CASE REPORT article

Front. Immunol.

Sec. Cancer Immunity and Immunotherapy

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1552052

Case Report: Long-term Response Control in a Patient with Metastatic Gastric Squamous Cell Carcinoma Treated with Nivolumab and Chemoradiotherapy

Provisionally accepted
Yu-ying  LeiYu-ying LeiLi  LiLi LiYa-bin  ShiYa-bin ShiXiao-hui  HanXiao-hui HanYi-tong  LiYi-tong LiWen-jun  RenWen-jun RenAi-xia  SuiAi-xia Sui*
  • Hebei General Hospital, Shijiazhuang, China

The final, formatted version of the article will be published soon.

Primary gastric squamous cell carcinoma (GSCC) is rare, typically associated with poor survival rates and unsatisfactory outcomes from conventional treatments including surgery, radiotherapy, and chemotherapy. It remains unclear whether nivolumab is as effective for GSCC as it is for gastric adenocarcinoma. Herein, we present the case of a 66-year-old man diagnosed with Epstein-Barr virus-positive metastatic GSCC, involving the liver, multiple lymph nodes, and invasion into the spleen, pancreatic body and tail, and splenic vein. The patient received nivolumab with oxaliplatin, leucovorin, and fluorouracil plus local radiotherapy as first-line treatment; nivolumab, paclitaxel polymer micelles, and carboplatin as the second-line treatment, and nivolumab and apatinib as the third-line treatment. The patient responded remarkably (49 months remission) with manageable treatment toxicity. Genomic and immune characteristics were analyzed to understand the underlying disease mechanisms. In conclusion, integrated therapy (immunotherapy, chemotherapy, local radiotherapy, and anti-angiogenic therapy) may be the ideal treatment approach for patients with GSCC with multiple metastases; however, prospective studies are needed to verify its efficacy.

Keywords: EBV-associated gastric squamous cell carcinoma, Immunotherapy, Long-term response, Nivolumab, Programmed cell death ligand-1 (PD-L1) positive

Received: 09 Jan 2025; Accepted: 16 Jul 2025.

Copyright: © 2025 Lei, Li, Shi, Han, Li, Ren and Sui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Ai-xia Sui, Hebei General Hospital, Shijiazhuang, China

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