Scirrhous gastric cancer (SGC), including the Borrmann type IV subtype, is characterized by a desmoplastic stroma, rapid progression, and a poor prognosis with limited effective treatment options. While fibroblast growth factor receptor 2 (FGFR2) alterations are recognized therapeutic targets in some cancers, their clinical application in gastric cancer, particularly in SGC, remains underexplored. We present the case of a 47-year-old female with advanced, chemotherapy-refractory Borrmann type IV gastric cancer harboring FGFR2 rearrangement and amplification. Treatment with the selective FGFR1-3 inhibitor pemigatinib elicited a marked clinical and serological response; however, disease progression ensued after 3 months. Comprehensive genomic profiling revealed an acquired FGFR2 N549K mutation, a recognized on-target resistance mechanism. Subsequent administration of the irreversible FGFR1-4 inhibitor futibatinib was associated with a declining trend in tumor biomarkers, indicating preliminary antitumor activity against the resistant clone. This case underscores the clinical activity of FGFR inhibition in FGFR2-altered SGC and exemplifies the emergence of kinase domain mutations as a principal resistance pathway. It further suggests that irreversible FGFR inhibitors may represent a rational therapeutic strategy upon progression on prior FGFR-directed therapy, warranting further clinical investigation in this molecularly defined patient subset.

Background Pancreatic ductal adenocarcinoma (PDAC) is in urgent need of a second‐line or later‐line treatment strategy. We aimed to analyze the efficacy and safety of additional anlotinib, specifically anlotinib in combination with immunotherapy, in patients with PDAC who have failed first‐line therapy. Methods Patients with pathological diagnosis of PDAC were additionally treated with anlotinib, and some patients were treated with anti‐PD‐1 agents at the same time, which could be retrospectively analyzed. The efficacy and safety of additional anlotinib were evaluated. Results A total of 23 patients were included. In patients treated with additional anlotinib, the overall median progression‐free survival (PFS) was 1.8 months and the median overall survival (OS) was 6.3 months, regardless of anti‐PD‐1 agents. Among patients receiving additional anlotinib in combination with anti‐PD‐1 agents, median PFS and OS were 1.8 and 6.5 months, respectively. Adverse events (AEs) were observed in 16 patients (69.6%). In patients treated with additional anlotinib, the majority of AEs were grade 1–3. Univariate analysis revealed that patients with baseline red blood cell distribution width (RDW) <14% treated with additional anlotinib plus anti‐PD‐1 agents had significantly longer OS than patients with baseline RDW ≥14% ( p = 0.025). Patients with additional anlotinib plus anti‐PD‐1 agents as second‐line therapy had a longer OS than those treated as later‐line therapy ( p = 0.012). Multivariate analysis showed that baseline RDW was the only independent risk factor for OS ( p = 0.042). Conclusion The combination of anlotinib and immunotherapy represents an effective add‐on therapy with tolerable AEs as second‐ or later‐line therapy in patients with PDAC, particularly in patients with baseline RDW <14%.

Combinatorial systemic chemotherapy is a powerful treatment paradigm against cancer, but it is fraught with problems due to the emergence of chemoresistance and additive systemic toxicity. In addition, coadministration of individual drugs suffers from uncontrollable pharmacokinetics and biodistribution, resulting in suboptimal combination synergy. Toward the goal of addressing these unmet medical issues, we describe a unique strategy to integrate multiple structurally disparate drugs into a self-assembling nanococktail platform. Conjugation of a polyunsaturated fatty acid (e.g., linoleic acid) with two chemotherapies generated prodrug entities that were miscible with tunable drug ratios for aqueous self-assembly. In vitro and in vivo assays were performed to investigate the mechanism of combinatorial nanococktails in mitigating chemoresistance and the efficacy of nanotherapy. The coassembled nanoparticle cocktails were feasibly fabricated and further refined with an amphiphilic matrix to form a systemically injectable and PEGylated nanomedicine with minimal excipients. The drug ratio incorporated into the nanococktails was optimized and carefully examined in lung cancer cells to maximize therapeutic synergy. Mechanistically, subjugated resistance by nanococktail therapy was achieved through the altered cellular uptake pathway and compromised DNA repair via the ATM/Chk2/p53 cascade. In mice harboring cisplatin-resistant lung tumor xenografts, administration of the nanococktail outperformed free drug combinations in terms of antitumor efficacy and drug tolerability. Overall, our study provides a facile and cost-effective approach for the generation of cytotoxic nanoparticles to synergistically treat chemoresistant cancers.

