• Gaili An, Xin Cheng He, Jun Bai, and Jianhua Wang.
• Department of Internal Medicine Oncology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
• Medicine (Baltimore). 2023 Mar 31; 102 (13): e33377e33377.

RationaleGastric cancer (GC) is one of the most common malignancies globally, and its occurrence and development are associated with genetic, dietary, biological, and immune factors. Epstein-Barr virus-associated gastric cancer (EBVaGC), as a special subtype of GC, has become a research hotspot in recent years. In patients with advanced GC, Epstein-Barr virus infection is closely related to lymph node metastasis, depth of tumor invasion, and poor prognosis. There is great clinical need for a new treatment modality for EBVaGC. Advances in molecular biology and cancer genetics have led to the development of immune checkpoint inhibitors (ICIs); patients treated with ICIs experience clinical benefit and few adverse effects.Patient Concerns And DiagnosesWe report a 31-year-old male with advanced EBVaGC and multiple sites of lymph node metastasis who was intolerant to multiple lines of chemotherapy.Interventions And OutcomeAfter immune checkpoint inhibitor treatment, both primary and metastatic tumors shrank significantly without noticeable adverse reactions. After 21 months of progression-free status, the patient underwent R0 resection.LessonsThis case report provides evidence for the use of ICIs in treating EBVaGC. It also shows that detection of Epstein-Barr virus-encoded small nuclear RNA may be a prognostic factor in gastric cancer.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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