Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5420
Peer-review started: September 19, 2021
First decision: December 10, 2021
Revised: December 19, 2021
Accepted: April 22, 2022
Article in press: April 22, 2022
Published online: June 6, 2022
Processing time: 255 Days and 21.5 Hours
Gastric hepatoid adenocarcinoma (GHA) is a rare and aggressive cancer that is characterized by foci with features of both hepatocellular differentiation and adenomatous differentiation. However, there is currently no standard treatment for this disease, which has a poor prognosis.
A 72-year-old male with a body mass index of 20.9 was diagnosed with GHA with perigastric lymph node and liver metastasis. He underwent first-line chemotherapy but that failed. Pembrolizumab and bevacizumab with chemotherapy were used in the second-line treatment. The progression-free survival and overall survival were 14 mo and 16 mo, respectively, after treatment. In addition, the main adverse reaction was tolerable. The patient did not die of tumor progression.
The combination of pembrolizumab and bevacizumab with chemotherapy is an effective and safe regimen for GHA and may be recommended as a new choice for GHA treatment. Further studies should evaluate this treatment in a larger cohort or a randomized controlled trial.
Core Tip: We report a rare case of gastric hepatoid adenocarcinoma in a patient who underwent general chemotherapy that failed. However, pembrolizumab and bevacizumab combination chemotherapy was successful. The overall survival was 16 mo, and the main adverse reaction was tolerable. The patient died of intestinal infection rather than tumor progression.