目的 探讨在恶性肿瘤治疗中免疫检查点抑制剂(ICI)引起的免疫相关甲状腺炎(irT)的临床特点及其影响因素.方法 回顾性分析2019—2020年在解放军总医院第一医学中心肿瘤内科接受ICI治疗,符合纳入标准的286例恶性肿瘤患者的临床资料.根据患者甲状腺不良反应的发生情况,将患者分为irT组(n=83)与非irT组(n=203),对比两组患者年龄、性别、肿瘤来源、既往治疗史及所用ICI药物之间的差异,并根据irT患者的临床表现及严重程度分为不同亚组,对比分析不同亚组患者甲状腺损伤的发生时间、自身抗体水平及恢复情况等.结果 入组患者中83例(29.0％)出现了irT,年龄低及有放疗史的患者irT发生率高.irT患者中临床表现为甲亢28例(33.7％)、甲减48例(57.8％)、甲状腺功能正常的甲状腺炎7例(8.4％).83例irT患者中76例(91.6％)为轻症,重症仅7例(8.4％).28例甲亢型irT患者中7例(25％)在病程后期转化为甲减型,其演变速度较原发性甲状腺炎快.4种临床常用ICI药物(帕博利珠单抗、纳武利尤单抗、信迪利单抗、特瑞普利单抗)的irT发生率差异无统计学意义.83例irT患者中,23例(29.5％)甲状腺球蛋白抗体(TGAb)、14例(12.8％)过氧化物酶抗体(TPOAb)存在异常,重症者的TGAb、TPOAb明显高于轻症者.在患者转归方面,经过治疗后irT的症状普遍可以缓解,仅3例(3.6％)因不可耐受的症状中断了免疫治疗.结论 irT的发生率高且变化快,行免疫治疗的患者应注意监测甲状腺功能,以发现irT并及早干预.

BackgroundCombination therapy with immune checkpoint inhibitors (ICIs) and antiangiogenic agents is generally effective and well tolerated and might be effective for metastatic urothelial carcinoma (UC). However, ICI treatment is often associated with unique responses, such as pseudoprogression and ICI-related pneumonitis (CIP), which may influence clinical decision making and affect treatment. Although there have been many studies on the mechanism of pseudoprogression and CIP, the characteristics and relationship of these special events in a clinical setting remain rarely reported.Case PresentationHere, we present a patient with lung metastatic UC who underwent surgery and two lines of chemotherapy. The programmed cell death-1 (PD-1) inhibitor nivolumab and antiangiogenics agent bevacizumab were used as maintenance treatments. The patient experienced pseudoprogression after 2 PD-1 inhibitor cycles. The lesions in both lungs were enlarged on computed tomography (CT) imaging, and treatments were continued for another two cycles, after which the tumor size decreased to below baseline, followed by a durable response. However, after 4 months of pseudoprogression, the patient then developed CIP. The CIP was responsive to glucocorticoid therapy but recurred during ICI rechallenge, leading to the termination of immune therapy. Ultimately, the patient achieved durable, stable disease for over 18 months without further anticancer treatment.ConclusionsOur case shows that pseudoprogression can occur in UC during immunotherapy even when combined with an effective antiangiogenic agent. In addition, pseudoprogression may be correlated with future adverse effects and a durable response. In the management of CIP, early rechallenge with ICIs may lead to CIP recurrence, which could be more severe and needs to be treated early and with appropriate drugs. Clinicians should be aware of atypical responses to ICIs and adjust the treatment plan accordingly.

