Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2022; 10(16): 5420-5427
Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5420
Treatment of gastric hepatoid adenocarcinoma with pembrolizumab and bevacizumab combination chemotherapy: A case report
Mei Liu, Cheng Luo, Zong-Zhou Xie, Xun Li
Mei Liu, Zong-Zhou Xie, Xun Li, Department of Medical Oncology, Haikou People's Hospital, Haikou 570100, Hainan Province, China
Cheng Luo, Department of Gynecology, Hainan Hospital of Chinese People’s Liberation Army General Hospital, Sanya 572013, Hainan Province, China
Author contributions: Liu M contributed to the design, analysis, and drafted the manuscript; Li X contributed to the analysis, and critically revised the manuscript; Luo C contributed to the analysis; Xie ZZ collected medical history information, and edited charts; and all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: Xun Li, MD, Chief Physician, Department of Medical Oncology, Haikou People's Hospital, No. 43 Renmin Avenue, Haikou 570100, Hainan, China. 1984661032@qq.com
Received: September 19, 2021
Peer-review started: September 19, 2021
First decision: December 10, 2021
Revised: December 19, 2021
Accepted: April 22, 2022
Article in press: April 22, 2022
Published online: June 6, 2022
Processing time: 255 Days and 21.5 Hours
Abstract
BACKGROUND

Gastric hepatoid adenocarcinoma (GHA) is a rare and aggressive cancer that is characterized by foci with features of both hepatocellular differentiation and adenomatous differentiation. However, there is currently no standard treatment for this disease, which has a poor prognosis.

CASE SUMMARY

A 72-year-old male with a body mass index of 20.9 was diagnosed with GHA with perigastric lymph node and liver metastasis. He underwent first-line chemotherapy but that failed. Pembrolizumab and bevacizumab with chemotherapy were used in the second-line treatment. The progression-free survival and overall survival were 14 mo and 16 mo, respectively, after treatment. In addition, the main adverse reaction was tolerable. The patient did not die of tumor progression.

CONCLUSION

The combination of pembrolizumab and bevacizumab with chemotherapy is an effective and safe regimen for GHA and may be recommended as a new choice for GHA treatment. Further studies should evaluate this treatment in a larger cohort or a randomized controlled trial.

Keywords: Gastric hepatoid adenocarcinoma, Serum, Immunotherapy, Targeted therapy, Chemotherapy, Case report

Core Tip: We report a rare case of gastric hepatoid adenocarcinoma in a patient who underwent general chemotherapy that failed. However, pembrolizumab and bevacizumab combination chemotherapy was successful. The overall survival was 16 mo, and the main adverse reaction was tolerable. The patient died of intestinal infection rather than tumor progression.