Li XQ, Yang J, Liu B, Han SM. Disitamab vedotin combined with apatinib in gastric cancer: A case report and review of literature. World J Clin Oncol 2024; 15(10): 1351-1358 [DOI: 10.5306/wjco.v15.i10.1351]
Corresponding Author of This Article
Shu-Mei Han, PhD, Associate Chief Physician, Department of Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 440 Jiyan Highway, Huaiyin District, Jinan 510000, Shandong Province, China. 15553115908@163.com
Research Domain of This Article
Oncology
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 Clin Oncol. Oct 24, 2024; 15(10): 1351-1358 Published online Oct 24, 2024. doi: 10.5306/wjco.v15.i10.1351
Disitamab vedotin combined with apatinib in gastric cancer: A case report and review of literature
Xiao-Qian Li, Jing Yang, Bo Liu, Shu-Mei Han
Xiao-Qian Li, Jing Yang, Bo Liu, Shu-Mei Han, Department of Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 510000, Shandong Province, China
Author contributions: Li XQ, Han SM written the draft of the manuscript; Liu B polished the manuscript and Yang J prepared figures; all authors commented on the previous versions of the manuscript; all authors read and approved the final manuscript.
Informed consent statement: The patient had sighed the Informed consent form.
Conflict-of-interest statement: No potential conflict of interest was reported by the author(s).
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: Shu-Mei Han, PhD, Associate Chief Physician, Department of Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 440 Jiyan Highway, Huaiyin District, Jinan 510000, Shandong Province, China. 15553115908@163.com
Received: April 15, 2024 Revised: August 18, 2024 Accepted: August 29, 2024 Published online: October 24, 2024 Processing time: 166 Days and 17.2 Hours
Abstract
BACKGROUND
In patients with human epidermal growth factor receptor 2 (HER2)-overexpressing gastric cancer (GC), the combination of HER2 targeting and a standard first-line chemotherapy regimen has been demonstrated to significantly improve their prognosis. However, in a proportion of patients, cancer progresses within a short period of time, and there is currently no standard treatment after disease progression.
CASE SUMMARY
This study presents a case of a 51-year-old male with advanced GC who underwent radical resection (Billroth type II subtotal gastrectomy and gastrojejunostomy) and resection of liver metastases. Immunohistochemical staining revealed a HER2 score of 2+, a dMMR status, and a Ki67 proliferation index of 30% to 40%. The gene test results indicated the presence of ERBB2 amplification and a PD-L1 expression level of less than 5%. Since December 2021, the patient has experienced disease progression during both first-line (two cycles of KN026 combined with KN046) and second-line (five cycles of nivolumab combined with trastuzumab and SOX chemotherapy) treatment regimens. The patient's prognosis following the first and second lines of treatment was unfavorable, with progression occurring in a relatively short time. For third-line therapy, disitamab vedotin (RC48) plus apatinib was used. At the time of this report, the patient had achieved a progression-free survival (PFS) of 25.8 months, which exceeded the median survival time for patients with advanced GC.
CONCLUSION
Despite the unfavorable prognosis associated with advanced GC, the implementation of personalized treatment approaches may still prove beneficial for select patients. In patients with HER2-positive GC with extensive metastatic involvement, the use of the HER2-targeted combination with apatinib has demonstrated the potential to prolong both PFS and overall survival.
Core Tip: Apatinib exhibits synergistic effect with pan-HER inhibitor and reverses acquired resistance in human epidermal growth factor receptor 2 (HER2)-positive gastric cancer (GC) via stem cell factor/c-kit signaling and its downstream pathways. The patient treated with HER2-targeted therapy (disitamab vedotin, RC48) and small molecule antiangiogenesis targeted therapy with apatinib experiencing excellent survival, which provide related data for posterior line treatment of advanced GC.