AbstractBackgroundMolecular testing for alterations in oncogenic driver genes and targeted therapies have become standard procedures for non‐small cell lung cancer (NSCLC) patients. However, little evidence has shed light on the pattern of co‐existence of driver genes in NSCLC, and whether they may have different tumor features affecting immunotherapy is still unclarified.MethodsGenomic alterations in 14 lung cancer‐related genes were conducted in 3440 Chinese NSCLC patients using next‐generation sequencing. Meanwhile, tumor mutational burden and immunotherapy dataset from the Memorial sloan kettering cancer center (MSKCC) and lung adenocarcinoma dataset from The Cancer Genome Atlas (TCGA) were utilized for analyzing the impact of the co‐occurring alterations on patients’ survival following immunotherapy.ResultsIn this cohort, 90.17% of patients had at least one somatic alteration in the 14 genes, including 51% of co‐occurring alterations. TP53 and epidermal growth factor receptor (EGFR) were the most prevalent genes (54.74% and 53.55%, respectively), followed by KRAS, ERBB2, ALK, PIK3CA, ROS1, RET, MET, BRAF, KIT, FGFR1, PDGFRA, and NRAS. The prevalence of TP53, EGFR, and ERBB2 in our cohort were significantly higher than that from the TCGA database, whereas KRAS, BRAF, and PDGFRA were significantly lower than the latter. Furthermore, the patients who harbored multiple alterations (8.86%, 31/350) in eight driver genes survived longer and have a higher tumor mutation burden compared to the patients with a single alteration. Similar result was found between the patients with co‐occurring alteration of EGFR and other driver genes and the patients with single EGFR alteration. Meanwhile, we found a distinct immune cell infiltration feature between patients with single and multiple driver gene alterations, as well as between patients with only EGFR alteration and co‐occurring groups.ConclusionThis study identified a unique driver gene feature and found patients harboring co‐occurring alterations of EGFR and other driver genes may benefit from immunotherapy, which may provide more therapeutic selections for EGFR‐mutated NSCLC patients and merit additional investigation.

Anti-programmed death-1 (PD-1) therapy has been extensively used to treat cancer. Recently, the combination of immunotherapy and anti-angiogenic therapy has emerged as a novel treatment approach. Therefore, we designed a study to evaluate the real-world benefit of the combination of anti-PD-1 and anti-angiogenesis therapy in patients with non-small cell lung cancer (NSCLC).We obtained the medical records of patients at the Chinese People's Liberation Army General Hospital who received either nivolumab or pembrolizumab combined with anti-angiogenesis therapy from January 2015 to December 2018. The overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) were evaluated for all patients.Sixty-nine patients with NSCLC were included in our study. The ORR was 31.9% (95% CI: 20.6-43.2%) and the median PFS was 8.37 months (95% CI: 6.5-10.0 months). The subgroup analysis statistically revealed a significant difference in ORR for patients receiving first-line treatment vs other lines, and the values were 58.8% (95% CI: 32.7-84.9%) compared with 23.1% (95% CI: 11.2-34.9%). We also observed a significant improvement in PFS, with a median value of 10.5 months (95% CI: 7.4-13.1 months) for patients without EGFR mutations and 5.4 months (95% CI: 4.0-6.3 months) for patients with EGFR mutations.The real-world ORR, PFS, and OS were comparable to previous clinical trials, despite the patients' different baseline characteristics. Importantly, compared with patients having identified EGFR mutations, patients without EGFR mutations had a better PFS. Furthermore, these data support the use of anti-PD-1 combined with anti-angiogenesis therapy as a novel treatment approach for patients with NSCLC.

Objective:To observe the baseline characteristics and clinical efficacy in cancer patients who were treated with immune checkpoint inhibitors (ICIs) and experienced immune-related adverse events (irAEs).Methods:The clinical efficacy in cancer patients experiencing irAEs was retrospectively analyzed, and the objective response rate, progression-free survival, and overall survival were evaluated.Results:The median onset time of irAEs in 23 patients was 3.17 months. There were 47.8% (11/23) patients with multi-system irAEs, 63.3% (7/11) of which were non-simultaneous. The most common irAEs were immune-related pneumonia, hypothyroidism and immune-related liver dysfunction. Complete remission, partial remission and stable disease were respectively achieved in 0, 10 and 11 cases, while the other two patients developed progressive disease. The objective response rate was 43.5% and the disease control rate was 91.3%. With a median follow-up period of 16.5 months, 17 patients (73.9%) had progressive disease and the median progression-free survival was 9.63 months. Eight patients (34.8%) died before reaching the median overall survival. The progression-free survival and overall survival of patients with irAEs ≥grade 3 were significantly shorter than those with irAEs of grade 1-2 ( P<0.01). Conclusions:The occurrence of irAEs might correlate with the short-term efficacy and clinical benefits in patients treated with ICIs.

