AUTHOR=Wang Jin , Cheng Yu , Wang Yulin , Liu Hengxin , Wu Shuang , Tian Guangwei , Qu Jinglei , Qu Xiujuan TITLE=Case report: A case of rare metastasis of gastric cancer to the axillary lymph node metastasis treated with combination immunotherapy JOURNAL=Frontiers in Immunology VOLUME=15 YEAR=2024 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1331506 DOI=10.3389/fimmu.2024.1331506 ISSN=1664-3224 ABSTRACT=

Lymph node (LN) metastasis is a common mode of metastasis in advanced gastric cancer (GC), while axillary LN metastasis infrequently occurs in GC. There are few reports on this rare type of metastasis – especially its clinicopathological features – and systemic treatment are unclear. We describe a case of GC with extensive metastasis, including the rare axillary LN metastasis. The patient achieved partial response of optimal efficacy, who was treated with combination immunotherapy as second-line treatment for nearly two years. The potential mechanisms were revealed by clinical and immune characteristics, such as high expression of PD-L1, high tumor mutational burden (TMB-H), Epstein-Barr virus (EBV) positive and CD8+ tumor-infiltrating lymphocyte positive.