Long-term response to treatment of metastatic HER2-positive gastric cancer. Clinical case
- Authors: Kutakov N.M.1, Senkina T.A.1, Yurichev I.N.1, Chekini D.A.1
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Affiliations:
- Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
- Issue: Vol 6, No 1 (2026)
- Pages: 29-34
- Section: NEW APPROACHES AND SUCCESSES IN TREATMENT OF ONCOLOGICAL PATIENTS AT THE CURRENT STAGE
- Published: 08.04.2026
- URL: https://mdonco.abvpress.ru/jour/article/view/218
- DOI: https://doi.org/10.17650/2782-3202-2026-6-1-29-34
- ID: 218
Cite item
Abstract
Metastatic gastric cancer remains a disease with unfavorable prognosis, median overall survival with standard chemotherapy is less than 1 year. In 15–20 % of patients, the tumor is characterized by HER2 hyperexpression/amplification which allows to use targeted therapy. Results of the ToGA trial showed that addition of trastuzumab to the 1st line chemotherapy in HER2-positive patients statistically significantly increased median overall survival to 16.0 months in the high expression (immunohistochemistry 3+) group, and this regimen remains the standard treatment in these patients in the 1st line.
A clinical case of a 46-year-old female patient with disseminated HER2-positive (immunohistochemistry 3+) stage IV (primary tumor, metastases in the liver, ovary, carcinomatosis) is presented. During 1st line therapy (XELOX + trastuzumab), partial and later complete regression of the tumor lesions was achieved. After 10 courses of induction therapy, supportive therapy with capecitabine and trastuzumab was started which has been going for more than 9 years with overall survival of 123 months and duration of complete response 116 months.
Results of the observation show the possibility of exceptionally long and deep response to chemotherapy and trastuzumab combination in individual patients with HER2-positive metastatic gastric cancer which emphasizes significant heterogeneity of this patient subgroup. Optimization of metastatic gastric cancer treatment requires further study aimed at identification of predictive biomarkers of response to anti-HER2 therapy.
Keywords
About the authors
N. M. Kutakov
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Author for correspondence.
Email: n.kutakov@gmail.com
ORCID iD: 0000-0002-0103-446X
Russian Federation, 111 1st Uspenskoe Shosse, Lapino, Moscow region 143081
T. A. Senkina
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Email: n.kutakov@gmail.com
Russian Federation, 111 1st Uspenskoe Shosse, Lapino, Moscow region 143081
I. N. Yurichev
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Email: n.kutakov@gmail.com
ORCID iD: 0000-0002-1345-041X
Russian Federation, 111 1st Uspenskoe Shosse, Lapino, Moscow region 143081
D. A. Chekini
Clinical Hospital “Lapino” of the “Mother and Child” Group of companies
Email: n.kutakov@gmail.com
ORCID iD: 0000-0001-8581-1328
Russian Federation, 111 1st Uspenskoe Shosse, Lapino, Moscow region 143081
References
- Thrift A.P., Wenker T.N., El-Serag H.B. Global burden of gastric cancer: epidemiological trends, risk factors, screening and prevention. Nat Rev Clin Oncol 2023;20(5):338–49. doi: 10.1038/s41571-023-00747-0
- Lordick F., Carneiro F., Cascinu S. et al. Gastric cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2022;33(10):1005–20. doi: 10.1016/j.annonc.2022.07.004
- Wagner A.D., Syn N.L., Moehler M. et al. Chemotherapy for advanced gastric cancer. Cochrane Database Syst Rev 2017;8(8):CD004064. doi: 10.1002/14651858.CD004064.pub4
- Bartley A.N., Washington M.K., Colasacco C. et al. HER2 testing and clinical decision making in gastroesophageal adenocarcinoma: guideline from the College of American Pathologists, American Society for Clinical Pathology, and the American Society of Clinical Oncology. J Clin Oncol 2017;35(4):446–64. doi: 10.1200/JCO.2016.69.4836
- Tanner M., Hollmen M., Junttila T.T. et al. Amplification of HER-2 in gastric carcinoma: association with Topoisomerase IIalpha gene amplification, intestinal type, poor prognosis and sensitivity to trastuzumab. Ann Oncol 2005;16(2):273–8. doi: 10.1093/annonc/mdi064
- Gravalos C., Jimeno A. HER2 in gastric cancer: a new prognostic factor and a novel therapeutic target. Ann Oncol 2008;19(9):1523–29. doi: 10.1093/annonc/mdn169
- Van Cutsem E., Bang Y.J., Feng-Yi F. et al. HER2 screening data from ToGA: targeting HER2 in gastric and gastroesophageal junction cancer. Gastric Cancer 2015;18(3):476–84. doi: 10.1007/s10120-014-0402-y
- Park S.R., Park Y.S., Ryu M.H. et al. Extra-gain of HER2-positive cases through HER2 reassessment in primary and metastatic sites in advanced gastric cancer with initially HER2-negative primary tumours: results of GASTric cancer HER2 reassessment study 1 (GASTHER1). Eur J Cancer 2016;53:42–50. doi: 10.1016/j.ejca.2015.09.018
- Bang Y.J., Van Cutsem E., Feyereislova A. et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 2010;376(9742):687–97. doi: 10.1016/S0140- 6736(10)61121-X
- Tabernero J., Hoff P.M., Shen L. et al. Pertuzumab plus trastuzumab and chemotherapy for HER2-positive metastatic gastric or gastro-oesophageal junction cancer (JACOB): final analysis of a double-blind, randomised, placebo-controlled phase 3 study. Lancet Oncol 2018;19(10):1372–84. doi: 10.1016/S1470-2045(18)30481-9
- Thuss-Patience P.C., Shah M.A., Ohtsu A. et al. Trastuzumab emtansine versus taxane use for previously treated HER2-positive locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma (GATSBY): an international randomised, open-label, adaptive, phase 2/3 study. Lancet Oncol 2017;18(5):640–53. doi: 10.1016/S1470-2045(17)30111-0
- Hecht J.R., Bang Y.J., Qin S.K. et al. Lapatinib in combination with capecitabine plus oxaliplatin in human epidermal growth factor receptor 2-positive advanced or metastatic gastric, esophageal, or gastroesophageal adenocarcinoma: TRIO-013/LOGiC – a randomized phase III trial. J Clin Oncol 2016;34(5):443–51. doi: 10.1200/JCO.2015.62.6598
- Satoh T., Xu R.H., Chung H.C. et al. Lapatinib plus paclitaxel versus paclitaxel alone in the second-line treatment of HER2-amplified advanced gastric cancer in Asian populations: TyTAN – a randomized, phase III study. J Clin Oncol 2014;32(19):2039–49. doi: 10.1200/JCO.2013.53.6136
- Shitara K., Van Cutsem E., Gümüş M. et al. Trastuzumab deruxtecan or ramucirumab plus paclitaxel in gastric cancer. N Engl J Med 2025;393(4):336–48. doi: 10.1056/NEJMoa2503119
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