A Case of Recurrence of HER2-Positive Esophagogastric Junction Cancer in Which Fourth-Line Treatment with Nivolumab Was Effective after Pseudo Progression-Like Growth

Miyazaki Hazuki, Nishikawa Kazuhiro, Hamakawa Takuya, Toshiyama Reishi, Miyo Masaaki, Takahashi Yusuke, Miyake Masakazu, Miyamoto Atsushi, Kato Takeshi, Mori Kiyoshi, Hirao Motohiro

doi:10.5833/jjgs.2020.0113

<p>We report a case of recurrence of HER2-positive esophagogastric junction cancer in which nivolumab was effective as fourth-line treatment. A 71-year-old man underwent distal gastrectomy for gastric cancer 15 years ago. Twelve years after the operation, type 3 cancer was found at the esophagogastric junction, and total remnant gastrectomy and lower esophagectomy were performed. Since recurrence in para-aortic lymph nodes was observed 2 months after the operation, capecitabine+oxaliplatin+trastuzumab therapy was started, and then paclitaxel+ramucirumab and trifluridine/tipiracil were administered. Since increased pancreatic tail lymph node metastasis and new multiple liver metastases were observed during the course, nivolumab was introduced as fourth-line treatment at 1 year and 9 months after the start of the first-line treatment. A temporary increase in lesion growth occurred in during the first course, but after the third course there was a marked reduction of the metastatic lesion and the outcome became a partial response (PR). Both performance status and tumor markers have improved, and PR is currently being maintained.</p>

A Case of Recurrence of HER2-Positive Esophagogastric Junction Cancer in Which Fourth-Line Treatment with Nivolumab Was Effective after Pseudo Progression-Like Growth

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