人源肿瘤异种移植(PDX)模型是一种将患者来源的新鲜肿瘤组织移植到免疫缺陷小鼠体内构建的新型肿瘤动物模型.PDX模型可以充分保留患者的肿瘤微环境,维持原发瘤的突变基因与异质性,在肿瘤机制研究和临床药物筛选中得到了广泛应用,也得以不断改进.本文就PDX技术近年来在耐药研究及生物信息技术等领域的新应用进行简述.同时结合传统PDX模型的局限性,介绍3种由PDX模型发展而来的新型异种移植瘤模型,即微型异种移植(MiniPDX)模型、人源化异种移植(Hu?PDX)模型和原位异种移植(PDOX)模型的特点及应用,并对PDX模型的发展方向进行展望.

e20543 Background: Immunotherapy has shown promising results for clinical management of various cancers. We reported our real world experience with PD-1 or PD-L1 immunotherapy in management of advanced lung cancer patients in China. Methods: This is a single-center retrospective study based on the de-identified electronic medical data collected in routine clinical practice. A total of 198 advanced lung cancer (stage IIIA-IV) patients who underwent anti-PD-1/PD-L1 therapy at Chinese People's Liberation Army General Hospital between 2015 and 2018 were included. Progression free survival and overall survival of patients were estimated by Kaplan-Meier methods. The treatment-related adverse events were also analyzed. Results: Median age of patients was 60.0 years (33.0-88.0 years). Most patients were male (150, 75.8%), smokers (116, 61.7%) and had a KPS score ≥70 (169, 97.7%). Of 198 patients, 106 (53.5%) had adenocarcinoma and 54 (17.3%) had squamous cell carcinoma. Thirty-one (15.7%) patients had CNS metastases. Seventy-one (38.8%) patients received two or more prior therapies. Estimated progression free survival was 5.6 months and overall survival was 24.5 months. One-hundred twenty-seven (64.1%) patients had documented to suffer adverse events, most commonly gastrointestinal adverse events and liver damage (Table). Conclusions: Our study showed survival benefits of PD-1/PD-L1 immunotherapy in advanced NSCLC patients in clinical practice. Safety profile was comparable to the previous studies. Our study supports the benefits of PD-1/PD-L1 immunotherapy in clinical management of advanced lung cancer patients. [Table: see text]

目的:探讨顺铂与唑来膦酸序贯联合应用对人肺巨细胞癌细胞株PLA-801 D的生长抑制作用.方法:MTT法测定顺铂与唑来膦酸不同序贯方式处理后细胞生长的抑制率,并通过流式细胞术分析不同处理组细胞周期的变化.结果:顺铂和唑来膦酸均能够抑制肿瘤细胞的生长,并在一定给药浓度范围内具有剂量依赖效应.两药联合应用对细胞生长抑制具有协同效应,其中以顺铂给药24 h后序以唑来膦酸处理对细胞生长的抑制效果最佳.顺铂与唑来膦酸序贯方式的改变,引起G0/G1期细胞比例下降,S期细胞比例显著提高.结论:先顺铂后唑来膦酸的联合给药方式对肺癌细胞的生长抑制作用最强,不同序贯应用方式导致细胞生长抑制率的差异与细胞周期的变化具有一定的相关性.

Objective To investigate androgen receptor (AR) expression in breast cancer tissues and its relationship with clinicopathological indicators and molecular subtypes. Methods Androgen receptor (AR), estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2) and proliferating cell nuclear antigen Ki-67 expression were evaluated in 200 breast cancer cases by immunohistochemistry assays. Data including patients' age, menstrual status, tumor size, lymph node metastasis, pathology TNM (pTNM) stage and tumor histological grade and other clinical pathological indicators were analyzed. Results The positive rate of AR in breast cancer tissue was 88.5%. It was 67.9% in ER negative breast cancer versus 95.9% in ER positive breast cancer, and 68.4% in PR negative breast cancer versus 96.5% in PR positive breast cancer. AR expression was positively associated with ER and PR expression (P < 0.01, respectively). The positive rate of AR was 94.9% in grade Ⅰ and grade Ⅱ breast cancer, and 74.2% in grade Ⅲ . The lower the histological grade was, the higher the positive rate of AR expression was (P < 0.01). The positive rate of AR was 96.3% in Luminal A subtypes and 96% in Luminal B subtypes, and was 87.5% in HER2 positive subtypes, and 44% in triple negative breast cancer (TNBC), and there were significant differences in different molecular subtypes (P < 0.01). Subtypes of Luminal A, Luminal B, and HER2 had higher AR expression rate when compared with TNBC (P < 0.01) with no significant difference between the former 3 subtypes. Conclusion AR is widely expressed in breast cancer tissues. Compared with the TNBC, AR expression is higher in Luminal A, Luminal B and HER2 positive breast cancers. However, it is 44% in TNBC subtype. AR could serve as a potential therapeutic target to breast cancer.

