PRaG Therapy of Refractory Metastatic Gastric Cancer: A Case Report
Hong Liang Xua b, Zhihui Hongc, Meiling Xub d e, Yuehong Kongb d e, Yifu Mab d e, Chanchan Shanb, Pengfei Xingb d e✉, Liyuan Zhangb d e✉
- aDepartment of Oncology, Changshu Hospital Affiliated to Soochow University, Suzhou, China
- bDepartment of Radiotherapy& Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, China
- cDepartment of Nuclear medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China
- dInstitution of Radiotherapy & Oncology, Soochow University, Suzhou, China
- eLaboratory for Combined Radiotherapy and Immunotherapy of Cancer, The Second Affiliated Hospital of Soochow University, Suzhou, China
- ✉Corresponding author
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Abstract
Patients with metastatic gastric cancer had limited treatments and often had a somber prognosis, especially when patients were unable to tolerate high-intensity cytotoxic treatment due to poor physical condition or organ dysfunction after the failure of standard therapy. Here, we reported a metastatic and proficient mismatch repair (pMMR) gastric adenocarcinoma patient with the Eastern Cooperative Oncology Group (ECOG) performance status score of 2 associated with hypoproteinemia and fatigue, and poor appetite that was unable to tolerate high-intensity therapy after several chemotherapy regimens and anti-angiogenic therapy. After receiving novel triple-combination therapy, which consists of PD-1 inhibitor, Radiotherapy and Granulocyte-macrophage colony-stimulating factor (GM-CSF) therapy (PRaG for short), the patient achieved a complete response (CR) with a progression-free survival time of 14 months, and ECOG performance status score improved from 2 to 0. A significant systemic effect was observed in this case and the PRaG triple-combination therapy might provide a novel treatment strategy for metastatic pMMR gastric cancer patients.