Efficacy and Safety of Chemotherapy Following Anti-PD-1 Antibody Therapy for Gastric Cancer: A Case of Sclerosing Cholangitis
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- Kono Masashi
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Sakurai Toshiharu
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Okamoto Kazuki
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Masaki Shou
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Nagai Tomoyuki
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Komeda Yoriaki
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Kamata Ken
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Minaga Kosuke
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Yamao Kentarou
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Takenaka Mamoru
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Watanabe Tomohiro
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Nishida Naoshi
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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- Kudo Masatoshi
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Japan
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Abstract
<p>Immunotherapy targeting programmed cell death-1 (PD-1) signaling is becoming the standard of care for advanced gastric cancer. We herein report a patient with gastric adenocarcinoma with peritoneal dissemination who was treated with nab-paclitaxel and ramucirumab following nivolumab and developed sclerosing cholangitis. Endoscopic retrograde cholangiography showed irregular narrowing and widening of the entire intrahepatic biliary system. Intriguingly, the patient receiving second-line chemotherapy with nab-paclitaxel plus ramucirumab prior to being administered nivolumab, however, he had experienced progressive disease. Thereafter, the administration of fourth-line chemotherapy with nab-paclitaxel and ramucirumab following nivolumab resulted in a clinical response. Nivolumab may enhance the efficacy of the subsequent chemotherapy regimens but also induce sclerosing cholangitis. </p>
Journal
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- Internal Medicine
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Internal Medicine 58 (9), 1263-1266, 2019-05-01
The Japanese Society of Internal Medicine