A Desperate Start with Advanced Gastric Cancer, Joyful cCR After Joining a HER2-Positive Clinical Trial | Patient Story

When Amu was young, he insisted on opening a Labrador kennel in rural Deyang. Initially, his father, a steadfast farmer, strongly opposed it. Amu also faced villagers' skepticism and the pressure of slow investment returns. However, once Amu made up his mind, his father offered unwavering support. For sixteen years, he balanced the roles of farmer and kennel manager, tending to the fields by day and caring for the dogs by dusk. The chatter under the setting sun and the barking of dogs wove a warm rural picture.

This understanding and support from his father later extended to his unconditional trust in the clinical trial Amu chose for him. Even when treatment side effects caused him immense suffering, his father never once thought of giving up.

Author | Zhong Lala Editor | Xianning Reviewer | Guangguang

「 I. Diagnosis: Frequent Stomach Aches Turn into Gastric Cancer 」

In the summer of 2020, as the rice was just heading out, the scorching sun cracked the earth. Father squatted on the ridge, clutching his stomach, saying it was just a stomachache. He would chew two pills, rest for ten minutes, and then pick up his hoe again. Mother urged him to rest for half a day, but he waved her off: "How can a farmer miss the farming season?"

Over the next two years, stomach pain became a frequent visitor. It hurt before meals and at night. He endured it with stomach medicine when it was mild, and curled up groaning when it was severe. Yet the next day, he would still go to work in the fields. He always said, "It's a minor issue, a waste of money." The drawer saw several changes of stomach medicine, but not a single hospital registration slip.

In the spring of 2022, things changed drastically. The stomach pain became more frequent, bringing out cold sweats, and he couldn't even swallow half a bowl of porridge. After a week of IV drips at the village clinic, the pain worsened. Seeing his father's increasingly gaunt face, Mother panicked and took him to the community hospital. The doctor palpated his abdomen, frowned, and urged: "Go to the municipal tertiary hospital for a gastroscopy and colonoscopy immediately."

Most honest farmer parents are like this. They have weak health awareness, fear burdening their children, and avoid gastroscopies. In hindsight, major illnesses rarely strike suddenly; they show early signs. Yet, due to parents' stubborn distrust of hospitals ("Going to the hospital might find an illness where there is none"), their habit of reporting only good news, or our own busy lives, we keep delaying with "I'll take them next time" or "They've always been healthy." Until one day, that "bearable" pain becomes a boulder thrown into a calm lake, stirring up family storms.

After the gastroscopy at Deyang People's Hospital, his parents photographed the incomprehensible report and sent it to Amu. Looking at it, Amu was at a loss, unsure of the next step. It was his wife who calmly stepped in, telling Amu to bring his father to Chengdu for treatment immediately.

His parents hadn't fully grasped the severity. His father didn't understand the medical jargon, thinking it was just a common stomach issue, and kept saying, "Just get some medicine back home to regulate it." He refused to go to Chengdu, citing high city expenses and delayed farm work. Amu's throat felt blocked, but this time he didn't indulge his father and told him the truth.

Later, Amu learned from his mother that the night his father learned the truth, the elderly couple sat in the dark room, crying silently under the moonlight all night. But the next morning, when his father pushed open the door, no trace of sorrow remained on his face. He picked up his hoe as usual, though his steps were heavier. At the breakfast table, he ate his rice without looking up and said: "Let's go to Chengdu. I'll finish the farm work first."

Every time Amu recalls this scene, his nose tingles. Rural elders are like this: stubborn as oxen in daily life, but when it truly matters, their innate resilience becomes a powerful force to flatten all hardships.

Three days before departure, his father seemed to be making a solemn farewell. He harvested and dried the wheat, polished the hoes, sickles, and plows in the corner, and neatly stored them in the tool shed. At dusk, he carried half a bucket of leftover rice to the kennel outside the courtyard wall, squatted down to feed the dogs for the last time, and stroked their fur with his rough hands, whispering, "Be good and guard the house." Sensing something, the dogs whimpered and rubbed against his trousers.

After doing all this, his father packed his bags and headed to Chengdu. This attachment to the land and the kennel became the heaviest burden in his luggage, accompanying him on the bumpy journey.

