David Zhen, MD, reviews the profile of a 60-year-old man with stage IV gastric adenocarcinoma and offers his initial impressions on the case.
Case: A 60-Year-Old Man with Stage IV Gastric Adenocarcinoma
Clinical Presentation:
Initial Clinical Workup and Diagnosis:
Current Treatments:
This is a video synopsis/summary of a Case-Based Peer Perspectives series featuring David Zhen, MD.
Zhen presents a case of a 60-year-old man with stage VI gastric adenocarcinoma. The patient experienced a 10-lb weight loss, dyspepsia, bloating after meals, and loss of appetite over the past 3 months. His medical history includes being overweight and having hypertension, and his father died of gastric cancer at age 50. Esophagogastroduodenoscopy revealed a 2-cm protruding mass in the stomach body, and biopsy confirmed poorly differentiated adenocarcinoma. CT and PET scans showed metastatic disease, including lung lesions. Molecular testing indicated the tumor was HER2/neu negative, mismatch repair proficient, and microsatellite stable. The patient was initiated on treatment with leucovorin, fluorouracil, oxaliplatin, and nivolumab. Zhen emphasizes the importance of maintaining patient nutrition, conducting molecular testing, and referring the patient to medical genetics due to the family history of gastric cancer. The treatment decision is based on the CheckMate649 trial, which demonstrated a survival benefit with the addition of nivolumab to standard chemotherapy in patients with a PD-L1 CPS equal to or greater than 5%.
Video synopsis is AI-generated and reviewed by Targeted Oncology™ editorial staff.
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