Platelet-lymphocyte ratio (PLR) is a hematological parameter which is investigated as a biomarker for prognosis in patients with breast cancer. Due to the controversial results from previous studies, we performed a meta-analysis. Databases of PubMed, Embase and Web of Science were searched to identify eligible studies. STATA version 12.0 was used for statistical analysis. Seven studies with 3,741 patients were ultimately included in this meta-analysis. High PLR was associated with poor overall survival (OS) (HR = 1.55, 95% CI = 1.07-2.25, p = 0.022) and disease-free survival (DFS) (HR = 1.73, 95% CI = 1.3-2.3, p < 0.001) in breast cancer patients. Subgroup analyses disclosed that elevated PLR could predict worse OS in Asian populations and poor DFS in both Asian and non-Asian patients. In addition, PLR remains a significant prognostic marker for OS in patients receiving systemic treatment (HR = 1.78, 95% CI = 1.06-2.99, p = 0.03) and patients receiving chemotherapy (HR = 2.82, 95% CI = 1.09-7.26, p = 0.032). High PLR also indicates poor DFS in patients who receive chemotherapy (HR = 2.6, 95% CI = 1.47-4.61, p = 0.001), surgery (HR = 1.8, 95% CI = 1.12-2.89, p = 0.016) and systemic treatment (HR = 2.03, 95% CI = 1.03-4.01, p = 0.042). Moreover, PLR was also in association with HER-2 positivity (OR = 1.48, 95% CI = 1.2-1.83, p < 0.001). In conclusion, this meta-analysis revealed that PLR could serve as an indicator of poor prognosis in patients with breast cancer.

AIM:To obtain a correlation between HER-2 expression and the clinicopathological features incolorectal cancers. (CRCs) using a meta.analysis based approach. MATERIALS AND METHODS:Electronic databases and reference lists were searched for relevant published studies. After inclusion and exclusion criteria were applied, case and control studies related to research topic were included in present meta-analysis. Data analysis was performed using Comprehensive Meta Analysis. (CMA) 2.0 software. RESULT:A total of 30 studies comprising 4,942 CRC patients and 521 healthy controls met the inclusion criteria. Our major results implied that the expression level of HER-2 was significantly higher in CRC patients than healthy controls (odds ratio (OR) = 10.436, 95% confidence interval (CI) = 5.498-19.810, P < 0.001). Sample stratification based on Dukes stages suggested that increased expression level of HER-2 protein was found in CRC patients with Dukes C/D compared with CRC patients with Dukes A/B (OR = 0.335, 95% CI = 0.198-0.568, P < 0.001). The current meta-analysis also found that, in CRC patients with lymph node metastasis (LNM), the HER-2 expression was significantly higher than that in CRC patients without LNM (OR = 1.987, 95%CI = 1.209-3.265, P = 0.007). CONCLUSION:Our meta-analysis study strongly suggests that HER-2 expression levels are clearly correlated with the clinicopathological features in CRC; therefore, HER-2 may be a potential biomarker for diagnosis and prognosis of CRC.

Immunotherapy may be an effective and potentially less toxic treatment for cancer in addition to the traditional therapies. The current study presents a case of advanced pancreatic cancer that was treated with cell-based immunotherapy using expanded activated allogeneic lymphocytes (EAAL*) in vitro with cluster of differentiation (CD)3(+) and CD8(+) cytotoxic T lymphocytes, and CD3(-) and CD56(+) natural killer cells as the major effector cells, together with chemotherapy and targeted agents. A 46-year-old female was diagnosed at the Chinese PLA General Hospital (Beijing, China) with stage IV pancreatic cancer with multiple metastases in October 2012. After receiving one cycle of chemotherapy plus nimotuzumab (Nimo), the patient received 14 infusions of EAAL*, which was obtained from a related donor, combined with seven cycles of chemotherapy with gemcitabine plus oxaliplatin and targeted therapy with Nimo. The patient was followed up for eight months. One day prior to the cell infusion, targeted therapy was administered and 48 h following the cell infusion, chemotherapy was administered. Following this treatment, carbohydrate antigen 19-9 levels decreased from 4,136 U/ml to within the normal ranges, along with the significant regression of the lesions. Occasionally mild upset was observed following the EAAL* transfusion. For the entire combined modality, grade II hematological and gastrointestinal toxicities plus grade I liver function damage and skin rash were identified. The present study demonstrated that combining allogeneic cell-based immunotherapy with conventional therapies is effective and safe, even in patients with end-stage pancreatic cancer. Therefore, this strategy is recommended for the treatment of similar cases.

