ArticleFrontiers in oncology2026
Case Report: Conversion therapy with chemotherapy, antiangiogenic therapy, and immunotherapy for locally advanced synchronous gastric hepatoid adenocarcinoma and poorly differentiated adenocarcinoma.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Hepatoid adenocarcinoma of the stomach (HAS) is a rare, aggressive gastric carcinoma that is frequently associated with elevated alpha-fetoprotein (AFP). We report a patient with resolved hepatitis B virus infection and two spatially distinct gastric lesions: poorly differentiated adenocarcinoma in the gastric body and HAS in the gastric angularis. The disease was initially considered unresectable. After multidisciplinary evaluation, the patient received oxaliplatin, S-1, sintilimab, and apatinib. Treatment produced radiological regression and AFP normalization, enabling total gastrectomy. Histopathology showed no viable carcinoma in either tumor bed or in 20 regional lymph nodes, confirming a pathological complete response. This case illustrates the potential role of individualized conversion therapy in selected patients with alpha-fetoprotein-producing gastric cancer. It does not establish the four-agent regimen as standard care. Interpretation is limited by the single-patient design, short follow-up, absence of lesion-specific sequencing and serial hepatitis B virus DNA data, and a nonstandardized maintenance strategy.
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