Gastric cancer (GC) is the fourth most common
cancer worldwide, with overall 5-year survival rate of approximate 20%. Although
multimodal treatments that combine surgery with
chemotherapy and
immunotherapy have been shown to improve survival, pathological complete response (pCR) is rare in advanced GC patients with liver
metastases. Pre-clinical studies and clinical trials have demonstrated the antitumor efficacy of invariant natural killer T (iNKT) cells in various
malignancies, including GC. While multimodal
therapy comprised of
chemotherapy, anti-programmed cell death-1 (PD-1)
therapy, and iNKT cell
immunotherapy have not been reported in GC patients. This case report describes the treatment of an early 60s patient diagnosed with advanced stage IVB (T1N1M1)
adenocarcinomas of gastric cardia with liver
metastases who received multimodal
therapy comprised of SOX
chemotherapy, anti-programmed cell death-1 (PD-1)
therapy, and iNKT cell
immunotherapy followed by surgical resection. Dramatic decreases in
tumor area were observed in both the primary
tumor and metastatic lesions following six cycles of SOX
chemotherapy and iNKT cell
immunotherapy, and four cycles of anti-PD-1
therapy. This combined treatment resulted in the transformation of a remarkably large, unresectable liver
metastases into a resectable
tumor, and the patient received total
gastrectomy with D2
lymph node dissection and liver
metastasectomy. Subsequent pathological examination detected no
cancer cells in either the primary site or liver metastatic lesions, supporting the likelihood that this treatment achieved pCR. To our knowledge, this report represents the first case of a metastatic
gastric cancer patient displaying pCR after six months of multimodal
therapy, thus supporting that a SOX
chemotherapy, anti-PD-1
therapy, and iNKT cell
immunotherapy combination strategy may be effective for treating, and potentially curing, patients with advanced gastric
adenocarcinoma.