Tracheoesophageal fistula and esophageal perforation in a patient with advanced gastroesophageal junction tumor post ramucirumab treatment. A case report and literature review

Abstract

Background: Ramucirumab is an anti-angiogenic drug that received Food and Drug Administration (FDA)-approvals for treatments of many cancers. Gastrointestinal fistulas and perforations are recognized side effects of anti-angiogenic therapies, however, there are very few reported cases of these conditions in patients managed with Ramucirumab. Here we report a case of a 46-year-old gentleman with a stage four gastroesophageal junction tumor, who developed multiple tracheoesophageal fistulas post ramucirumab containing regimen. To the best of our knowledge, this is the first case report that describes a serious uncommon complication of ramucirumab in a patient with a gastroesophageal junction tumor.

Keywords

• Tracheoesophageal fistula
• Gastroesophageal junction tumor
• Ramucirumab
• Anti-angiogenic
• FOLFOX
• GEJ