Qijun Wang
- National Center for Neurological Disorders, Shanghai, China
- Qijun Wang
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Qijun Wang
- Neurosurgical Institute of Fudan University, Shanghai, China
- Qijun Wang
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Zhewei Shen
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Zhewei Shen
- National Center for Neurological Disorders, Shanghai, China
- Zhewei Shen
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Zhewei Shen
- Neurosurgical Institute of Fudan University, Shanghai, China
- Zhewei Shen
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Mengxi Ge
- Department of Oncology, Huashan Hospital, Fudan University, Shanghai, China
- Jie Xu
- Institute of Biomedical Sciences, Fudan University, Shanghai, China
- Xin Zhang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Xin Zhang
- National Center for Neurological Disorders, Shanghai, China
- Xin Zhang
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Xin Zhang
- Neurosurgical Institute of Fudan University, Shanghai, China
- Xin Zhang
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Wei Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Wei Zhu
- National Center for Neurological Disorders, Shanghai, China
- Wei Zhu
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Wei Zhu
- Neurosurgical Institute of Fudan University, Shanghai, China
- Wei Zhu
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Jie Liu
- Department of Digestive Diseases, Huashan Hospital, Fudan University, Shanghai, China
- Wei Hua
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Wei Hua
- National Center for Neurological Disorders, Shanghai, China
- Wei Hua
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Wei Hua
- Neurosurgical Institute of Fudan University, Shanghai, China
- Wei Hua
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Ying Mao
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Ying Mao
- National Center for Neurological Disorders, Shanghai, China
- Ying Mao
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Ying Mao
- Neurosurgical Institute of Fudan University, Shanghai, China
- Ying Mao
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- DOI
- https://doi.org/10.3389/fonc.2023.1042417
- Journal volume & issue
-
Vol. 13
Abstract
BackgroundGastric cancer (GC) is the third most common cause of cancer-related death in the world. Several clinical trials have proven that the use of PD-1/PD-L1 inhibitors can improve the survival of late-stage GC patients and is suggested in NCCN and CSCO guidelines. However, the correlation between PD-L1 expression and the response to PD-1/PD-L1 inhibitors is still controversial. GC rarely develops brain metastasis (BrM) and currently there is no therapeutic protocol for GC BrMs.Case presentationWe report a case of a 46-year-old male suffering from GC with PD-L1 negative BrMs 12 years after GC resection and 5 cycles of chemotherapy. We treated the patient with the immune checkpoint inhibitor (ICI) pembrolizumab and all metastatic tumors achieved a complete response (CR). A durable remission of the tumors is confirmed after 4 years of follow-up.ConclusionWe shared a rare case with PD-L1 negative GC BrM responsive to PD-1/PD-L1 inhibitors, the mechanism of which is still unclear. The protocol of therapeutic choice for late-stage GC with BrM is urgently needed. And we are expecting biomarkers other than PD-L1 expressions to predict the efficacy of ICI treatment.
Keywords
