内容紹介
A Case of HER2-Positive Gastric Cancer Successfully Treated with Trastuzumab plus Capecitabine plus Cisplatin Chemotherapy as Third-Line Treatment
Summary
A 67-year-old woman was diagnosed as having advanced gastric cancer(poorly differentiated adenocarcinoma)with multiple liver metastases. She had received combined S-1 plus cisplatin chemotherapy as first-line treatment and weekly paclitaxel chemotherapy as second-line treatment, however, both had eventually proved ineffective. Because the gastric cancer was HER2-positive, she was treated with trastuzumab plus capecitabine plus cisplatin(XP)chemotherapy as third-line treatment. The primary lesion and liver metastatic lesions were confirmed to show remarkable regression. The ToGA trial revealed increased efficacy of trastuzumab in first-line treatment of cancers showing high expression levels of the HER2-protein. This case suggested the increased efficacy of trastuzumab in third-line treatment. Neutropenia and hand foot syndrome of grade 2 were all reported adverse events. She could receive trastuzumab plus XP chemotherapy safely by dose reduction or dormancy temporarily of capecitabine.
要旨
症例は67歳,女性。胃体部癌(低分化腺癌),多発肝転移の診断で,S-1+シスプラチン療法,weeklyパクリタキセル療法を施行し不応となった。HER2強陽性のため,三次化学療法としてカペシタビン+シスプラチン(XP)+トラスツズマブ療法を導入したところ,原発巣・肝転移巣ともに著明な縮小を認めた。ToGA試験では一次療法におけるHER2陽性胃癌に対するトラスツズマブの上乗せ効果が証明されたが,本例から三次療法でも有効である可能性が示唆された。また,有害事象はGrade 2の好中球減少症と手足症候群のみで,カペシタビンを適宜減量・休薬することにより安全に投与可能であった。
目次
Summary
A 67-year-old woman was diagnosed as having advanced gastric cancer(poorly differentiated adenocarcinoma)with multiple liver metastases. She had received combined S-1 plus cisplatin chemotherapy as first-line treatment and weekly paclitaxel chemotherapy as second-line treatment, however, both had eventually proved ineffective. Because the gastric cancer was HER2-positive, she was treated with trastuzumab plus capecitabine plus cisplatin(XP)chemotherapy as third-line treatment. The primary lesion and liver metastatic lesions were confirmed to show remarkable regression. The ToGA trial revealed increased efficacy of trastuzumab in first-line treatment of cancers showing high expression levels of the HER2-protein. This case suggested the increased efficacy of trastuzumab in third-line treatment. Neutropenia and hand foot syndrome of grade 2 were all reported adverse events. She could receive trastuzumab plus XP chemotherapy safely by dose reduction or dormancy temporarily of capecitabine.
要旨
症例は67歳,女性。胃体部癌(低分化腺癌),多発肝転移の診断で,S-1+シスプラチン療法,weeklyパクリタキセル療法を施行し不応となった。HER2強陽性のため,三次化学療法としてカペシタビン+シスプラチン(XP)+トラスツズマブ療法を導入したところ,原発巣・肝転移巣ともに著明な縮小を認めた。ToGA試験では一次療法におけるHER2陽性胃癌に対するトラスツズマブの上乗せ効果が証明されたが,本例から三次療法でも有効である可能性が示唆された。また,有害事象はGrade 2の好中球減少症と手足症候群のみで,カペシタビンを適宜減量・休薬することにより安全に投与可能であった。