case_images: PMC11058207_01
case_images: (A) Coronal PET scans (June 2019 and March 2021). (B) Axial PET and CT scans (June 2019, March 2021, and August 2022).
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case_images: F1
case_images: Five months into chemotherapy, a follow-up PET scan revealed complete metabolic resolution of all previously metastatic areas, and another EGDS demonstrated a macroscopically clear esophagogastric junction (Figures 1, 2).
case_images: Endoscopic findings: (A) June 2019 and (B) May 2022.
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case_images: PMC11058207_01_fsurg-11-1297083-g002.jpg
case_images: F2
case_images: Five months into chemotherapy, a follow-up PET scan revealed complete metabolic resolution of all previously metastatic areas, and another EGDS demonstrated a macroscopically clear esophagogastric junction (Figures 1, 2).
case_images: (A) Number of somatic mutations in the National Cancer Institute's Genomic Data Commons data portal (https://portal.gdc.cancer.gov/projects/EXCEPTIONAL_RESPONDERS-ER) in six patients and in the case reported at Gemelli Hospital. (B) Number of somatic mutations in the top 30-mutated genes as reported in the data portal (https://portal.gdc.cancer.gov).
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case_images: PMC11058207_01_fsurg-11-1297083-g003.jpg
case_images: F3
case_images: The comparison revealed that TP53 was the most frequent simple somatic mutation involved in gastric cancer exceptional responders (Figure 3).
case_images: (A) Disease timeline and clinical course. Red circles mark the beginnings of medical history and the achievement of the exceptional clinical response. (B) time course of oncological markers: CA 19-9 (normal range < 35 U/ml) and CEA (normal range < 3 ng/ml). CEA, Carcino-Embryonic Antigen.
case_images: fsurg-11-1297083-g004.jpg
case_images: PMC11058207_01_fsurg-11-1297083-g004.jpg
case_images: F4
case_images: Consequently, the patient continued with five cycles of chemotherapy using folinic acid, fluorouracil, and oxaliplatin (FOLFOX), which had to be suspended four months later owing to its toxicity (Figure 4).