[A Case of Advanced Gastric Cancer That Had Been Completely Cured by Single Dose of wPTX plus RAM]

A 72-year-old man was diagnosed with advanced gastric cancer with severe gastric stenosis, lymph node metastasis, and portal vein invasion. He underwent ileo-gastrostomy, then received chemotherapy using 4 cycles of S-1 and 2 cycles of SOX. The response to this therapy was judged PD; thus, second-line therapy of wPTX + RAM was introduced, although icterus and ascites were recognized then. After a single injection of wPTX + RAM, G4 neutropenia, anorexia, and severe ascites were observed. Thus, the chemotherapy was discontinued. At that point, he had been diagnosed with severe liver cirrhosis, and internal treatment was introduced. Six weeks after the last injection of anti-cancer drugs, CT revealed tumor shrinkage and highly reduced serum CEA, although ascites increased. Subsequently, ascites and general condition gradually recovered without anti-cancer therapy. One year after the last injection of anti-cancer drugs, the primary tumor, lymph node metastasis, and portal vein invasion were not observed on CT and endoscopy, and the patient was judged cCR. This rare case demonstrated prolonged effect of wPTX + RAM that caused the depression of liver metabolism. Therefore, anti-cancer immune response has been induced by an unknown mechanism.