Pathologic complete response after Sintilimab combined with FOLFOX therapy in MSI-H type patients with locally advanced GC: a case report

As one of the most common gastrointestinal tumors, Gastric Cancer (GC) poses a serious threat to human health due to its high morbidity and mortality. The current treatment strategy is a comprehensive treatment program mainly based on surgery, especially for advanced GC patients. The emergence of im...

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Main Authors: Xiaoke Wang, Yuanhui Gu, Lin Yi, Tao Wu, Ling Wang, Jiao Tian, Yuyuan Lu, Penghui Jin, Xin Yang, Yan Yang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1560450/full
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author Xiaoke Wang
Xiaoke Wang
Yuanhui Gu
Lin Yi
Tao Wu
Tao Wu
Ling Wang
Jiao Tian
Yuyuan Lu
Penghui Jin
Xin Yang
Yan Yang
author_facet Xiaoke Wang
Xiaoke Wang
Yuanhui Gu
Lin Yi
Tao Wu
Tao Wu
Ling Wang
Jiao Tian
Yuyuan Lu
Penghui Jin
Xin Yang
Yan Yang
author_sort Xiaoke Wang
collection DOAJ
description As one of the most common gastrointestinal tumors, Gastric Cancer (GC) poses a serious threat to human health due to its high morbidity and mortality. The current treatment strategy is a comprehensive treatment program mainly based on surgery, especially for advanced GC patients. The emergence of immune checkpoint inhibitors has completely changed this status quo, and the synergistic effect of neoadjuvant immunotherapy combined with chemotherapy has significantly improved the resection and radical rate and overall survival of patients with advanced local GC. We present a case of locally advanced GC (cT4N0Mx) with microsatellite instability high (MSI-H) and PD-L1 Combined Positive Score (CPS)=2. The patient received neoadjuvant therapy with Sintilimab combined with FOLFOX (folinic acid (leucovorin), 5-fluorouracil (5-FU), and oxaliplatin), and significantly reduced tumor volume after 3 cycles of treatment. Then she underwent subtotal gastrectomy with gastrojejunostomy and D2 lymph node dissection. The postoperative pathological results showed that no cancerous tissue remained in the tumor tissue, and pathologic complete response (pCR) was achieved. The first cycle of adjuvant therapy with the same protocol was received after surgery. During adjuvant therapy, patients mainly experienced side effects such as dyspepsia, nausea and mild myelosuppression. Therefore, immunotherapy with Sintilimab combined with FOLFOX chemotherapy has the potential to be an effective treatment option for patients with resectable locally advanced MSI-H GC.
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publisher Frontiers Media S.A.
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spelling doaj-art-9cdbd15f90944b8b9ec5010e7a5d0d932025-08-20T02:16:17ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15604501560450Pathologic complete response after Sintilimab combined with FOLFOX therapy in MSI-H type patients with locally advanced GC: a case reportXiaoke Wang0Xiaoke Wang1Yuanhui Gu2Lin Yi3Tao Wu4Tao Wu5Ling Wang6Jiao Tian7Yuyuan Lu8Penghui Jin9Xin Yang10Yan Yang11Department of General Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaFirst School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of General Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, ChinaDepartment of General Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, ChinaPathology Department, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, ChinaSchool of Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, ChinaFirst School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, Gansu, ChinaFirst School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, Gansu, ChinaPharmacy Department, Gansu Provincial Hospital, Lanzhou, Gansu, ChinaAs one of the most common gastrointestinal tumors, Gastric Cancer (GC) poses a serious threat to human health due to its high morbidity and mortality. The current treatment strategy is a comprehensive treatment program mainly based on surgery, especially for advanced GC patients. The emergence of immune checkpoint inhibitors has completely changed this status quo, and the synergistic effect of neoadjuvant immunotherapy combined with chemotherapy has significantly improved the resection and radical rate and overall survival of patients with advanced local GC. We present a case of locally advanced GC (cT4N0Mx) with microsatellite instability high (MSI-H) and PD-L1 Combined Positive Score (CPS)=2. The patient received neoadjuvant therapy with Sintilimab combined with FOLFOX (folinic acid (leucovorin), 5-fluorouracil (5-FU), and oxaliplatin), and significantly reduced tumor volume after 3 cycles of treatment. Then she underwent subtotal gastrectomy with gastrojejunostomy and D2 lymph node dissection. The postoperative pathological results showed that no cancerous tissue remained in the tumor tissue, and pathologic complete response (pCR) was achieved. The first cycle of adjuvant therapy with the same protocol was received after surgery. During adjuvant therapy, patients mainly experienced side effects such as dyspepsia, nausea and mild myelosuppression. Therefore, immunotherapy with Sintilimab combined with FOLFOX chemotherapy has the potential to be an effective treatment option for patients with resectable locally advanced MSI-H GC.https://www.frontiersin.org/articles/10.3389/fonc.2025.1560450/fulladvanced gastric cancerMSI-HPCRimmunotherapycase report
spellingShingle Xiaoke Wang
Xiaoke Wang
Yuanhui Gu
Lin Yi
Tao Wu
Tao Wu
Ling Wang
Jiao Tian
Yuyuan Lu
Penghui Jin
Xin Yang
Yan Yang
Pathologic complete response after Sintilimab combined with FOLFOX therapy in MSI-H type patients with locally advanced GC: a case report
Frontiers in Oncology
advanced gastric cancer
MSI-H
PCR
immunotherapy
case report
title Pathologic complete response after Sintilimab combined with FOLFOX therapy in MSI-H type patients with locally advanced GC: a case report
title_full Pathologic complete response after Sintilimab combined with FOLFOX therapy in MSI-H type patients with locally advanced GC: a case report
title_fullStr Pathologic complete response after Sintilimab combined with FOLFOX therapy in MSI-H type patients with locally advanced GC: a case report
title_full_unstemmed Pathologic complete response after Sintilimab combined with FOLFOX therapy in MSI-H type patients with locally advanced GC: a case report
title_short Pathologic complete response after Sintilimab combined with FOLFOX therapy in MSI-H type patients with locally advanced GC: a case report
title_sort pathologic complete response after sintilimab combined with folfox therapy in msi h type patients with locally advanced gc a case report
topic advanced gastric cancer
MSI-H
PCR
immunotherapy
case report
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1560450/full
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