四次治療nivolumabにてpseudo progression様増大後に奏効したHER2陽性食道胃接合部癌再発の1例
HER2陽性食道胃接合部癌再発に対して四次治療でnivolumabが奏効した1例を経験したので報告する．症例は71歳の男性で，15年前に胃癌に対して幽門側胃切除術を施行した．術12年後に食道胃接合部に3型癌を認め，残胃全摘・下部食道切除を施行した．術後2か月で傍大動脈リンパ節再発を認めたため，capecitabine+oxaliplatin+trastuzumabを開始し，その後paclitaxel+ramcirumab，trifluridine/tipiracilを施行した．経過中に膵尾部リンパ節転移の増大と新規多発肝転移を認めたため，今回一次治療開始後1年9か月の時点で四次治療としてniv...
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| Published in | 日本消化器外科学会雑誌 Vol. 54; no. 12; pp. 853 - 860 |
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| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本消化器外科学会
01.12.2021
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| Online Access | Get full text |
| ISSN | 0386-9768 1348-9372 |
| DOI | 10.5833/jjgs.2020.0113 |
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| Abstract | HER2陽性食道胃接合部癌再発に対して四次治療でnivolumabが奏効した1例を経験したので報告する．症例は71歳の男性で，15年前に胃癌に対して幽門側胃切除術を施行した．術12年後に食道胃接合部に3型癌を認め，残胃全摘・下部食道切除を施行した．術後2か月で傍大動脈リンパ節再発を認めたため，capecitabine+oxaliplatin+trastuzumabを開始し，その後paclitaxel+ramcirumab，trifluridine/tipiracilを施行した．経過中に膵尾部リンパ節転移の増大と新規多発肝転移を認めたため，今回一次治療開始後1年9か月の時点で四次治療としてnivolumabを導入した．1コース目途中で一時的増大を来したが，3コース後に転移巣の著明な縮小を認め，部分奏効（partial response；以下，PRと略記）となった．PS・腫瘍マーカーともに改善し，現在PRを維持している． |
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| AbstractList | HER2陽性食道胃接合部癌再発に対して四次治療でnivolumabが奏効した1例を経験したので報告する．症例は71歳の男性で，15年前に胃癌に対して幽門側胃切除術を施行した．術12年後に食道胃接合部に3型癌を認め，残胃全摘・下部食道切除を施行した．術後2か月で傍大動脈リンパ節再発を認めたため，capecitabine+oxaliplatin+trastuzumabを開始し，その後paclitaxel+ramcirumab，trifluridine/tipiracilを施行した．経過中に膵尾部リンパ節転移の増大と新規多発肝転移を認めたため，今回一次治療開始後1年9か月の時点で四次治療としてnivolumabを導入した．1コース目途中で一時的増大を来したが，3コース後に転移巣の著明な縮小を認め，部分奏効（partial response；以下，PRと略記）となった．PS・腫瘍マーカーともに改善し，現在PRを維持している． |
| Author | 森, 清 加藤, 健志 宮﨑, 葉月 西川, 和宏 三宅, 正和 宮本, 敦史 平尾, 素宏 俊山, 礼志 三代, 雅明 浜川, 卓也 高橋, 佑典 |
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| References_xml | – reference: 1) 日本胃癌学会編．胃癌治療ガイドライン医師用 第5版．東京：金原出版；2018. p. 25–31. – reference: 10) Ota Y, Takahari D. Changes in the neutrophil-to-lymphocyte ratio during nivolumab monotherapy are associated with gastric cancer survival. Cancer Chemother Pharmacol. 2020;85(2):265–272. – reference: 11) Tanaka H, Muguruma K, Toyokawa T, Kubo N, Ohira M, Hirakawa K. Differential impact of the neutrophil-lymphocyte ratio on the survival of patients with stage IV gastric cancer. Dig Surg. 2014;31(4–5):327–333. – reference: 5) Ogata T, Satake H, Ogata M, Hatachi Y, Yasui H. Hyperprogressive disease in the irradiation field after a single dose of nivolumab for gastric cancer: a case report. Case Rep Oncol. 2018;11(1):143–150. – reference: 6) Champiat S, Dercle L, Ammari S, Massard C, Hollebecque A, Postel-Vinay S, et al. Hyperprogressive disease is a new pattern of progression in cancer patients treated by anti-PD-1/PD-L1. Clin Cancer Res. 2017;23(8):1920–1928. – reference: 13) Yamada T, Hayashi T, Inokuchi Y, Hayashi K, Watanabe H, Komori K, et al. Impact of the neutrophil-to-lymphocyte ratio on the survival of patients with gastric cancer treated with nivolumab monotherapy. Target Oncol. 