[A Case of Advanced Gastric Cancer in Which Tumor Relapse Was Observed after Discontinuation of Nivolumab Due to Complete Response, and for Which Re-Administration Was Initiated].

A 61-year-old male was diagnosed with unresectable advanced gastric cancer(cT4b[SI; panc], N+, M0, cStage ⅣA). However he was administered S-1 plus oxaliplatin as a primary treatment and ramucirumab plus paclitaxel as a secondary treatment, the primary tumor and lymph nodes were enlarged. We judged PD and switched to the third-line treatment with nivolumab. After starting nivolumab, both the primary tumor and the lymph nodes shrank, and the PET-CT scan after 24 courses showed no FDG accumulation in the primary tumor or lymph nodes, so we judged the response as CR. The patient requested discontinuation of nivolumab, and nivolumab administration was stopped. Twenty months later after nivolumab administration was discontinued, CT scan showed re-growth of the primary tumor, and nivolumab administration was resumed. After resumption, he received 22 courses of nivolumab for 10 months with maintenance of SD.

[Multidisciplinary therapy for recurrent pancreatic cancer].

We report 2 cases of pancreatic cancer with distant organ metastasis. Case 1: A 67-year-old man with pancreatic cancer (T3N0M0, Stage III) underwent pancreaticoduodenectomy (PD). A follow-up computed tomography (CT) scan performed 48 months after the primary resection detected two masses in his right lung, which were treated by stereotactic body radiotherapy ( SBRT). Twenty-three months after SBRT, the patient is alive. Case 2: A 54-year-old woman with pancreatic cancer (T3N1M0, Stage III) underwent PD. A follow-up CT scan performed 12 months after the primary resection detected 3 masses in her liver, which were treated by SBRT. The patient died because of lymph node metastasis of the pancreatic cancer 32 months after SRT.