「 II. HER2 Amplification, Decision to Join Clinical Trial 」

At Sichuan Provincial People's Hospital, his father underwent another gastroscopy. The results showed: "A huge new growth at the gastric angle, covered with dirty moss; gastric angle lesion (advanced CA)." CT scans and immunohistochemistry were also completed. At the time, Amu knew little about gastric cancer and had only one thought: "Treatment must be at a major hospital, and surgery is the only way out."

Expecting to schedule surgery quickly at the provincial hospital, Amu checked the daily surgery list at the nurses' station every day, only to return disappointed. With no other clues, he could only wait passively, lacking a clear treatment direction. This was the most agonizing period for Amu, casting a shadow over both father and son.

Bad news followed: too many lymph node metastases. The doctor advised against surgery. Even if forced, the outcome might not be ideal, and the recurrence risk would be extremely high.

In gastric cancer treatment, surgery is central, but not all patients are suitable for immediate operation. When lymph node metastasis is extensive or the invasion range is wide, the tumor adheres severely to surrounding tissues. Direct surgery cannot achieve a clean cut, leading to rapid metastasis and recurrence, quickly turning it into late-stage disease.

At this point, "neoadjuvant therapy" (preoperative chemotherapy, targeted therapy, and immunotherapy) demonstrated its strategic value: like artillery bombardment before a siege, it not only kills circulating micro-cancer cells and reduces postoperative recurrence risk but also shrinks the originally massive tumor and downstages it, significantly improving the R0 resection rate.

Large-scale clinical data confirms that this "medicine first, surgery later" model brings significant survival benefits to locally advanced patients. Especially for HER2-positive patients, adding targeted drugs is like attaching a "missile warhead" to chemotherapy, precisely striking cancer cells and creating a better clinical window for subsequent surgery or long-term survival.

Nearly two months had passed since leaving home for Chengdu, and his father still hadn't started any treatment. Watching fellow patients in the ward being wheeled into surgery one after another, his father could only wait in the pandemic-locked ward. He often tossed and turned at night, sighing silently at the ceiling.

Meanwhile, the dogs at the kennel inexplicably fell ill and passed away one by one. His father told Amu: "Maybe they know I'm sick and won't be able to care for them anymore, so they left first." Amu quickly comforted him: "They took the disaster for you, so you can stay safe and sound."

Though he comforted his father verbally, Amu was deeply anxious. He worried about disease progression while enduring blows from various test results: traditional chemotherapy had limited efficacy, and surgery was off the table. Treatment seemed at a dead end, and Amu felt a touch of despair.

Just when they were at their wit's end, the doctor recommended a clinical trial for HER2-positive gastric cancer patients led by Professor Q at West China Hospital. To be safe, the doctor also ordered a supplementary FISH test.

[HER2 stands for Human Epidermal Growth Factor Receptor 2, a transmembrane protein involved in normal cell growth and differentiation. When the HER2 gene is amplified or overexpressed in gastric cancer cells, it disrupts the balance of cell growth regulation—like installing an "accelerator" on cancer cells. It not only stimulates uncontrolled rapid proliferation but also enhances their invasive and metastatic capabilities. The proportion of HER2-positive gastric cancer patients is about 10%-20%. Detection requires immunohistochemistry (IHC); 3+ indicates HER2-positive. If 2+, a FISH (fluorescence in situ hybridization) test is needed to confirm. For HER2-positive gastric cancer, various targeted and ADC drugs can significantly improve survival and prognosis, making HER2 testing essential for every gastric cancer patient.]

Soon, the pathology report and FISH test results confirmed once again: HER2-positive.

At that time, many held prejudices against "clinical trial enrollment," viewing it as "being a guinea pig." His father initially had doubts: "Will this unapproved drug really work? Will I suffer for nothing?"

Amu felt the same: "I hadn't joined the patient support group yet. If I had, information channels might have been smoother. But back then, we were truly out of options. Besides this plan, there were almost no other choices."

The enrollment opportunity was fleeting. After discussing with his father, they decided to join the clinical trial. Amu described it as a "desperate gamble."

"At worst, it's death. That's how I prepared him mentally. I told him we must do our best and prepare for the worst. The new drug might work better. Anyway, if you don't want to die, you must face it without fear of death."

The evolution of HER2-targeted therapy for gastric cancer is a relay race in humanity's search for a "precise key."

Initially, traditional chemotherapy was the only path for advanced gastric cancer. Until the 2010 ToGA trial results were published, trastuzumab combined with chemotherapy broke the one-year survival barrier for advanced gastric cancer patients, officially ushering in the 1.0 era of targeted therapy.

