Case Reports in Oncology (Jul 2019)

A Case of Advanced Gastric Cancer with Peritoneal Metastasis Treated Successfully with Nivolumab

  • Hirofumi Tazawa,
  • Takahisa Suzuki,
  • Toshiaki Komo,
  • Haruna Kubota,
  • Shunya Tahara,
  • Haruki Sada,
  • Naoto Hadano,
  • Wataru Shimizu,
  • Kohei Ishiyama,
  • Takashi Onoe,
  • Takeshi Sudo,
  • Yosuke Shimizu,
  • Hirotaka Tashiro

DOI
https://doi.org/10.1159/000501717
Journal volume & issue
Vol. 12, no. 2
pp. 523 – 528

Abstract

Read online

Peritoneal metastasis (PM) is detected in 14% of gastric cancers at the time of initial diagnosis, with a median survival time of 4 months. A 66-year-old woman diagnosed with cT4a(SE) N2M1(LYN) cStage IV was treated with three lines of chemotherapy for a year. During the third line of chemotherapy, computed tomography (CT) scan revealed a large amount of ascites, periportal collar sign, and bilateral ureteral stenosis owing to PM. The tumor biomarkers (CEA and CA 19–9) remained elevated similar to the initial levels. The patient was administered 3 mg/kg nivolumab intravenously biweekly as the fourth line of chemotherapy. Three months after the nivolumab treatment, gastroscopy revealed an extreme reduction of the tumor size, while CT scan revealed the absence of ascites and a well-controlled tumor. There was no immune-related adverse event with nivolumab during and after the treatment, and performance status improved to 0. The patient has been alive for about 2.5 years since her first visit with her sixth line of chemotherapy (docetaxel). We report a case of advanced gastric cancer with PM that was treated successfully with nivolumab.

Keywords