Abstract
We illustrated a patient with advanced alpha-fetoprotein producing gastric cancer, who was treated with chemotherapy combined with trastuzumab, resulting in complete response in four months after therapy. It has been 5 years after his initial therapy, he is now healthy and shows no evidence of tumor recurrence. The efcacy of the trastuzumab therapy in breast cancer patients prompted studies to evaluate potential clinical benet of the drug in patients with HER2 positive gastric cancer. The largest study, ToGA trial, has published a promising result leading FDA to approve the use of trastuzumab for HER2 positive gastric and gastroesophageal cancer. We discuss the need for the standardized assay method for HER2 status. We also bring attention to the existence of intratumoral heterogeneity in gastric cancer tissue which may cause false negative test for HER2 assay
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