Successful treatment of late stage esophageal cancer with gastrointestinal complications with chemotherapy combined with targeted therapy and autologous immunity

This is an automatically translated article.

The article was written by MSc. Quach Thanh Dung, Internal Oncologist, Radiation Oncology Center - Vinmec Times City International Hospital.
Vinmec Times City is one of the first medical facilities in Vietnam to offer the treatment regimen Ramucirumab combined with Paclitaxel for patients with gastric adenocarcinoma/esophagogastric junction. Initial results give good response, few side effects, suitable for elderly patients, poor health, have failed with other chemotherapy regimens.

1. Treatment of esophageal cancer patients at Vinmec

In May 2019, a 66-year-old patient who vomited a lot of blood, had black stools, was given emergency treatment at a grassroots hospital and received 4 emergency blood transfusions and was diagnosed with esophageal cancer.
In June 2019, the patient was admitted to Vinmec Hospital because of the second gastrointestinal bleeding and was diagnosed with liver metastases of the esophagus-stomach junction. Anatomical results showed that this is adenocarcinoma, Her2 negative, MSI stable. He was very tired, anemic, had pain all over his abdomen, and had lost nearly 10kg. At the same time, the patient also discovered cancerous sigmoid colon polyp, so the colon polyp was removed and treated with chemotherapy regimen XELOX 2 times.
However, the patient continued to have 3rd gastrointestinal bleeding and was assessed for a poor response to treatment. The doctors consulted to change the treatment regimen (using Paclitaxel, Ramucirumab) combining autologous immunotherapy
Ramucirumab with the brand name Cyramza of Lilly Pharmaceuticals, an IgG1 monoclonal receptor antagonist. in humans, is designed to bind to the extracellular domain of VEGFR-2, thereby preventing the binding of many VEGF ligands and inhibiting receptor activation.

Ramucirumab is approved by the US FDA, European Medical Association and other regulatory agencies for the treatment of adenocarcinoma of the stomach/gastro-oesophageal junction that has failed chemotherapy regimens. earlier (research Rainbow).
Ramucirumab in combination with paclitaxel is the preferred choice of many doctors worldwide for patients with metastatic gastric/gastroesophageal cancer who have failed prior treatment (chemotherapy with platinum- and Fluoropyrimidine or trastuzumab in combination with Cisplatin, 5-fluorouracil, Capecitabine...). The regimen is easy to implement, has few side effects and is highly effective.
Autologous immune system booster therapy is a method of using NK cells, T lymphocytes extracted from blood, cultured and activated to enhance the ability to fight cancer cells, then retransfused. for the patient. This biological therapy, when combined with traditional treatments, increases the ability to kill cancer cells, helping patients respond better to treatment.
This method is indicated to apply to many common types of cancer today such as lung, stomach, liver, bile, pancreas, esophagus, colon, cervix, ovary, breast, brain, and solid tumors. head and neck, melanoma in complex stages (III, IV, metastatic recurrence, patients in palliative care) or after the end of treatment.

After 9 cycles of combined chemotherapy, targeted therapy with monoclonal antibodies, 4 times of autologous immune infusion, the patient gained 6 kg, his health improved markedly, no recurrence of gastrointestinal bleeding , no more abdominal pain, especially optimistic spirit.
The most recent test results show: Cancer marker CA19-9: 24 decreased (compared to before treatment was 251). Whole body PET/CT scan: Esophageal tumors, paragastric lymph nodes, liver metastases were greatly reduced in number, size and FDG metabolism.

2. New applications in cancer treatment at Vinmec

Esophageal cancer is a type of cancer with a poor prognosis, especially in cases of late detection, complications such as perforation, gastrointestinal bleeding or distant metastases such as liver and lung metastases, etc. like this case. At that time, the treatment is extremely difficult, the treatment effectiveness is often low. However, when applying a multimodality regimen and receiving care at Vinmec Hospital, the patient recovered and made very positive progress.
Always pioneer in the application of advances in science and technology, applying many advanced methods in the treatment of multi-modality of cancer such as surgery, chemotherapy, radiation therapy, thermotherapy, immunotherapy. autologous translation, drug immunity. Vinmec Times City International Hospital is one of the first medical facilities in Vietnam to offer the treatment regimen Ramucirumab combined with Paclitaxel for patients with gastric adenocarcinoma/esophagogastric junction. Initial results give good response, few side effects, suitable for elderly patients, poor physical condition, have failed with other chemotherapy regimens.

Customers can directly go to Vinmec Health system nationwide to visit or contact the hotline here for support.
Reference source: Pubmed
SEE ALSO:
Can metastatic cancer use autologous immunotherapy? Which cancer can use autologous immune system therapy? Combination of autologous immunotherapy, thermotherapy in cancer treatment