Successful treatment of advanced gastric cancer through multimodality and personalized medicine

Associate Professor, Doctor, Doctor Vo Duy Long, Deputy Head of the Department of Digestive Surgery, University of Medicine and Pharmacy Hospital, Ho Chi Minh City, is examining a patient.

The patient was admitted to the hospital with persistent abdominal pain, poor appetite, vomiting after meals and a weight loss of 9 kg within 2-3 months. Previously, he was diagnosed with gastritis at another medical facility.

Through endoscopy and biopsy at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, doctors determined that the patient had diffuse gastric cancer (linitis plastica), the tumor had invaded the pancreas, transverse colon mesentery and peritoneal metastasis. This is a rare case because gastric cancer usually occurs in people over 60 years old.

Right from the time of admission, the multidisciplinary team including the Department of Gastroenterology, Cancer Chemotherapy, Pathology, Diagnostic Imaging, etc. conducted a consultation and developed a multimodal treatment regimen based on the molecular biology of the tumor. Test results showed that the tumor expressed the PD-L1 receptor, so the patient was prescribed a combination of immunotherapy and systemic chemotherapy from the beginning.

After 6 treatment sessions lasting more than 4 months, the metastases reduced by 90% in size, the main tumor shrank significantly. The patient gained 10kg, his health improved significantly and he was eligible for surgery. The team performed a total gastrectomy, D2 lymph node dissection, and biopsies of the metastatic sites. The surgery went smoothly, the patient recovered quickly and was discharged after 7 days.

Post-operative pathology results showed a near-complete response, with only about 10% of malignant cells remaining in the primary tumor and no cancer cells remaining in the metastatic sites. The patient continues to be monitored by testing for gene mutations and circulating cancer DNA in the blood, and maintenance immunotherapy is considered to prevent recurrence.

Associate Professor, Doctor, Doctor Vo Duy Long, Deputy Head of the Department of Digestive Surgery, said: “The success of this case demonstrates the effectiveness of multi-modal treatment and personalized medicine in advanced gastric cancer. The key lies in interdisciplinary coordination, accurate diagnosis at the cellular and molecular level and the development of a treatment regimen appropriate for each patient.”

Since 2018, Ho Chi Minh City University of Medicine and Pharmacy Hospital has provided multimodal treatment to more than 100 patients with advanced gastric cancer. The response rate has reached more than 50%, which is considered “spectacular” compared to before – when metastatic gastric cancer was almost synonymous with incurability. These results were published in the European Journal of Surgical Oncology in early 2025.

THANH SON

Source: https://www.sggp.org.vn/dieu-tri-thanh-cong-ung-thu-da-day-tien-xa-nho-da-mo-thuc-va-y-hoc-ca-the-hoa-post804827.html