Successful multimodal therapy for an α-fetoprotein-producing gastric cancer patient with simultaneous liver metastases

Fang,Yu; Wang,Lin; Yang,Ningrong; Gong,Xinlei; Zhang,Yu; Qin,Shukui

doi:10.3892/ol.2015.3731

Successful multimodal therapy for an α-fetoprotein-producing gastric cancer patient with simultaneous liver metastases

Authors:
- Yu Fang
- Lin Wang
- Ningrong Yang
- Xinlei Gong
- Yu Zhang
- Shukui Qin
View Affiliations

Affiliations: Department of Medical Oncology, 81st Hospital of the People's Liberation Army, Nanjing, Jiangsu 210002, P.R. China
Published online on: September 21, 2015 https://doi.org/10.3892/ol.2015.3731
Pages: 3021-3025

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

α-fetoprotein-producing gastric cancer (AFPGC) is considered to be a special type of stomach cancer, due its features of high malignancy, fast progression, easy transferral and a poor prognosis. No standard therapy is currently available for patients with AFPGC. In the present study, the case of a 59‑year‑old male diagnosed with AFPGC and simultaneous liver metastases is presented. The patient presented with abdominal bloating and multiple liver lesions were revealed upon imaging. During the course of treatment, the patient's serum AFP level increased to a maximum of 20,624.6 µg/l. The patient survived for 30 months and was ultimately treated with multimodal therapy, including surgery, chemotherapy, interventional therapy and molecular targeted therapy. Treatment with paclitaxel, irinotecan and TS‑1, particularly sorafenib as a molecular targeted drug, are effective for such patients. The choice of chemotherapy regimen according to the Lauren classification and the use of oral sorafenib are likely to be novel and effective treatments for this type of stomach cancer. However, investigations should be performed to identify the gastric cancer patient population most receptive to sorafenib treatment. In addition, combined chemotherapy and molecular targeting treatment requires further study in order to determine if a synergistic effect is present. Further investigation in a large‑sample study is required to confirm the validity of these results.

