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Case Reports
. 2025 Apr 1:16:1387661.
doi: 10.3389/fphar.2025.1387661. eCollection 2025.

Case Report: Second-line favourable effect of pembrolizumab plus chemotherapy in a patient with metastatic hepatoid adenocarcinoma of the stomach

Yao Tang #  1 , Xiaofen Li #  1   2 , Yu Yang  1   2
Affiliations
Case Reports

Case Report: Second-line favourable effect of pembrolizumab plus chemotherapy in a patient with metastatic hepatoid adenocarcinoma of the stomach

Yao Tang et al. Front Pharmacol. .

Abstract

Hepatoid adenocarcinoma of the stomach (HAS) is a rare and aggressive malignancy with poor prognosis. HAS is characterized by both adenocarcinoma and hepatocellular carcinoma like differentiation, which often produces alpha-fetoprotein (AFP) and responds poorly to systemic chemotherapy. Herein we report a case of 62-year-old male diagnosed with liver metastatic HAS, who progressed rapidly after first-line cisplatin + fluorouracil chemotherapy combined with pembrolizumab. However, the patient achieved favourable outcome after second-line oxaliplatin + capecitatine chemotherapy combined with pembrolizumab. This case indicated that the chemotherapy regimen might influence the efficacy of immune check-point inhibiors plus chemotherapy.

Keywords: case report; chemotherapy; hepatoid adenocarcinoma of the stomach(HAS); immunotherapy; pembrolizumab.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
After three cycles of treatment with FP regimen combined with pembrolizumab, the patient’s tumor progressed. (A-C) The baseline examination images of the patient, or the images before anti-tumor treatment. (D-F) The images of the patient after first-line three cycles of FP regimen combined with pembrolizumab. The red arrow indicates the area where the tumor is located.
FIGURE 2
FIGURE 2
PET-CT examination before initial anti-tumor treatment, considering gastric cardia cancer with peripheral lymph nodes and liver metastasis. (A) Overall image. (B) Cross-sectional image. (C) Coronal image).
FIGURE 3
FIGURE 3
After four cycles of follow-up with CAPEOX combined with pembrolizumab, the efficacy evaluation was sustained partial remission (PR), according to RECIST 1.1. (A-D) Progress (PD) after three cycles of FP regimen combined with parolizumab, follow-up CT scan upon admission to our hospital. (E-H) After receiving CAPEOX combined with pembrolizumab treatment for two cycles in our hospital, the efficacy evaluation was partial remission (PR). (I-L) Four cycles CAPEOX combined with pembrolizumab treatment, the efficacy evaluation was sustained partial remission (PR).
FIGURE 4
FIGURE 4
The timeline for patient treatment.
See this image and copyright information in PMC

References

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