Overview
The regimen of Albumin paclitaxel+SOX+BEV neoadjuvant therapy lasted for 6 cycles, during which PD-1 monoclonal antibody therapy was interspersed for 4 cycles for locally advanced diffuse gastric cancer.
Description
The biweekly regimen of Albumin paclitaxel+SOX+BEV neoadjuvant therapy lasted for 6 cycles, during which PD-1 monoclonal antibody therapy was interspersed for 4 cycles. Review CT and gastroscopy every 3 cycles to evaluate the therapeutic effect. Patients who have been evaluated as effective after 6 cycles of treatment may consider surgery; Or continue the dual cycle regimen ofAlbumin paclitaxel+Bevacizumab for 3 cycles, while PD-1 monoclonal antibody for 2 cycles. Afterwards, the therapeutic effect will be evaluated, and surgery, radiotherapy, or maintenance medication treatment will be determined based on the therapeutic effect. Surgical patients begin adjuvant treatment 1-2 months after surgery based on the curative and pathological results of the surgery. Those who fail to evaluate during neoadjuvant therapy will undergo surgery or radiation therapy, or switch to a second-line systemic treatment plan.
Eligibility
Inclusion Criteria:
- Local advanced diffuse or mixed type gastric cancer detected by pathology and endoscopy;
- Chest, abdomen, and pelvis enhanced CT, neck and supraclavicular ultrasound, gastroscopy, and endoscopic ultrasound were used to diagnose T3-4NanyM0 gastric cancer or gastroesophageal junction cancer (refer to AJCC staging, 8th edition);
- Has not received any anti-tumor treatment for gastric cancer yet;
- Age range from 18 to 75 years old;
- ECOG score 0-1 points;
- Liver and kidney function and blood routine meet the following conditions:
Neutrophils>1.5G/L, Hb>90g/L, PLT>100G/L; ALT and AST<2.5ULN; TBIL<1.5 ULN; Cr<1.0ULN;
- Left ventricular ejection fraction>60%;
- Good compliance and ability to accept long-term follow-up;
- Sign informed consent.
Exclusion Criteria:
- Gastrointestinal obstruction or recurrent bleeding cannot be controlled;
- Those who cannot swallow pills;
- Diagnose immunodeficiency or active autoimmune diseases, have received or are currently receiving immunomodulators, systemic steroid therapy, or immunosuppressive drugs within the past two years;
- Interstitial pneumonia;
- Moderate to severe cirrhosis caused by any reason;
- Uncontrollable hypertension, severe kidney disease, and significant cardiovascular and cerebrovascular diseases;
- Active infections that require systemic treatment;
- Previously suffered from other tumors, excluding cured skin cancer and cervical cancer in situ;
- Internal medicine diseases that do not meet the chemotherapy criteria at the same time;
- Pregnant and lactating patients;
- Individuals with a history of mental illness and poor compliance.