Significant response to ramucirumab, monotherapy in chemotherapy-resistant recurrent alpha-fetoprotein-producing gastric cancer: A case report

被引：31

作者：

Arakawa, Yasuhiro ^{[1
]}

Tamura, Miho ^{[1
]}

Aiba, Keisuke ^{[1
]}

Morikawa, Kazuhiko ^{[2
]}

Aizawa, Daisuke ^{[3
]}

Ikegami, Masahiro ^{[3
]}

Yuda, Masami ^{[4
]}

Nishikawa, Katsunori ^{[4
]}

机构：

[1] Jikei Univ, Sch Med, Dept Hematol & Oncol, Tokyo 1058471, Japan

[2] Jikei Univ, Sch Med, Dept Radiol, Tokyo 1058471, Japan

[3] Jikei Univ, Sch Med, Dept Pathol, Tokyo 1058471, Japan

[4] Jikei Univ, Sch Med, Dept Surg, Tokyo 1058471, Japan

来源：

ONCOLOGY LETTERS | 2017年 / 14卷 / 03期

关键词：

alpha-fetoprotein-producing gastric cancer; chemotherapy-resistant gastric cancer; recurrent gastric cancer; ramucirumab monotherapy; anti-angiogenic therapy; ADVANCED HEPATOCELLULAR-CARCINOMA; PHASE-3; TRIAL; DOUBLE-BLIND; VEGF-C; SORAFENIB; THERAPY; PLACEBO; FLUOROPYRIMIDINE; ANGIOGENESIS; MULTICENTER;

D O I：

10.3892/ol.2017.6514

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Alpha-fetoprotein (AFP)-producing gastric cancer (AFPGC) is a relatively rare type of gastric cancer characterized by a high incidence of liver and lymph node metastases, and a poor prognosis. Few advanced AFPGC cases treated successfully with conventional chemotherapy have been reported thus far. Although the development of molecular-targeted therapy has improved the prognosis of various types of cancer, there are currently no tailored therapies for AFPGC. In the present report, the case of a chemotherapy-resistant recurrent AFPGC patient who exhibited a significant response to ramucirumab monotherapy is presented. Following six doses of ramucirumab, a metastatic lymph node displayed central necrosis, and the patient's serum AFP levels decreased from 12,800 to 225 ng/ml. AFPGC is known to have increased vascular endothelial growth factor (VEGF) expression and rich neovascularization. Furthermore, in the present case, tumor cells were positive for VEGF. Ramucirumab is a monoclonal antibody for VEGF receptor-2 and the first anti-angiogenic drug approved for the treatment of advanced gastric cancer. However, the clinical efficacy of ramucirumab in patients with AFPGC has not been reported previously. The present report suggests that AFP production in gastric cancer can be a predictor for the response to anti-angiogenic drugs such as ramucirumab.

引用

页码：3039 / 3042

页数：4

共 29 条

[1] AFP-Producing gastric carcinoma: Multivariate analysis of prognostic factors in 270 patients [J].

Adachi, Y ;

Tsuchihashi, J ;

Shiraishi, N ;

Yasuda, K ;

Etoh, T ;

Kitano, S .

ONCOLOGY, 2003, 65 (02) :95-101

[2]

Bang YJ, 2010, LANCET, V376, P1302

[3] Sorafenib Inhibits Signal Transducer and Activator of Transcription-3 Signaling in Cholangiocarcinoma Cells by Activating the Phosphatase Shatterproof 2 [J].

Blechacz, Boris R. A. ;

Smoot, Rory L. ;

Bronk, Steven F. ;

Werneburg, Nathan W. ;

Sirica, Alphonse E. ;

Gores, Gregory J. .

HEPATOLOGY, 2009, 50 (06) :1861-1870

[4] Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte [J].

Coiffier, Bertrand ;

Thieblemont, Catherine ;

Van Den Neste, Eric ;

Lepeu, Gerard ;

Plantier, Isabelle ;

Castaigne, Sylvie ;

Lefort, Sophie ;

Marit, Gerald ;

Macro, Margaret ;

Sebban, Catherine ;

Belhadj, Karim ;

Bordessoule, Dominique ;

Ferme, Christophe ;

Tilly, Herve .

