AUTHOR=Huang Ren-Ze , Chen Nuo , Hu Yan , Hu Wan-Ming , Wang Feng-Hua , Chen Dong-Liang 

TITLE=Case report: PD-1 inhibitor-based treatment strategies in gastric cancer complicated by bone marrow metastasis and disseminated intravascular coagulation: A report of two cases

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1019702

DOI=10.3389/fonc.2023.1019702

ISSN=2234-943X

ABSTRACT=1	Abstract
Introduction: Gastric cancer (GC) complicated by bone marrow metastasis (BMM) and disseminated intravascular coagulation (DIC) represents poor prognosis and most of these patients would die in a few months. Active treatment strategies such as chemotherapy are effective to restore coagulation function and prolong patients’ survival time. Immunotherapy including programmed death protein 1 (PD-1) or programmed death protein ligand 1 (PD-L1) inhibitors has emerged as a first-line treatment of gastric cancer. However, the efficacy of PD-1 inhibitor-based treatment strategies in these patients remains unknown.
Case Description: Herein, we presented two cases of advanced gastric cancer complicated by BMM and DIC, in which two patients received chemotherapy and PD-1 inhibitor as a first-line treatment. Both of them achieved partial response after treatment, and the coagulation function restored. The patient who discontinued the PD-1 inhibitor after 6 months experienced DIC relapse while the other patient who maintains the PD-1 inhibitor treatment cycle remained responsive after 10 months.
Conclusions: We speculate that PD-1 inhibitor-based treatment strategies are effective and safe to prolong survival against gastric cancer with BMM and DIC, and the coagulation function is well controlled by the treatment with a combination of immunotherapy and chemotherapy.