Subsequently, the medical community kept advancing. The KEYNOTE-811 trial further introduced immunotherapy, opening the "immunotherapy + targeted therapy + chemotherapy" tri-combination era, significantly boosting the tumor response rate to 72.6% and OS exceeding 20 months.

History did not stop there. The clinical trial Amu's father joined represents more cutting-edge exploration—the "dual-target" collaboration of novel monoclonal antibodies like HLX22 with trastuzumab. By synergistically blocking different epitopes, it aims to more thoroughly cut off cancer cell growth signals. This series of research paths clearly tells us: the treatment blueprint for advanced gastric cancer is constantly being reconstructed, and patients' lifespans are extended through each scientific breakthrough.

「 III. Clinical Trial Treatment Makes Cancer Cells Disappear Completely 」

Amu took his father from the provincial hospital to West China Hospital for enrollment screening.

He borrowed slides from the provincial hospital and sent them to the trial group for retesting. The HER2 result was +++, meeting the enrollment criteria. However, before enrollment, his hemoglobin levels failed to meet the standard twice. Traveling back and forth to the hospital to adjust his indicators during the pandemic was exceptionally difficult. The turning point of fate lay in persistence. Just as Amu was about to give up, the third hemoglobin test barely met the standard, allowing him to pass just before the deadline.

"In the last chance, we finally passed the screening. The indicators met the requirements perfectly, not too much, not too little. We were so lucky! Seeing the results, I was speechless with excitement, feeling like I had grabbed a lifeline."

On June 20, 2022, his father officially enrolled and began the first phase of treatment. The regimen was oxaliplatin + capecitabine (chemotherapy) + trastuzumab + experimental drug HLX22 (dual-target), with a 21-day cycle.

[HLX22 is an innovative anti-HER2 humanized monoclonal antibody injection. It synergizes with trastuzumab to block HER2 signaling, used for solid tumors like gastric and breast cancer, currently in Phase III clinical trials. Its core mechanism promotes endocytosis and degradation of HER2 homo/heterodimers, synergistically blocking signaling pathways, inhibiting proliferation, and inducing apoptosis.]

Although Amu had psychologically prepared his father beforehand, giving him a "vaccination" that the treatment might be tough, his father patted his shoulder and said, "It's fine. Take a chance, and there's hope."

However, the reaction after the first dose was far stronger than expected. His father vomited severely, suffered unbearable body pain, and broke into cold sweats. Yet he never mentioned the agonizing pain or sleepless nights. Amu only learned the severity of the side effects later when he called his mother and heard her sighs.

Amu immediately consulted the trial doctors for solutions. He packed antiemetic ondansetron hydrochloride and painkiller celecoxib into his bag without missing a single item, then drove home. "Actually, express delivery would have arrived the next day, but I couldn't bear to let him suffer for a moment longer."

As soon as the car stopped, he pushed the door open and rushed out.

It was a hot day. His father sat on a stone pier at the courtyard gate, hunched over, holding a palm-leaf fan but too weak to wave it. Seeing Amu, he was startled, a flash of panic in his eyes, then quickly put on a stern face and scolded his mother who came out: "Oh, I said I was fine. This pain is nothing, I can endure it. Why did you tell him!" His voice wasn't loud but carried a forced confidence, with a slight tremor at the end.

Amu said nothing, walked over quickly, squatted in front of his father, handed him the medicine bottle, swallowed hard, and finally managed to say: "Dad, take your medicine."

Fortunately, from the second dose onward, the reactions were much milder, and his father felt more at ease.

Miracles quietly arrived through persistence. After two doses, the doctor ordered a contrast-enhanced CT scan, which showed significant tumor shrinkage. The doctor told Amu the treatment was working very well. After two months, Amu finally saw a glimmer of hope.

After four doses, another contrast-enhanced CT scan showed further tumor shrinkage, and the stomach pain symptoms completely disappeared.

His father's appetite improved, and he could sleep soundly at night. He rubbed his stomach, feeling a long-lost sense of relief. In the ward, he often shared funny stories about the kennel with fellow patients: "My rooster was so bold, it dared to challenge a pack of dogs alone, and got beaten up by them, haha."

After eight cycles, imaging scans no longer showed any trace of metastatic lymph nodes. His father's heart ignited with hope: "This drug really seems to work. Maybe my condition will truly improve, and I can go back to check on the dogs and fertilize the corn." He began practicing walking slowly in the ward, dreaming of returning to the ridges with dogs happily running behind him.

