Immune checkpoint inhibitors are effective in the treatment of Epstein-Barr virus-associated gastric cancer: A case report

Medicine (Baltimore). 2023 Mar 31;102(13):e33377. doi: 10.1097/MD.0000000000033377.

Abstract

Rationale: Gastric cancer (GC) is one of the most common malignancies globally, and its occurrence and development are associated with genetic, dietary, biological, and immune factors. Epstein-Barr virus-associated gastric cancer (EBVaGC), as a special subtype of GC, has become a research hotspot in recent years. In patients with advanced GC, Epstein-Barr virus infection is closely related to lymph node metastasis, depth of tumor invasion, and poor prognosis. There is great clinical need for a new treatment modality for EBVaGC. Advances in molecular biology and cancer genetics have led to the development of immune checkpoint inhibitors (ICIs); patients treated with ICIs experience clinical benefit and few adverse effects.

Patient concerns and diagnoses: We report a 31-year-old male with advanced EBVaGC and multiple sites of lymph node metastasis who was intolerant to multiple lines of chemotherapy.

Interventions and outcome: After immune checkpoint inhibitor treatment, both primary and metastatic tumors shrank significantly without noticeable adverse reactions. After 21 months of progression-free status, the patient underwent R0 resection.

Lessons: This case report provides evidence for the use of ICIs in treating EBVaGC. It also shows that detection of Epstein-Barr virus-encoded small nuclear RNA may be a prognostic factor in gastric cancer.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Epstein-Barr Virus Infections* / complications
  • Epstein-Barr Virus Infections* / diagnosis
  • Epstein-Barr Virus Infections* / drug therapy
  • Herpesvirus 4, Human / genetics
  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Lymphatic Metastasis
  • Male
  • Stomach Neoplasms* / pathology

Substances

  • Immune Checkpoint Inhibitors