CASE REPORT article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1611281
This article is part of the Research TopicCheckpoint Immunotherapy: Reshaping the Landscape of Gastrointestinal Cancer TreatmentView all 13 articles
Pathological Complete Response Achieved with Neoadjuvant immunochemotherapy in Synchronous Multiple Gastric Adenocarcinoma
Provisionally accepted
- 1Department of Gastrointestinal Surgery, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- 2Department of Hepatobiliary and Pancreatic Surgery, Hainan General Hospital, Haikou, Hainan Province, China
- 3Department of Pathology, Hainan General Hospital, Hainan, China
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Synchronous multiple gastric cancers (SMGC) represent a rare clinical entity with no established treatment guidelines. We report a 76-year-old female with two synchronous poorly differentiated adenocarcinomas (dMMR/MSI-H phenotype) in the gastric lesser curvature, clinically staged as cT4bN2M0. Following three cycles of neoadjuvant immunochemotherapy, the patient demonstrated remarkable tumor regression (RECIST 1.1 partial response) and subsequently underwent R0 distal gastrectomy. Histopathological examination confirmed a pathological complete response (ypT0N0, TRG 0).To our knowledge, this represents the first documented case of SMGC achieving pCR with neoadjuvant immunochemotherapy. Our findings suggest that PD-1 inhibition combined with chemotherapy may induce profound tumor regression in SMGC, even in cases with high tumor burden, potentially converting unresectable to resectable disease. This case provides compelling evidence for incorporating immunotherapy in SMGC management and warrants further investigation through clinical trials.
Keywords: SMGC, Neoadjuvant immunochemotherapy, Pathological complete response, immune checkpoint inhibitors, Microsatellite Instability
Received: 14 Apr 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Sun, Chen, Li, Ma, Liang, He and Zou. 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: Xianwen Liang, Department of Gastrointestinal Surgery, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
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