Partial response of metastatic cardia neuroendocrine carcinoma with the combined therapy involving PD-1 blockade after failed multi-line chemotherapies: a case report and literature review.

Abstract

Cardia neuroendocrine cancer is a rare malignant tumor. The treatment regimens mainly refer to the small-cell lung cancer diagnosis and treatment guidelines and there is no standard treatment guideline specifically for neuroendocrine cancer. The use of albumin paclitaxel plus carboplatin combined with sintilimab for refractory cardia neuroendocrine carcinoma (NEC) has never been reported. This article reported a case that a 68-year-old man presented with belching without obvious reasons who was diagnosed with refractory cardia NEC by gastroscopy and pathological results. After failure of multi-line therapy including etoposide plus cisplatin as the first-line therapy, surufatinib plus toripalimab as the second-line therapy, FOLFIRI combined with bevacizumab as the third-line therapy, he received three cycles of albumin paclitaxel plus carboplatin combined with sintilimab as the fourth-line therapy and still obtained partial response of good efficiency. After the patient received this treatment regimen, the symptoms of dysphagia disappeared and the change trends of neuron-specific enolase were decreased. The computed tomography (CT) examination after three cycles of treatment was performed to show that the measured lesions have shrunk by more than 30% compared to the baseline CT. Additionally, there were no other adverse events such as nausea, vomiting, and diarrhea, except for grade III bone marrow suppression. At present, the patient is still being treated. This is the first case report that the albumin paclitaxel plus carboplatin combined with sintilimab has achieved good efficacy after failure of multi-line treatment of cardia NEC. It is very necessary to further explore the effectiveness and safety of this regimen in the treatment of NEC.

• Authors: Yang Yang, Huan Xu, Li Zhang, Liangliang Bai, Hong Zhu, Qiu Li
• Journal: Anti-cancer drugs (Anticancer Drugs) Vol. 33 Issue 2 Pg. 214-219 (02 01 2022) ISSN: 1473-5741 [Electronic] England
• PMID: 34620744 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Albumin-Bound Paclitaxel
• Antibodies, Monoclonal, Humanized
• Programmed Cell Death 1 Receptor
• sintilimab
• Carboplatin

Topics

• Albumin-Bound Paclitaxel (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
• Carboplatin (therapeutic use)
• Carcinoma, Neuroendocrine (drug therapy)
• Humans
• Male
• Middle Aged
• Programmed Cell Death 1 Receptor (antagonists & inhibitors)
• Stomach Neoplasms (drug therapy)