Zhang XL, Zhang JY, Xie L, Li H, Wang L. Advanced gastric small cell carcinoma with immunotherapy-based treatment: A case report. World J Gastrointest Oncol 2025; 17(12): 114390 [DOI: 10.4251/wjgo.v17.i12.114390]
Corresponding Author of This Article
Hui Li, MD, Doctor, Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, Nanjing 210029, Jiangsu Province, China. lihui19830401@163.com
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Gastroenterology & Hepatology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 15, 2025 (publication date) through Dec 14, 2025
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World Journal of Gastrointestinal Oncology
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1948-5204
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhang XL, Zhang JY, Xie L, Li H, Wang L. Advanced gastric small cell carcinoma with immunotherapy-based treatment: A case report. World J Gastrointest Oncol 2025; 17(12): 114390 [DOI: 10.4251/wjgo.v17.i12.114390]
World J Gastrointest Oncol. Dec 15, 2025; 17(12): 114390 Published online Dec 15, 2025. doi: 10.4251/wjgo.v17.i12.114390
Advanced gastric small cell carcinoma with immunotherapy-based treatment: A case report
Xiao-Long Zhang, Jing-Yan Zhang, Ling Xie, Hui Li, Li Wang
Xiao-Long Zhang, Digestive Endoscopy Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Jing-Yan Zhang, Li Wang, Department of Oncology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Ling Xie, Hui Li, Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Co-first authors: Xiao-Long Zhang and Jing-Yan Zhang.
Co-corresponding authors: Hui Li and Li Wang.
Author contributions: Li H designed and wrote the case report and performed the literature search; Zhang XL and Xie L assisted in the literature search and wrote the paper; Wang L and Zhang JY participated in the data acquisition.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Li, MD, Doctor, Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, No. 155 Hanzhong Road, Nanjing 210029, Jiangsu Province, China. lihui19830401@163.com
Received: September 19, 2025 Revised: October 23, 2025 Accepted: November 13, 2025 Published online: December 15, 2025 Processing time: 84 Days and 0.9 Hours
Abstract
BACKGROUND
The clinical and pathological characteristics of primary gastric small cell carcinoma (GSCC) resemble those of small cell lung cancer, which is less sensitive to chemotherapy and has a poor prognosis. Currently, platinum-etoposide chemotherapy is a primary chemotherapy regimen for small cell carcinoma, but it is still imperfect. Programmed cell death ligand 1 (PD-L1) inhibitors are recommended for the treatment of small cell lung cancer. However, to determine whether PD-L1 inhibitors are optimal for metastatic GSCC requires more clinical data.
CASE SUMMARY
A 67-year-old male experienced upper abdominal pain without any obvious cause for 1 week. Gastroscopy examination revealed a mass in the gastric body. Pathological examination of the biopsy specimen combined with immunohistochemistry showed a high-grade neuroendocrine carcinoma (small cell carcinoma). Genetic tests showed TP53, CREBBP, RB1, ABCB1, DNMT3A, and HGF gene mutations. Computed tomography (neck + chest + abdomen) showed multiple enlarged lymph nodes, occupying space in the greater curvature of the stomach and intrahepatic metastases. A regimen consisting of cisplatin and etoposide combined with durvalumab was administered every three weeks as palliative chemotherapy, for seven cycles. Durvalumab was then maintained every three weeks. However, the tumor recurred two months after the completion of chemotherapy. A regimen consisting of carboplatin and irinotecan combined with durvalumab was then given every three weeks. The tumor in the gastric body and liver shrank significantly, and the patient did not report any specific discomfort.
CONCLUSION
GSCC is a highly malignant tumor with a poor prognosis. Whether immune-related drugs are optimal for metastatic GSCC requires further exploration.
Core Tip: The clinical and pathological characteristics of primary gastric small cell carcinoma (GSCC) resemble those of small cell lung cancer, but it is less sensitive to chemotherapy and has a poor prognosis. Here we report a case of a 67-year-old man who was found to have a primary stage IV GSCC with metastasis to the liver. The patient was treated with chemotherapy combined with a programmed cell death ligand 1 (PD-L1) inhibitor. Whether PD-L1 inhibitors are optimal for metastatic GSCC requires further exploration.