View Figures

View References

1	Parkin DM, Bray F, Ferlay J and Pisani P: Global cancer statistics, 2002. CA Cancer J Clin. 55:74–108. 2005. View Article : Google Scholar : PubMed/NCBI
2	Bourreille J, Metayer P, Sauger F, Matray F and Fondimare A: Existence of alpha fetoprotein during gastric-origin secondary cancer of the liver. Presse Med. 78:1277–1278. 1970.(In French). PubMed/NCBI
3	Hirajima S, Komatsu S, Ichikawa D, Kubota T, Okamoto K, Shiozaki A, Fujiwara H, Konishi H, Ikoma H and Otsuji E: Liver metastasis is the only independent prognostic factor in AFP-producing gastric cancer. World J Gastroenterol. 19:6055–6061. 2013. View Article : Google Scholar : PubMed/NCBI
4	Kono K, Amemiya H, Sekikawa T, Iizuka H, Takahashi A, Fujii H and Matsumoto Y: Clinicopathologic features of gastric cancers producing alpha-fetoprotein. Dig Surg. 19:359–365. 2002. View Article : Google Scholar : PubMed/NCBI
5	Chang YC, Nagasue N, Kohno H, Taniura H, Uchida M, Yamanoi A, Kimoto T and Nakamura T: Clinicopathologic features and long-term results of alpha-fetoprotein-producing gastric cancer. Am J Gastroenterol. 85:1480–1485. 1990.PubMed/NCBI
6	Chun H and Kwon SJ: Clinicopathological characteristics of alpha-fetoprotein-producing gastric cancer. J Gastric Cancer. 11:23–30. 2011. View Article : Google Scholar : PubMed/NCBI
7	Liu X, Cheng Y, Sheng W, Lu H, Xu Y, Long Z, Zhu H and Wang Y: Clinicopathologic features and prognostic factors in alpha-fetoprotein-producing gastric cancers: Analysis of 104 cases. J Surg Oncol. 102:249–255. 2010. View Article : Google Scholar : PubMed/NCBI
8	McIntire KR, Waldmann TA, Moertel CG and Go VL: Serum alpha-fetoprotein in patients with neoplasms of the gastrointestinal tract. Cancer Res. 35:991–996. 1975.PubMed/NCBI
9	Lauren P: The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 64:31–49. 1965.PubMed/NCBI
10	National Cancer Institute: Common Terminology Criteria for Adverse Events v3.0 (CTCAE). http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdfAccessed. June 16–2014
11	Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC and Gwyther SG: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 92:205–216. 2000. View Article : Google Scholar : PubMed/NCBI
12	Koneri K, Hirono Y, Fujimoto D, Sawai K, Morikawa M, Murakami M, Goi T, Iida A, Katayama K and Yamaguchi A: Five-year survival of alpha-fetoprotein producing gastric cancer with synchronous liver metastasis: A case report. J Gastric Cancer. 13:58–64. 2013. View Article : Google Scholar : PubMed/NCBI
13	Lew DH, Jung WT, Kim HJ, Min HJ, Ha CY, Kim HJ, Kim TH and Ko GH: Clinicopathological characteristics and prognosis of alpha-fetoprotein producing gastric cancer. Korean J Gastroenterol. 62:327–335. 2013.(In Korean). View Article : Google Scholar : PubMed/NCBI
14	Yamaguchi K, Tada M, Horikoshi N, Otani T, Takiuchi H, Saitoh S, Kanamaru R, Kasai Y, Koizumi W, Sakata Y, et al: Phase II study of paclitaxel with 3-h infusion in patients with advanced gastric cancer. Gastric Cancer. 5:90–95. 2002. View Article : Google Scholar : PubMed/NCBI
15	Emi Y, Yamamoto M, Takahashi I, Orita H, Kakeji Y, Kohnoe S and Maehara Y: Phase II study of weekly paclitaxel by one-hour infusion for advanced gastric cancer. Surg Today. 38:1013–1020. 2008. View Article : Google Scholar : PubMed/NCBI
16	Narahara H, Iishi H, Imamura H, Tsuburaya A, Chin K, Imamoto H, Esaki T, Furukawa H, Hamada C and Sakata Y: Randomized phase III study comparing the efficacy and safety of irinotecan plus S-1 with S-1 alone as first-line treatment for advanced gastric cancer (study GC0301/TOP-002). Gastric Cancer. 14:72–80. 2011. View Article : Google Scholar : PubMed/NCBI
17	Ajani JA, Rodriguez W, Bodoky G, Moiseyenko V, Lichinitser M, Gorbunova V, Vynnychenko I, Garin A, Lang I and Falcon S: Multicenter phase III comparison of cisplatin/S-1 with cisplatin/infusional fluorouracil in advanced gastric or gastroesophageal adenocarcinoma study: The FLAGS trial. J Clin Oncol. 28:1547–1553. 2010. View Article : Google Scholar : PubMed/NCBI
18	Fukuda K, Ito S, Shimizu K, Mikami E, Sakuraba S, Shiroki T, Ikehata A, Murakami A, Ono S, Sakuma T and Kato S: Retrospective analysis concerning AFP-producing gastric cancer. Gan To Kagaku Ryoho. 40:191–195. 2013.(In Japanese). PubMed/NCBI
19	Shiochi H, Yamada M, Kishina M, Murawaki Y, Miura M, Azumi T, Yuuki T, Tanaka S, Kono M, Yoshimura T, et al: A case of AFP-producing gastric cancer responding to the combination of systemic chemotherapy, transcatheter arterial embolization and hepatic infusion chemotherapy. Gan To Kagaku Ryoho. 36:843–846. 2009.(In Japanese). PubMed/NCBI
20	Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, et al: Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 359:378–390. 2008. View Article : Google Scholar : PubMed/NCBI
21	Cheng AL, Kang YK, Chen Z, Tsao CJ, Qin S, Kim JS, Luo R, Feng J, Ye S, Yang TS, et al: Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: A phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 10:25–34. 2009. View Article : Google Scholar : PubMed/NCBI
22	Cheng AL, Guan Z, Chen Z, Tsao CJ, Qin S, Kim JS, Yang TS, Tak WY, Pan H, Yu S, et al: Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma according to baseline status: Subset analyses of the phase III Sorafenib Asia-Pacific trial. Eur J Cancer. 48:1452–1465. 2012. View Article : Google Scholar : PubMed/NCBI
23	Kim C, Lee JL, Choi YH, Kang BW, Ryu MH, Chang HM, Kim TW and Kang YK: Phase I dose-finding study of sorafenib in combination with capecitabine and cisplatin as a first-line treatment in patients with advanced gastric cancer. Invest New Drugs. 30:306–315. 2012. View Article : Google Scholar : PubMed/NCBI