Abstract
Gastric cancer patients with widespread metastasis, especially meningeal metastases, have an extremely prognosis and limited therapeutic choices. We reported the case of a 39-year-old male patient with HER2-positive gastric cancer with bone and meningeal metastases. He presented with multiple bone metastases and received 3 cycles of docetaxel plus S1. However, he complained with headache and imaging examinations revealed leptomeningeal carcinomatosis. FISH revealed that tumor cells in the cerebrospinal fluid were HER-positive. Herceptin was added to the regimen, but the symptoms were not relieved, the patient suffered from dizziness and nausea. The chemotherapy regimen was switched d to lapatinib (orally at 1250 mg/day, every day), capecitabine (orally at 1000 mg/m2, bid for 2 weeks, followed by a 1-week rest interval, as 1 cycle) and Herceptin (390 mg/3 weeks). After 3 weeks of the new treatment, all the symptoms relieved. The clinical complete response was maintained for 3 months. Lapatinib/Capecitabine combination therapy is an alternative treatment strategy for leptomeningeal carcinomatosis of HER2-positive gastric cancer in which trastuzumab and/or chemotherapy essentially has no effect.
References
Feb 15, 1982·Cancer·W R WasserstromJ B Posner
Aug 17, 1999·Journal of Neuro-oncology·M Kim
Oct 11, 2005·Journal of Neuro-oncology·Sophie TaillibertJean-Yves Delattre
Feb 19, 2009·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Guanzhen YuKeping Xie
Feb 25, 2010·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Zev A WainbergRichard S Finn
Aug 24, 2010·Lancet·Yung-Jue BangUNKNOWN ToGA Trial Investigators
Oct 21, 2011·Pharmaceutical Research·Kunal S TaskarQuentin R Smith
Mar 31, 2012·Science Translational Medicine·Howard M Stern
Dec 20, 2012·Current Cancer Therapy Reviews·Ticiana LealH Ian Robins
Jan 22, 2013·Breast Cancer : the Journal of the Japanese Breast Cancer Society·Muhammet Ali KaplanZuhat Urakci
Apr 17, 2013·Breast Cancer Research and Treatment·Flora ZagouriMatthias Preusser
Nov 28, 2013·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Nian FangNong-Rong Wang
Apr 25, 2014·Annals of Surgical Treatment and Research·Nam-Hee KimKyong-Hwa Jun
Apr 18, 2015·BMC Cancer·Jing ChaiDebin Wang
May 16, 2015·EJNMMI Research·Azeem SaleemRaoul C Coombes
Aug 16, 2015·Cancer Treatment Reviews·Valentina D'AmatoRoberto Bianco
Jan 26, 2016·CA: a Cancer Journal for Clinicians·Wanqing ChenJie He
Feb 2, 2016·Cancer Treatment Reviews·F MackM Glas
Apr 23, 2016·Radiation Oncology Journal·Taeryool Koo, In Ah Kim
Apr 25, 2016·The Lancet Oncology·Andrea Sartore-BianchiSalvatore Siena