作者: Tomita, Naohiro ; Shinno, Naoki ; Shimizu, Junzo ; Imamura, Hiroshi ; Okuda, Tadahiro ; Suzuki, Yozo ; Hagihara, Kiyotaka ; Noma, Toshiki ; Matsushita, Katsunori ; Kawase, Tomono

A 52‒year‒old female with gastric cancer revealed by a medical examination. The patient was diagnosed with T4b(pancreas)N2M0, CY0P0, cStage ⅣA, and after 3 courses of docetaxel+oxaliplatin+S‒1(DOS)therapy as preoperative chemotherapy, laparoscopic distal gastrectomy with D2 lymph node dissection and Roux‒en‒Y reconstruction were performed. Pathological histological examination showed ypT3(SS)N2M1(CY+), Stage Ⅳ, HER2(-), and S‒1+oxaliplatin(SOX)therapy was initiated as first‒line treatment. Tumor markers elevated and CT scan showed ascites after 5 courses and the treatment was consequently changed to paclitaxel+ramucirumab(PTX+Ram)therapy as second‒line treatment. CT scan showed para‒aortic lymph node enlarged and increased ascites after 2 courses, MSI‒High was identified at the same time and the treatment was consequently changed to pembrolizumab(Pem)monotherapy(200 mg/body, q21 days)as third‒line treatment. CT scan showed partial response(PR)after 3 courses, and subsequently resulted in a complete response(CR). After 36 courses of Pem monotherapy, the chemotherapy was terminated at the patient's request. Four years after the initial onset, the patient is currently alive without recurrence. No serious adverse events have occurred since the start of Pem monotherapy.

2026-02-01·Gan to kagaku ryoho. Cancer & chemotherapy

[Long‒Term Complete Response after Salvage Radiotherapy with Nivolumab Following Mediastinoscopic Esophagectomy in a High‒Risk Elderly Patient with Advanced Esophageal Cancer].

Article

作者: Matsumoto, Yoshihisa ; Otsuji, Eigo ; Matsuo, Hisataka ; Shiozaki, Atsushi ; Kuriu, Yoshiaki ; Ikoma, Hisashi ; Ito, Shun ; Takeda, Ryo ; Komatsu, Shuhei ; Fujita, Yuji ; Okamoto, Kazuma ; Ogawa, Soichiro ; Konishi, Tomoki

Neoadjuvant chemotherapy followed by radical esophagectomy is the standard treatment for advanced esophageal cancer in Japanese treatment guideline. However, in elderly patients with dysphagia and impaired organ function, preoperative chemotherapy may worsen their condition. We report here a case of a 79‒year‒old malnourished man with advanced esophageal squamous cell carcinoma and EGJ adenocarcinoma presenting with severe dysphagia. Given his age, frailty, and high‒risk of systemic decline, initial mediastinoscopic esophagectomy was selected over neoadjuvant therapy. Pathology showed a positive radial margin and PD‒L1 expression, prompting postoperative local salvage radiotherapy(40 Gy/20 fr)with nivolumab(480 mg/4 weeks). After 4 cycles, nivolumab was discontinued due to immune‒related pneumonitis, and S‒1 chemotherapy was initiated. Nearly 2 years postoperatively, the patient remains recurrence‒free. This case demonstrates the feasibility of a personalized, minimally invasive treatment strategy with tailored adjuvant therapy in high‒risk elderly patients.

2026-02-01·Journal of Hepato-Biliary-Pancreatic Sciences

Neoadjuvant Chemotherapy With Gemcitabine/Cisplatin/S‐1 for Resectable Biliary Tract Cancer With FDG ‐ PET ‐Positive Lymph Node Metastasis ( KHBO1201 ): A Multicenter Phase II Trial

Article

作者: Seo, Satoru ; Ogiso, Satoshi ; Hatano, Etsuro ; Wada, Hiroshi ; Kobayashi, Shogo ; Eguchi, Hidetoshi ; Ioka, Tatsuya ; Nagano, Hiroaki ; Higashi, Tatsuya ; Kanai, Masashi

ABSTRACT:

Purpose:

To evaluate the safety and efficacy of neoadjuvant gemcitabine, cisplatin, and S‐1 (GCS) chemotherapy for resectable biliary tract cancer (BTC) and FDG‐PET‐positive lymph nodes in a multicenter phase II study (KHBO1201).

Methods:

Patients with resectable BTC (intrahepatic/extrahepatic bile duct, gallbladder, or ampullary cancers) and FDG‐PET‐positive lymph nodes received GCS chemotherapy: gemcitabine/cisplatin on Day 1 and oral S‐1 for 7 days, repeated every 2 weeks for 3–6 cycles. Surgery was planned 4–8 weeks later if the tumor was deemed resectable. The primary endpoint was the curative resection rate. Secondary endpoints were the completion rate, radiological response, radiological/pathological complete response (CR) of FDG‐PET‐positive lymph nodes, and 1‐year survival (UMIN000009831).

Results:

Twenty‐five patients were enrolled. Twenty‐three (92%) completed GCS without treatment‐related deaths; grade 3 biliary infection occurred in 8.0%. Curative resection was achieved in 60% with a morbidity rate of 40%. The radiological response rate was 13%, and the radiological and pathological CR rates of FDG‐PET‐positive lymph nodes were 24% and 28%, respectively. The 1‐year survival rate was 75%.

Conclusions:

Neoadjuvant GCS chemotherapy is safe, feasible, and potentially effective for resectable BTC with FDG‐PET‐positive lymph nodes. A randomized phase III trial (JCOG1920) is underway to compare neoadjuvant GCS chemotherapy with upfront surgery (jRCTs031200388).

100 项与 (S)-1(Duquesne University) 相关的药物交易

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