Successful multimodal therapy for an α-fetoprotein-producing gastric cancer patient with simultaneous liver metastases

Fang, Yuan; Wang, Lin; Yang, Ni; Gong, Xiaomeng; Zhang, Y U; Qin, Shukui

doi:10.3892/ol.2015.3731

Cited by 13 publications

(17 citation statements)

References 18 publications

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“…Similarly, in our present study, we also found that serum AFP in one patient decreased from 2000 ng/mL to 400 ng/mL with apatinib. Also, multi-target tyrosine kinase inhibitors, including sorafenib, which was approved for first-line treatment of HCC, were reported to be effective for this type of GC[ 28 ], indicating a correlation between the carcinogenesis of AFPGC and HCC.…”

Section: Discussionmentioning

confidence: 99%

Predictive and prognostic value of serum AFP level and its dynamic changes in advanced gastric cancer patients with elevated serum AFP

Wang¹,

Shen²,

Ji³

et al. 2018

WJG

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AIMTo investigate predictive and prognostic value of serum alpha-fetoprotein (AFP) level and its dynamic changes in patients with advanced gastric cancer with elevated serum AFP (AFPAGC).METHODSOne hundred and five patients with AFPAGC were enrolled in the study, and all of them underwent at least one cycle of systemic chemotherapy at our institute and had serum AFP ≥ 20 ng/mL at diagnosis or recurrence. Clinicopathologic features, serum AFP level at diagnosis and changes during treatment, first-line chemotherapy regimens, efficacy and toxicity, and survival information were collected. A Person’s χ2 or Fisher’s exact test was used to measure the differences between variables. Survival prognostic factors were investigated using the Kaplan-Meier method and Cox regression.RESULTSMedian serum AFP level was 161.7 ng/mL (range, 22.9-2557110 ng/mL). Objective response rates (ORR) was significantly lower in the AFP ≥ 160 ng/mL group than in the AFP < 160 ng/mL group (30.4% vs 68.3%, P < 0.001). ORR to doublet regimens was significantly lower in the AFP ≥ 160 ng/mL group, whereas ORR to triplet regimens was similar between the two groups. Liver metastasis rate was significantly higher in the AFP ≥ 160 ng/mL group than in the AFP < 160 ng/mL (69.8% vs 50.0%, P < 0.001). Overall survival (OS) in the two cohorts did not show any significant difference (P = 0.712). Dynamic changes of AFP were consistent with response to chemotherapy, and median OS of patients with a serum AFP decline ≥ 50% and those with a serum AFP decline < 50% was 17.5 m and 10.0 m, respectively (P = 0.003). Hepatic (P = 0.005), peritoneal (P < 0.001), non-regional lymph node metastasis (P < 0.001), and portal vein tumor thrombus (PVTT) (P = 0.042) were identified as independent prognostic factors for AFPAGC.CONCLUSIONReal-time examination of AFP has great predictive and prognostic value for managing AFPAGC. For those with markedly elevated AFP, triplet regimens may be a better choice.

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Section: Discussionmentioning

confidence: 99%

Predictive and prognostic value of serum AFP level and its dynamic changes in advanced gastric cancer patients with elevated serum AFP

Wang¹,

Shen²,

Ji³

et al. 2018

WJG

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“…Since VEGF and VEGF-C serve as angiogenic factors in the tumor microenvironment (22), their inhibition may exhibit anti-angiogenic and anti-tumor activities on AFPGC. However, only a few cases of the efficacy of an anti-angiogenic multi-kinase inhibitor (namely sorafenib) in AFPGC patients have been reported thus far (23,24). The clinical efficacy of ramucirumab, a monoclonal antibody for VEGF receptor-2, in AFPGC patients has not yet been reported.…”

Section: Discussionmentioning

confidence: 99%

Significant response to ramucirumab monotherapy in chemotherapy-resistant recurrent alpha-fetoprotein-producing gastric cancer: A case report

Arakawa¹,

Tamura²,

Aiba³

et al. 2017

Oncology Letters

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Abstract. Alpha-fetoprotein (AFP)-producing gastric cancer (AFPGC) is a relatively rare type of gastric cancer characterized by a high incidence of liver and lymph node metastases, and a poor prognosis. Few advanced AFPGC cases treated successfully with conventional chemotherapy have been reported thus far. Although the development of molecular-targeted therapy has improved the prognosis of various types of cancer, there are currently no tailored therapies for AFPGC. In the present report, the case of a chemotherapy-resistant recurrent AFPGC patient who exhibited a significant response to ramucirumab monotherapy is presented. Following six doses of ramucirumab, a metastatic lymph node displayed central necrosis, and the patient's serum AFP levels decreased from 12,800 to 225 ng/ml. AFPGC is known to have increased vascular endothelial growth factor (VEGF) expression and rich neovascularization. Furthermore, in the present case, tumor cells were positive for VEGF. Ramucirumab is a monoclonal antibody for VEGF receptor-2 and the first anti-angiogenic drug approved for the treatment of advanced gastric cancer. However, the clinical efficacy of ramucirumab in patients with AFPGC has not been reported previously. The present report suggests that AFP production in gastric cancer can be a predictor for the response to anti-angiogenic drugs such as ramucirumab.

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“…One study described several different treatment options that can delay the progression of HAS, including cisplatin plus uorouracil and epirubicin or irinotecan combined with mitomycin C [23]. Fang et al reported a case of AFPGC patients with liver metastasis who underwent multimodal treatment including surgery, chemotherapy, interventional therapy and sorafenib targeted therapy, with an OS of 30 months [24].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological and Prognostic Characteristics of Hepatoid Adenocarcinoma of the Stomach

Liu

Qin

Chang

et al. 2020

Preprint

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Objectives The aim of this study is to analyze the clinical and pathological features of HAS and investigate the factors affecting prognosis.Methods From January 2014 to May 2020, 31 patients were diagnosed as HAS in in the First Affiliated Hospital of Zhengzhou University. The clinicopathologic features and the relevant prognosis of these patients were analyzed.Results Of the 31 patients, 23 were male, with a median age of 62 years. And among the 31 patients, 22 patients underwent a radical gastrectomy and a D2 lymph node dissection. During the follow up period, 18 patients died of the disease. The median OS (mOS) was 28 months. The 1-year survival rate was 55%, the 3-year survival rate was 47%, and the 5-year survival rate was 34%. An elevated CA125 level, distant metastasis, and radical surgery were associated with the prognosis of HAS, and distant metastasis is an independent prognostic risk factor for survival. Conclusion HAS had a poor prognosis because of its frequent vascular involvement, and lymph node and liver metastasis. Aggressive multimodal treatment comprising radical gastrectomy and adjuvant chemotherapy is warranted.This article describes the Clinicopathological of Hepatoid Adenocarcinoma of the Stomach and through survival analysis, the factors affecting the patient’s prognosis were studied.

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Successful multimodal therapy for an α-fetoprotein-producing gastric cancer patient with simultaneous liver metastases

Cited by 13 publications

References 18 publications

Predictive and prognostic value of serum AFP level and its dynamic changes in advanced gastric cancer patients with elevated serum AFP

Predictive and prognostic value of serum AFP level and its dynamic changes in advanced gastric cancer patients with elevated serum AFP

Significant response to ramucirumab monotherapy in chemotherapy-resistant recurrent alpha-fetoprotein-producing gastric cancer: A case report

Clinicopathological and Prognostic Characteristics of Hepatoid Adenocarcinoma of the Stomach

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