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Disitamab vedotin and camrelizumab achieved durable remission in a patient with metastatic gastric cancerNew treatment combination shows promise for gastric cancer with brain metastasis

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Key Takeaway
Note that disitamab vedotin and camrelizumab achieved durable remission in one case of metastatic gastric cancer.

This case report and literature review describes the management of a 52-year-old male with HER2-low, PD-L1 CPS 5, microsatellite-stable (MSS) advanced gastric cancer and brain metastasis. The patient received stereotactic radiosurgery (SRS) followed by a combination of disitamab vedotin and camrelizumab. The patient achieved a complete response (CR) and remained disease-free for over three years after discontinuing therapy.

The authors suggest that the combination of disitamab vedotin and camrelizumab may overcome PD-1 resistance, while SRS may prime systemic antitumor immunity. They further hypothesize that a finite-duration ADC plus ICI therapy might establish long-lasting immunological memory. However, these conclusions are based on a single case (n=1) and are not confirmed by controlled trials.

Clinical application of these findings is currently limited by the low certainty of evidence. While the case suggests a potential pathway for treating resistant gastric cancer, the results are not generalizable to a broader population without further clinical investigation.

How this fits prior evidence

This case report addresses a gap in the management of advanced gastric cancer. It builds upon prior coverage of disitamab vedotin and tislelizumab for bladder carcinoma, and the use of biomarkers like HER2 and PD-L1 to guide treatment selection in gastric cancer. While those findings established the potential of disitamab vedotin in specific contexts, this report explores its use in combination with camrelizumab and SRS for gastric cancer.

When a patient has advanced gastric cancer that has spread to the brain, treatment options can be very limited. A recent case report looks at a 52-year-old man with this specific, difficult diagnosis. He received a combination of stereotactic radiosurgery (a precise form of radiation) followed by a specific drug combination called RC48 and camrelizumab.

During the follow-up period, the patient showed a partial response and eventually achieved a complete response. Most importantly, he remained disease-free for over three years after stopping his treatment. This suggests that the combination of radiation and these specific drugs might help create a lasting immune response in some patients.

It is important to note that this finding comes from a single patient case. While the results are encouraging, the evidence is currently limited because it was not a large-scale clinical trial. The patient did experience a side effect called grade 2 pneumonitis, which led to the discontinuation of his treatment. Talk to your doctor to see if these types of targeted therapies are right for your specific situation.

What this means for you:
A combination of radiation and targeted drugs may lead to long-term remission in some patients with gastric cancer.

Common questions

What was the outcome for the patient in this study?

The patient achieved a complete response and remained disease-free for over three years after stopping his treatment. This long-term remission occurred after he received stereotactic radiosurgery followed by a combination of RC48 and camrelizumab.

What were the side effects of the treatment?

The patient experienced grade 2 pneumonitis, which is a type of lung inflammation. Because of this side effect, the medical team had to stop his treatment. However, he still achieved a long-term remission.

How certain are these results for other patients?

Because this was a case report involving only one patient, the certainty of these results is low. While the combination of radiation and targeted drugs showed success in this specific case, more large-scale studies are needed to confirm if it works for others.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Brain metastasis from gastric cancer carries a dismal prognosis, with median overall survival of only 3–6 months. Patients who progress on immune checkpoint inhibitor (ICI)-containing regimens have limited salvage options. HER2-low expression (IHC 1+ or IHC 2+/FISH-negative), historically excluded from anti-HER2 therapy, has now emerged as a novel therapeutic target for antibody-drug conjugates (ADCs) such as RC48 (disitamab vedotin). A 52-year-old male with HER2-low (IHC 2+/FISH-negative), PD-L1 CPS 5, microsatellite-stable (MSS) advanced gastric cancer received first-line XELOX plus camrelizumab, achieving a partial response (PR) followed by progression with new brain metastases. After stereotactic radiosurgery (SRS) for a solitary brain lesion, he received RC48 plus camrelizumab for eight months, achieving PR. Treatment was discontinued due to grade 2 pneumonitis (managed without corticosteroids). Complete response (CR) was achieved during the follow-up. The patient has been off therapy over three years and remains disease-free. We review the current evidence for HER2-low gastric cancer treatment, ADC plus ICI combinations, the potential immunomodulatory role of radiotherapy (including the abscopal effect) as it may contribute to systemic antitumor responses when combined with ICIs, and treatment-free remission following ICI discontinuation. This is the first report of durable, treatment-free survival over 36 months in an ICI-refractory, HER2-low gastric cancer patient with brain metastasis suggests that RC48 can reverse PD-1 resistance, SRS may prime systemic antitumor immunity, and finite-duration ADC plus ICI therapy can establish long-lasting immunological memory.
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