Rapid symptomatic relief of HER2-positive gastric cancer leptomeningeal carcinomatosis with lapatinib, trastuzumab and capecitabine: a case report

BMC Cancer

Xiao-Dong Jiao¹  Yuan-Sheng Zang¹  Chunming Ding²  Guanzhen Yu² 

[1] Department of Medical Oncology, Changzheng Hospital;School of Laboratory Medicine and Life Science, Wenzhou Medical University;

关键词: Gastric cancer;    Leptomeningeal Carcinomatosis;    HER2;    Lapatinib;   

DOI  :  10.1186/s12885-018-4116-0

来源: DOAJ

【 摘 要 】

Abstract Background Gastric cancer patients with widespread metastasis, especially meningeal metastases, have an extremely prognosis and limited therapeutic choices. Case presentation 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. Conclusions 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.

【 授权许可】

Unknown