A case of severe cerebral embolism after chemotherapy for HER2-positive gastric cancer

BMC Research Notes

Kazuhiko Nakagawa¹  Shinichi Nishina¹  Masayuki Takeda¹  Takayuki Takahama¹ 

[1] Department of Medical Oncology, Kinki University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-Sayama 589-8511, Osaka, Japan

关键词: Human epidermal growth factor receptor 2;    Gastric cancer;    Chemotherapy;    Intracranial embolism;   

Others  :  1145816
DOI  :  10.1186/s13104-015-1059-2

 received in 2015-02-04, accepted in 2015-03-17,  发布年份 2015

【 摘 要 】

Background

Trastuzumab + chemotherapy is considered the standard therapy for advanced human epidermal growth factor receptor 2 (HER2)-positive gastric cancer with mild manageable toxicity, on the basis of the results of a pivotal phase-III trial. Cerebrovascular events are not recognized as expected adverse effects of such therapy.

Case presentation

We report the case of a 67-year-old, current-smoking male with stage-IV HER2-positive gastric cancer who suffered right middle cerebral artery (MCA) embolism after trastuzumab + chemotherapy. He received trastuzumab and cisplatin on Day 1, followed by a continuous 5-fluorouracil infusion for 5 days as a first-line treatment. Four days after chemotherapy initiation, he presented with left hemiplegia, and brain magnetic resonance imaging and magnetic resonance angiography revealed a right MCA occlusion. No further chemotherapy was administered because of worsening performance status.

Conclusion

The present case, possibly the first such reported case, suggests the risk of development of embolism after trastuzumab + chemotherapy in HER2-positive advanced gastric cancer, although other factors should be considered.

【 授权许可】

   
2015 Takahama et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Bang YJ, Van Cutsem E, Feyereislova A, Chung HC, Shen L, Sawaki A, et al.: Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 2010, 376:687-7.
• [2]Al-Thenayan E, Maghfoor I: Complications of malignancy: case 1. Systemic tumor embolism from lung cancer at presentation. J Clin Oncol 2004, 22:372-3.
• [3]Blom JW, Doggen CJ, Osanto S, Rosendaal FR: Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 2005, 293:715-22.
• [4]Mannami T, Iso H, Baba S, Sasaki S, Okada K, Konishi M, et al.: Cigarette smoking and risk of stroke and its subtypes among middle-aged Japanese men and women: the JPHC Study Cohort I. Stroke 2004, 35:1248-53.
• [5]Li SH, Chen WH, Tang Y, Rau KM, Chen YY, Huang TL, et al.: Incidence of ischemic stroke post-chemotherapy: a retrospective review of 10,963 patients. Clin Neurol Neurosurg 2006, 108:150-6.
• [6]Cardinale D, Sandri MT, Martinoni A, Tricca A, Civelli M, Lamantia G, et al.: Left ventricular dysfunction predicted by early troponin I release after high-dose chemotherapy. J Am Coll Cardiol 2000, 36:517-22.
• [7]Cardinale D, Sandri MT, Colombo A, Colombo N, Boeri M, Lamantia G, et al.: Prognostic value of troponin I in cardiac risk stratification of cancer patients undergoing high-dose chemotherapy. Circulation 2004, 109:2749-54.
• [8]Cardinale D, Colombo A, Torrisi R, Sandri MT, Civelli M, Salvatici M, et al.: Trastuzumab-induced cardiotoxicity: clinical and prognostic implications of troponin I evaluation. J Clin Oncol 2010, 28:3910-6.