2020;15:317–325. – reference: 17) Satoh T, Kang YK, Chao Y, Ryu MH, Kato K, Cheol Chung H, et al. Exploratory subgroup analysis of patients with prior trastuzumab use in the ATTRACTION-2 trial: a randomized phase III clinical trial investigating the efficacy and safety of nivolumab in patients with advanced gastric/gastroesophageal junction cancer. Gastric Cancer. 2020;23(1):143–153. – reference: 15) Oki E, Okano S, Saeki H, Umemoto Y, Teraishi K, Nakaji Y, et al. Protein expression of programmed death 1 ligand 1 and HER2 in gastric carcinoma. Oncology. 2017;93(6):387–394. – reference: 9) Kang YK, Boku N, Satoh T, Ryu MH, Chao Y, Kato K, et al. Nivolumab in patients with advanced gastric or gastro-oesophageal junction cancer refractory to, or intolerant of, at least two previous chemotherapy regimens (ONO-4538-12, ATTRACTION-2): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2017;390(10111):2461–2471. – reference: 8) Seymour L, Bogaerts J, Perrone A, Ford R, Schwartz LH, Mandrekar S, et al. iRECIST: guidelines for response criteria for use in trials testing immunotherapeutics. Lancet Oncol. 2017;18(3):e143–e152. – reference: 7) Wolchok JD, Hoos A, O’Day S, Weber JS, Hamid O, Lebbé C, et al. Guidelines for the evaluation of immune therapy activity in solid tumors: immune-related response criteria. Clin Cancer Res. 2009;15(23):7412–7420. – reference: 2) 山口 研成，高張 大亮，陳 勁松．胃癌化学療法のup to date．日本内科学会雑誌．2017;106(9):1901–1909. – reference: 3) Chen L-T, Kang Y-K, Satoh T, Chao Y, Kato K, Chung HC, et al. A phase III study of nivolumab (Nivo) in previously treated advanced gastric or gastric esophageal junction (G/GEJ) cancer (ATTRACTION-2): three-year update data. J Clin Oncol. 2020;38(4_suppl):383. – reference: 16) Varadan V, Gilmore H, Miskimen KL, Tuck D, Parsai S, Awadallah A, et al. Immune signatures following single dose trastuzumab predict pathologic response to preoperative trastuzumab and chemotherapy in HER2-positive early breast cancer. Clin Cancer Res. 2016;22(13):3249–3259. – reference: 18) Van Cutsem E, Bang YJ, Feng-Yi F, Xu JM, Lee KW, Jiao SC, et al. HER2 screening data from ToGA: targeting HER2 in gastric and gastroesophageal junction cancer. Gastric Cancer. 2015;18(3):476–484. – reference: 12) Ogata T, Satake H, Ogata M, Hatachi Y, Inoue K, Hamada M, et al. Neutrophil-to-lymphocyte ratio as a predictive or prognostic factor for gastric cancer treated with nivolumab: a multicenter retrospective study. Oncotarget. 2018;9(77):34520–34527. – reference: 14) Suh KJ, Sung JH, Kim JW, Han SH, Lee HS, Min A, et al. EGFR or HER2 inhibition modulates the tumor microenvironment by suppression of PD-L1 and cytokines release. Oncotarget. 2017;8(38):63901–63910. – reference: 4) Michalarea V, Fontana E, Garces AI, Williams A, Smyth EC, Picchia S, et al. Pseudoprogression on treatment with immune-checkpoint inhibitors in patients with gastrointestinal malignancies: Case series and short literature review. Curr Probl Cancer. 2019;43(5):487–494. |
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| Title | 四次治療nivolumabにてpseudo progression様増大後に奏効したHER2陽性食道胃接合部癌再発の1例 |
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