Tuesday, June 29, 2021

Pathological Complete Response and Successful Conversion Surgery After Nivolumab Therapy for Stage IV Oesophagogastric Junction Cancer

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In Vivo. 2021 Jul-Aug;35(4):2247-2251. doi: 10.21873/invivo.12497.

ABSTRACT

BACKGROUND: Multimodality treatment including immune check point inhibitors is required for stage IV oesophagogastric junction cancer (OGJC).

CASE REPORT: A 69-year-old man, was diagnosed with advanced OGJC and para-aortic lymph node metastasis (T3N+M1, stage IV), which upon biopsy, was shown to be an adenocarcinoma. After eight courses of nivolumab as third-line chemotherapy, the primary tumour and enlarged regional and para-aortic lymph nodes shrunk markedly, while tumour markers decreased within normal ranges. We performed a minimally invasive Ivor-Lewis oesophagectomy with completion of an abdominal D2 and transhiatal lower mediastinal lymph node dissection. Pathological findings revealed a complete response for the primary tumour and a regional lymph node metastasis. A biopsy of the previous sample revealed microsatellite instability-negativity, Epst ein-Barr virus-negativity, and programmed cell death-1-ligand combined positive score of 2. He was followed up for 3 months without recurrence.

CONCLUSION: Nivolumab may induce pathological complete response for stage IV OGJC even in cases negative for microsatellite instability and Epstein-Barr virus, besides the programmed cell death-1-ligand combined positive score of <5.

PMID:34182503 | DOI:10.21873/invivo.12497

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