Successful Treatment of a Patient with HER2-Positive Metastatic Gastric Cancer with Third-Line Combination Therapy with Irinotecan, 5-Fluorouracil, Leucovorin and Trastuzumab (FOLFIRI-T)
Successful Treatment of a Patient with HER2-Positive Metastatic Gastric Cancer with Third-Line Combination Therapy with Irinotecan, 5-Fluorouracil, Leucovorin and Trastuzumab (FOLFIRI-T)
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DOI：
10.1159/000332226
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发表时间：
2011-10-01
期刊：
影响因子：
0.3
通讯作者：
Krueger, Martin
中科院分区：
文献类型：
--
作者：
Weissinger, Florian;Reymond, Marc;Krueger, Martin
背景：对于her2过表达的胃癌患者，在一线治疗中，在铂类化合物和氟嘧啶化疗的基础上，额外使用曲妥珠单抗可以改善预后。目前在各种研究中对二线组合进行了评估。病例报告：我们报告一例43岁男性患者，于18个月前根治性手术后复发转移性胃癌来到我院。他的病对几种治疗方案反应良好。一线化疗联合表柔比星、奥沙利铂和卡培他滨（EOX）和以下治疗-腹膜切除术、多内脏切除术、腹腔热化疗（HIPEC）和二线化疗联合奥沙利铂、5-氟尿嘧啶和亚叶酸素(FLO) -诱导完全缓解。在随后的进展中，检测到HER2过表达。我们给予伊立替康、5-氟尿嘧啶、亚叶酸钙（FOLFIRI）和曲妥珠单抗联合治疗，据我们所知，这是第一次在转移性胃癌患者的三线治疗中使用。该方案再次诱导疾病完全缓解，目前已持续至少8个月。结论：这是文献中首次成功使用FOLFIRI联合曲妥珠单抗（FOLFIRI- t）治疗复发性转移性胃癌患者。
Background: For patients with HER2-overexpressing gastric cancer, there is an improved prognosis with additional trastuzumab to chemotherapy with a platinum compound and a fluoropyrimidin in first-line therapy. Second-line combinations are currently evaluated in various studies. Case Report: We report the case of a 43-year-old male patient who came to our hospital with recurrent metastatic gastric cancer after curative surgery 18 months before. His disease responded well to several therapeutic regimens. First-line chemotherapy with a combination of epirubicin, oxaliplatin and capecitabine (EOX) and the following therapies - peritonectomy, multi-visceral resection, hyperthermic intraperitoneal chemotherapy (HIPEC), and second-line chemotherapy with oxaliplatin, 5-fluorouracil and leucovorin (FLO) - induced a complete remission. At the time of the subsequent progression, HER2 overexpression was detected. We administered the combination of irinotecan, 5-fluorouracil, leucovorin (FOLFIRI) and trastuzumab, which to our knowledge was used for the first time in a patient with metastatic gastric cancer in third-line therapy. This regimen again induced a complete remission of the disease, which has been sustained now for at least 8 months. Conclusion: This is the first time in the literature that a combination of FOLFIRI and trastuzumab (FOLFIRI-T) was used successfully in a patient with recurrent metastatic gastric cancer.