In the summer of 2023, his son's college application was securely set for Xi'an. The day the admission letter arrived, his father held the corner of the paper, rubbing it repeatedly, unable to hide his smile. Amu saw this and immediately planned a trip—to send his son to college and fulfill his father's wish.

On the university campus, his father smiled with his eyes narrowed to slits, holding relatives' hands and insisting on taking photos. He stood straight, deliberately smoothing his shirt corners. In the photo, he looked even prouder than his grandson who had just been admitted.

"My son and his grandfather are very close." Amu's voice gradually lowered. "When his grandfather was diagnosed, the boy was only in his second year of high school. After hearing the news, his monthly exam scores dropped sharply. His mother and I didn't dare tell him much, fearing it would affect his studies, so we kept it hidden."

It wasn't until his son received the admission letter, and the family stood on the Xi'an campus watching his father and grandson smile side by side, that the heavy stone in Amu's heart finally eased.

"Rural folks always think that getting cancer means waiting for the end, accepting fate, not struggling, not fighting." He suddenly paused, choking up. "If we had thought that way back then, if we had given up, he might not be here today..."

In June 2024, a gastroscopy two years into treatment brought wonderful news: CR (Complete Response). "This feeling is even more thrilling than my son's college exam results. I shared this good news in all the patient groups," Amu said. "No malignant tumors were shown, and there's no cancer anymore."

In October 2024, Amu's father continued into the second phase of the clinical trial. Fellow patients from the same cohort had gradually exited, leaving only his father still persisting. The clinical staff told him that his father's treatment response was excellent, truly one in a hundred.

Due to severe hand-foot syndrome from long-term capecitabine use, after repeated discussions with the doctor, in June 2025, capecitabine was discontinued, leaving only trastuzumab and the experimental drug for maintenance therapy.

In August 2025, his father had another gastroscopy, which only showed a gastric angle ulcer and chronic gastritis. No other abnormalities were found.

「 IV. Persistence Makes Miracles Bloom 」

Looking back on the treatment journey, Amu transitioned from initial blind fear of cancer to a rational understanding of treatment; from bearing pressure alone in confusion to mutual support after joining the patient group; from knowing nothing about clinical trials to rejoicing at his father's rebirth. Along the way, there were hardships during pandemic lockdowns, anxiety over unmet indicators, and heartache from side effects, but more importantly, the hope brought by persistence.

His father's mindset also underwent a huge shift. From the initial breakdown upon diagnosis to calmness after treatment, he now proactively discusses with Amu about which village elder passed away from illness, with no trace of his former fear. "He now views cancer as a chronic disease requiring long-term management, neither blindly fearing it nor neglecting it," Amu said. This mindset shift was key to overcoming the crisis.

Sixteen years of running the kennel forged a unique synergy between father and son. Amu handled direction and clients, while his father managed daily care and stability. Like balancing dog food, Amu focused on scientific ratios, while his father prioritized practical feel; both were indispensable. They survived puppy distemper crises, weathered market slumps, and stayed up for newborn puppies together. His father often said: "Raising dogs is like farming. It requires heart and persistence. You can't fish for three days and dry nets for two." This later became their motto for fighting cancer.

Those debates over feeding philosophies, those days and nights guarding the kennel, all transformed into a deep emotional bond that sustained them through the hardest times.

After stopping capecitabine, his father's hand-foot symptoms significantly improved. His nails grew back, and he could plant vegetables and raise chickens and ducks back home. Every time he came to Chengdu for check-ups, he would bring Amu a full bag of homegrown vegetables.

Though the kennel closed, Amu specifically kept an old yellow dog and the most obedient puppy to accompany his father. Every morning, he walks the old dog along the ridges, just like when he managed the kennel. In the evening, he feeds and grooms them, chatting about the harvest and village gossip. The old dog always lies quietly at his feet, occasionally nudging his hand with its head, as if responding.

Today, Amu still debates whether to continue maintenance therapy, but seeing his father's robust health and fulfilling later life, he already has his answer.

"Except for coming to the hospital for medication every 21 days, his life is no different from a normal person's. As long as the family is together, ordinary life is the greatest happiness."

To protect patient privacy, names in the article are pseudonyms. Images containing patient portraits are used with patient authorization and may not be used without permission.

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