Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 24, 2025; 16(4): 102418
Published online Apr 24, 2025. doi: 10.5306/wjco.v16.i4.102418
Multiple primary tumors patient developed microsatellite stable gastric cancer after cadonilimab treatment for liver cancer: A case report
Si-Qi Luo, Li Dai, Yong-Jin Zhou, Tong He, Fang-Jie Wang, Xiang-Ren Jin, Qian Wang
Si-Qi Luo, Yong-Jin Zhou, Department of Clinical Medicine, Guizhou Medical University, Guiyang 550004, Guizhou Province, China
Li Dai, Tong He, Xiang-Ren Jin, Qian Wang, Department of Gastrointestinal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou Province, China
Fang-Jie Wang, Department of Emergency, The People’s Hospital of Xishui, Zunyi 564600, Guizhou Province, China
Co-first authors: Si-Qi Luo and Li Dai.
Co-corresponding authors: Xiang-Ren Jin and Qian Wang.
Author contributions: Luo SQ contributed to conceptualization, data curation, formal analysis, investigation, methodology, software, visualization, writing original draft, and reviewed and editing; Dai L contributed to methodology and supervision; Luo SQ and Li D contributed equally as co-first authors; Wang Q contributed to conceptualization, funding acquisition, resources; Wang Q and Jin XR contributed to supervision, validation, writing original draft, and reviewed and editing, they contributed equally as co-corresponding authors; He T, Zhou YJ, and Wang FJ contributed to data curation, investigation.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Qian Wang, MD, Professor, Department of Gastrointestinal Surgery, The Affiliated Hospital of Guizhou Medical University, No 28 Guiyijie Street, Guiyang 550004, Guizhou Province, China. wangqian118@outlook.com
Received: October 16, 2024
Revised: January 22, 2025
Accepted: February 27, 2025
Published online: April 24, 2025
Processing time: 160 Days and 20 Hours
Abstract
BACKGROUND

Multiple primary malignant tumors refer to the occurrence of two or more primary malignant tumors in the same organ or multiple organs or tissues at the same time or successively in the same patient, and can occur anywhere in the body. The treatment guidelines for patients with multiple primary malignant tumors are currently controversial.

CASE SUMMARY

A 51-year-old male patient with liver cancer and portal hypertension received 42 months of co-treatment with atezolizumab and bevacizumab. After that, the disease was rated stable disease. The patient was then diagnosed with gastric cancer. Since the patient was not sensitive to anti-programmed death ligand 1 immunosuppressive agents, a co-treatment with oxaliplatin, tegafur, apatinib, and cadonilimab was selected after multidisciplinary consultation and the patient’s agreement. After four cycles of treatment, partial response and stable disease were observed in gastric and liver cancers, respectively. Surgical treatment was performed considering the high-risk factors of gastrointestinal bleeding in patients with gastroesophageal varices. Postoperative pathology showed that the Tumor Regression Grade was 1. Moreover, the genetic testing of postoperative tumor specimens indicated negative programmed death ligand 1 and microsatellite stability. In addition, the latest follow-up indicated an 8 and 40-month progression-free survival in gastric and liver cancer patients, respectively. Currently, the patient is receiving postoperative immunotherapy with cadonilimab.

CONCLUSION

Cadonilimab not only treats microsatellite stability gastric cancer patients but can also be used for liver cancer treatment.

Keywords: Gastric cancer; Liver cancer; Multiple primary malignant tumors; Cadonilimab; Case report

Core Tip: The incidence of multiple primary malignant tumors is gradually increasing worldwide. There are still many controversies and challenges in the treatment of multiple primary malignant tumors due to the different pathological types, pathogenesis and treatment methods. We report a case of a patient diagnosed with both liver cancer and microsatellite instability gastric cancer following treatment with cadonilimab. The latest follow-up revealed progression-free survival of 8 months for gastric cancer and 40 months for liver cancer. This study provides a reference for further study of multiple primary gastrointestinal tumors.