Published online Sep 26, 2023. doi: 10.12998/wjcc.v11.i27.6483
Peer-review started: March 30, 2023
First decision: July 3, 2023
Revised: July 8, 2023
Accepted: July 21, 2023
Article in press: July 21, 2023
Published online: September 26, 2023
Processing time: 174 Days and 8.5 Hours
The pathological complete response (ypCR) rate following neoadjuvant chemotherapy for advanced gastric cancer remains low and lacks a universally accepted treatment protocol. Immunotherapy has achieved breakthrough progress.
We report two female patients with gastric cancer defined as clinical stage cT4N1-2M0. Detection of mismatch repair protein showed mismatch repair function defect, and perioperative treatment with programmed death protein 1 inhibitor combined with S-1+oxaliplatin achieved ypCR. Surprisingly, the patients underwent clinical observation after surgery but developed different degrees of metastasis at ~6 mo after surgery.
PD-1 inhibitor combined with chemotherapy provides a more strategic choice for comprehensive perioperative treatment of gastric cancer.
Core tip: The enhanced antitumor effect of synergistic chemotherapy and immunotherapy has achieved commendable remission rates and survival benefit. We reported two patients who achieved pathological complete remission (ypCR) with perioperative treatment with programmed death protein 1 inhibitor combined with S-1+oxaliplatin. Surprisingly, the patients underwent clinical observation after surgery but developed different degrees of metastasis at ~6 mo after surgery. Achieving ypCR reflects an excellent short-term treatment response but does not necessarily predict long-term survival.