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Successful Treatment of a Patient with HER2-Positive Metastatic Gastric Cancer with Third-Line Combination Therapy with Irinotecan, 5-Fluorouracil, Leucovorin and Trastuzumab (FOLFIRI-T)Weissinger F.a · Reymond M.b · Dumke K.c · Krüger M.d
a Klinik für Innere Medizin, Hämatologie/Onkologie und Palliativmedizin, b Klinik für Viszeralchirurgie, c Institut für Pathologie, d Klinik für Innere Medizin und Gastroenterologie, Evangelisches Krankenhaus Bielefeld, Germany
Background: For patients with HER2overexpressing gastric cancer, there is an improved prognosis with additional trastuzumab to chemotherapy with a platinum compound and a fluoropyrimidin in firstline therapy. Secondline combinations are currently evaluated in various studies. Case Report: We report the case of a 43yearold male patient who came to our hospital with recurrent metastatic gastric cancer after curative surgery 18 months before. His disease responded well to several therapeutic regimens. Firstline chemotherapy with a combination of epirubicin, oxaliplatin and capecitabine (EOX) and the following therapies – peritonectomy, multivisceral resection, hyperthermic intraperitoneal chemotherapy (HIPEC), and secondline chemotherapy with oxaliplatin, 5fluorouracil and leucovorin (FLO) – induced a complete remission. At the time of the subsequent progression, HER2 overexpression was detected. We administered the combination of irinotecan, 5fluorouracil, leucovorin (FOLFIRI) and trastuzumab, which to our knowledge was used for the first time in a patient with metastatic gastric cancer in thirdline therapy. This regimen again induced a complete remission of the disease, which has been sustained now for at least 8 months. Conclusion: This is the first time in the literature that a combination of FOLFIRI and trastuzumab (FOLFIRIT) was used successfully in a patient with recurrent metastatic gastric cancer.
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