BLOOD, 2010, 116 (12) :2040-2045

[5] Comparison of tumor response by Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST in patients treated with sorafenib for hepatocellular carcinoma [J].

Edeline, Julien ;

Boucher, Eveline ;

Rolland, Yan ;

Vauleon, Elodie ;

Pracht, Marc ;

Perrin, Christophe ;

Le Roux, Catherine ;

Raoul, Jean-Luc .

CANCER, 2012, 118 (01) :147-156

[6] Successful multimodal therapy for an α-fetoprotein-producing gastric cancer patient with simultaneous liver metastases [J].

Fang, Yu ;

Wang, Lin ;

Yang, Ningrong ;

Gong, Xinlei ;

Zhang, Yu ;

Qin, Shukui .

ONCOLOGY LETTERS, 2015, 10 (05) :3021-3025

[7] Ramucirumab monotherapy for previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (REGARD): an international, randomised, multicentre, placebo-controlled, phase 3 trial [J].

Fuchs, Charles S. ;

Tomasek, Jiri ;

Yong, Cho Jae ;

Dumitru, Filip ;

Passalacqua, Rodolfo ;

Goswami, Chanchal ;

Safran, Howard ;

dos Santos, Lucas Vieira ;

Aprile, Giuseppe ;

Ferry, David R. ;

Melichar, Bohuslav ;

Tehfe, Mustapha ;

Topuzov, Eldar ;

Zalcberg, John Raymond ;

Chau, Ian ;

Campbell, William ;

Sivanandan, Choondal ;

Pikiel, Joanna ;

Koshiji, Minori ;

Hsu, Yanzhi ;

Liepa, Astra M. ;

Gao, Ling ;

Schwartz, Jonathan D. ;

Tabernero, Josep .

LANCET, 2014, 383 (9911) :31-39

[8] A phase II study of sequential methotrexate and 5-fluorouracil chemotherapy in previously treated gastric cancer: A report from the gastrointestinal oncology group of the Japan Clinical Oncology Group, JCOG 9207 trial [J].

Hamaguchi, Tetsuya ;

Shirao, Kuniaki ;

Yamamichi, Noboru ;

Hyodo, Ichinosuke ;

Koizumi, Wasaburo ;

Seki, Shigeki ;

Imamura, Tetsuri ;

Honma, Hisanobu ;

Ohtsu, Atsushi ;

Boku, Narikazu ;

Mukai, Toshikazu ;

Yamamoto, Seiichiro ;

Fukuda, Haruhiko ;

Yoshida, Shigeaki .

JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 2008, 38 (06) :432-437

[9] Randomized, Open-Label, Phase III Study Comparing Irinotecan With Paclitaxel in Patients With Advanced Gastric Cancer Without Severe Peritoneal Metastasis After Failure of Prior Combination Chemotherapy Using Fluoropyrimidine Plus Platinum: WJOG 4007 Trial [J].

Hironaka, Shuichi ;

Ueda, Shinya ;

Yasui, Hirofumi ;

Nishina, Tomohiro ;

Tsuda, Masahiro ;

Tsumura, Takehiko ;

Sugimoto, Naotoshi ;

Shimodaira, Hideki ;

Tokunaga, Shinya ;

Moriwaki, Toshikazu ;

Esaki, Taito ;

Nagase, Michitaka ;

Fujitani, Kazumasa ;

Yamaguchi, Kensei ;

Ura, Takashi ;

Hamamoto, Yasuo ;

Morita, Satoshi ;

Okamoto, Isamu ;

Boku, Narikazu ;

Hyodo, Ichinosuke .

JOURNAL OF CLINICAL ONCOLOGY, 2013, 31 (35) :4438-+

[10] Prognostic significance of the expression of vascular endothelial growth factor (VEGF) and VEGF-C in gastric carcinoma [J].

Ichikura, T ;

Tomimatsu, S ;

Ohkura, E ;

Mochizuki, H .

JOURNAL OF SURGICAL ONCOLOGY, 2001, 78 (02) :132-137

← 1 2 3 →