The value of pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio(PLR) in predicting survival in patients undergoing hepatectomy for hepotocelluar carcinoma was assessd. We conducted a retrospective analysis of 80 patients who underwent hepatectomy for hepatocellular carcinoma. Data of haematological laboratory values as well as demographics and histopathology were collected. Univariate and multivariate analyses were applied. Pretreatment high NLR was associated with shorter overall survival (OS)(P=0.034). Pretreatment high PLR was linked with shorter overall survival and disease-free survival (DFS)(P=0.038 and P=0.020). The patients with both high pretreatment NLR and PLR had shorter median OS and DFS than those with both low pretreatment NLR and PLR (P=0.026 and P=0.015). On multivariate analyses, pretreatment NLR (P=0.008), tumor-node-metastasis (TNM) stage (P=0.003), capsule invasion (P=0.025) and tumor differentiation (P=0.000) were independent of prognostic factors for overall survival. Pretreatment PLR (P=0.040), TNM stage (P=0.003) and tumor differentiation (P=0.011) were independent of prognostic factors for disease-free survival. Pretreatment high NLR and PLR might be potential biomarkers in cases of poor prognosis for patients undergoing hepatectomy for hepatocellular carcinoma.

肺癌是目前全球肿瘤相关性死亡的首要原因,严重威胁人们的健康与生活.以酪氨酸蛋白激酶抑制剂(tyrosine kinase inhibitor,TKI)类为代表的靶向治疗在部分患者中显示了一定程度的优越性,但仍没能改变肺癌5年生存率过低的现状.肿瘤的免疫治疗近几年发展迅速,几种癌症疫苗的临床疗效已得到证实,但总体来说这种主动特异性免疫治疗尚处于起步阶段.本文对已进入Ⅲ期临床研究的非小细胞肺癌疫苗进行了总结.

Lung cancer is a heterogeneous and complex disease that remains the leading cause of cancer-related mortality worldwide. The identification of epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangements has changed the treatment of non-small cell lung cancer, creating a personalized treatment era that is based on the appropriate molecular selection of patients. In spite of the efficacy of tyrosine kinase inhibitors (TKIs), acquired resistance remains inevitable due to various mechanisms. The present study reports the case of a 30-year-old patient with stage IV lung adenocarcinoma initially harboring an EGFR mutation. However, following disease progression and a series of treatments, the wild-type EGFR gene was observed and the ALK rearrangements were revealed. Erlotinib administration resulted in a good response in the patient initially, but crizotinib did not. This indicated an association between the secondary mutations in kinases and the drug resistance to TKIs. This case should also highlight the clinical significance of repeat biopsies for the subsequent therapeutic choices at the onset of clinical progression.

Objective To investigate the efficacy and side effects of cetuximab plus chemotherapy in treatment of advanced gastric cancer.Methods Thirteen patients with advanced gastric cancer were treated with cetuximab plus traditional chemotherapy.Cetuximab 400mg/m2 was taken at the first dose and a maintenance dose was 250mg/m2 every week.The curative effects were evaluated after 2-3 cycles.Results Out of the total 13 patients,6 cases received first-line treatment,2 with PR,4 with SD;seven cases received multi-chemotherapy treatment,1 with PR,2 with SD,3 with PD,and 1 case could not be evaluated.The main toxic reactions were myelosuppression,digestive tract reaction and skin and mucosa reactions.Until the deadline date(December 30,2012),two of the 13 patients survived,and 11 patients died.The survival time ranged from 3.9 to 40.8 months,and the median survival time was 16.4 months(95% CI:8.4-20.4).Conclusion Cetuximab plus chemotherapy in the treatment of advanced gastric cancer may have good efficacy and toxicity can be tolerated.