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 \nUniversity of Murcia, Spain  \nREVIEWED BY  \nThomas Böldicke,  \nHelmholtz Association of German Research Centers (HZ), Germany  \nU˘gur ahin,  \nAnkara University, Türkiye  \n*CORRESPONDENCE  \nZheng-Quan Feng  \n [fzhq213@aliyun.com](fzhq213@aliyun.com)  \n†These authors have contributed equally to this work  \nRECEIVED 20 April 2025  \nACCEPTED 21 July 2025  \nPUBLISHED 05 August 2025  \nCITATION  \nZhang Q-Q, Luo X-X, Chen H, Wang W, Xie Y-F, Qiao H-L, Miao H-J and Feng Z-Q (2025) Case Report: Successful treatment of triple primary cancers (lung, stomach, and intestine) using sintilimab combined with chemotherapy and targeted therapy.  \nFront. Immunol. 16:1614911 .  \ndoi: 10.3389/fimmu.2025.1614911  \nCOPYRIGHT  \n© 2025 Zhang, Luo, Chen, Wang, Xie, Qiao, Miao and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nCase Report: Successful treatment of triple primary cancers (lung, stomach, and intestine) using sintilimab combined with chemotherapy and targeted therapy  \nQi-Qing Zhang 1†, Xin-Xin Luo 2†, Hua Chen 1, Wei Wang 3, Yi-Fan Xie3, