Mou YH, Zhang J, Shen H, Yu J, Han L, Li H, Li QF. Multiple pseudoprogressions during ongoing immunotherapy-based treatment of advanced gastric neuroendocrine carcinoma: A case report and review of literature. World J Gastrointest Oncol 2025; 17(3): 102804 [DOI: 10.4251/wjgo.v17.i3.102804]
Corresponding Author of This Article
Qing-Feng Li, MD, Professor, Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136 Jingzhou Road, Xiangyang 441021, Hubei Province, China. liqfeng@hbuas.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2025; 17(3): 102804 Published online Mar 15, 2025. doi: 10.4251/wjgo.v17.i3.102804
Multiple pseudoprogressions during ongoing immunotherapy-based treatment of advanced gastric neuroendocrine carcinoma: A case report and review of literature
Yan-Hua Mou, Juan Zhang, Hui Shen, Jing Yu, Lan Han, Hui Li, Qing-Feng Li
Yan-Hua Mou, Juan Zhang, Hui Shen, Jing Yu, Lan Han, Hui Li, Qing-Feng Li, Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441021, Hubei Province, China
Yan-Hua Mou, Juan Zhang, Hui Shen, Jing Yu, Lan Han, Hui Li, Qing-Feng Li, Institute of Oncology, Hubei University of Arts and Science, Xiangyang 441021, Hubei Province, China
Author contributions: Li H, Yu J, and Han L consulted the literature; Mou YH wrote the first draft of the manuscript; Zhang J wrote some sections of the manuscript; Mou YH, Shen H, and Li QF contributed to the conception and design of the study. All authors contributed to the article and approved the submitted version.
Supported by Wu Jieping Medical Foundation, No. 320.6750.2021-02-113.
Informed consent statement: Written informed consent was obtained from the patient for the publication of their anonymized case details and images.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing-Feng Li, MD, Professor, Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136 Jingzhou Road, Xiangyang 441021, Hubei Province, China. liqfeng@hbuas.edu.cn
Received: October 31, 2024 Revised: December 24, 2024 Accepted: January 15, 2025 Published online: March 15, 2025 Processing time: 107 Days and 5.9 Hours
Abstract
BACKGROUND
Gastric neuroendocrine carcinomas (NECs) exhibit aggressive features, such as rapid growth, higher rate of metastasis, and a generally unfavorable prognosis compared to gastric adenocarcinoma. As a result, therapeutic options for NECs remain limited, contributing to the poor prognosis of patients. Immunotherapy has emerged as a promising treatment strategy and demonstrated the potential to partially improve the survival and prognosis of patients with NECs. Nevertheless, the unique clinical response termed pseudoprogression (PsP) has garnered considerable attention in the context of immunotherapy.
CASE SUMMARY
Presented here is a case of NEC recurrence five and a half months after radical gastric surgery. The 45-year-old male patient underwent combination treatment involving a PD-1 blocker and tyrosine kinase inhibitors and encountered two instances of PsP during treatment. The patient ultimately achieved a durable treatment response without altering his treatment regimens, resulting in a substantial therapeutic benefit.
CONCLUSION
This case report aimed to provide the authors’ experience with the diagnosis of PsP and treatment strategies for PsP in ongoing immunotherapy.
Core Tip: Neuroendocrine carcinomas (NECs) are generally considered highly malignant, characterized by rapid growth, a high metastasis rate, and poor prognosis, and their malignancy is much higher than that of gastric adenocarcinoma. Immune checkpoint inhibitors are a new type of immunotherapy drugs used in cancer treatment. However, the differences in clinical response and drug resistance pose significant challenges in immunotherapy. This article aims to report an extremely rare case of NEC, in which two significant pseudoprogression (PsP) occurred during treatment with PD-1 inhibitors combined with tyrosine kinase inhibitors. More rarely, this case had two PsP in the same organ under the same treatment plan. Besides, we mainly introduced the existing research on the possible mechanisms, timepoint, clinical manifestations, biomarkers, and medical imaging techniques associated with PsP.
