Gairong Zhang1, Li Lin2, Dapeng Dong1, Hui Qiu1, Tao Liu1, Li Lian1, Ge Shen1,3. 1. Department of Oncology, Beijing Huian Hospital of Integrated TCM and Western Medicine. 2. Department of Oncology, Peking University International Hospital, the 8th Clinical Medical College. 3. Department of Oncology, Beijing Fengtai You'anmen Hospital, Beijing, China.
Abstract
INTRODUCTION: Small bowel adenocarcinomas (SBAs) are rare cancers that have a distinct clinical characteristic and genetic profile. The only potentially curative treatment for localized SBAs is surgery, and treatment options are limited for patients in the advanced stage of disease. PATIENT CONCERNS: A 39-year-old woman presented in October 2015 with a complaint of persistent vomiting for 8 months. DIAGNOSIS: The patient had obstruction caused by a 3 × 2 cm mass at the ascending part of the duodenum and suspected metastasis in the right adnexal region. Postoperative pathology showed a moderately differentiated adenocarcinoma with serosal invasion. The diagnosis was stage IV duodenum adenocarcinoma with right adnexal metastasis. INTERVENTIONS: After the failure of multi-line treatment with chemotherapy and targeted therapy, she was treated with the immune checkpoint inhibitor nivolumab plus regorafenib. OUTCOMES: Disease control lasted for 15 months with markedly improved symptoms. CONCLUSION: To the best of our knowledge, this is the first case of small bowel adenocarcinoma that has been treated with nivolumab combined with regorafenib. This case highlights the potential efficacy of combining nivolumab and regorafenib in the treatment of SBAs.
INTRODUCTION: Small bowel adenocarcinomas (SBAs) are rare cancers that have a distinct clinical characteristic and genetic profile. The only potentially curative treatment for localized SBAs is surgery, and treatment options are limited for patients in the advanced stage of disease. PATIENT CONCERNS: A 39-year-old woman presented in October 2015 with a complaint of persistent vomiting for 8 months. DIAGNOSIS: The patient had obstruction caused by a 3 × 2 cm mass at the ascending part of the duodenum and suspected metastasis in the right adnexal region. Postoperative pathology showed a moderately differentiated adenocarcinoma with serosal invasion. The diagnosis was stage IV duodenum adenocarcinoma with right adnexal metastasis. INTERVENTIONS: After the failure of multi-line treatment with chemotherapy and targeted therapy, she was treated with the immune checkpoint inhibitor nivolumab plus regorafenib. OUTCOMES: Disease control lasted for 15 months with markedly improved symptoms. CONCLUSION: To the best of our knowledge, this is the first case of small bowel adenocarcinoma that has been treated with nivolumab combined with regorafenib. This case highlights the potential efficacy of combining nivolumab and regorafenib in the treatment of SBAs.
Authors: Dung T Le; Jennifer N Uram; Hao Wang; Bjarne R Bartlett; Holly Kemberling; Aleksandra D Eyring; Andrew D Skora; Brandon S Luber; Nilofer S Azad; Dan Laheru; Barbara Biedrzycki; Ross C Donehower; Atif Zaheer; George A Fisher; Todd S Crocenzi; James J Lee; Steven M Duffy; Richard M Goldberg; Albert de la Chapelle; Minori Koshiji; Feriyl Bhaijee; Thomas Huebner; Ralph H Hruban; Laura D Wood; Nathan Cuka; Drew M Pardoll; Nickolas Papadopoulos; Kenneth W Kinzler; Shibin Zhou; Toby C Cornish; Janis M Taube; Robert A Anders; James R Eshleman; Bert Vogelstein; Luis A Diaz Journal: N Engl J Med Date: 2015-05-30 Impact factor: 91.245
Authors: D Santini; M E Fratto; C Spoto; A Russo; S Galluzzo; A Zoccoli; B Vincenzi; G Tonini Journal: Br J Cancer Date: 2010-09-14 Impact factor: 7.640
Authors: Axel Grothey; Eric Van Cutsem; Alberto Sobrero; Salvatore Siena; Alfredo Falcone; Marc Ychou; Yves Humblet; Olivier Bouché; Laurent Mineur; Carlo Barone; Antoine Adenis; Josep Tabernero; Takayuki Yoshino; Heinz-Josef Lenz; Richard M Goldberg; Daniel J Sargent; Frank Cihon; Lisa Cupit; Andrea Wagner; Dirk Laurent Journal: Lancet Date: 2012-11-22 Impact factor: 79.321
Authors: Alexa B Schrock; Craig E Devoe; Robert McWilliams; James Sun; Thomas Aparicio; Philip J Stephens; Jeffrey S Ross; Richard Wilson; Vincent A Miller; Siraj M Ali; Michael J Overman Journal: JAMA Oncol Date: 2017-11-01 Impact factor: 31.777
Authors: Jolien Bruls; Michiel Simons; Lucy I Overbeek; Johan Bulten; Leon F Massuger; Iris D Nagtegaal Journal: Virchows Arch Date: 2015-04-19 Impact factor: 4.064
Authors: Ondřej Kubeček; Jan Laco; Jiří Špaček; Jiří Petera; Jindřich Kopecký; Alena Kubečková; Stanislav Filip Journal: Clin Exp Metastasis Date: 2017-07-20 Impact factor: 5.150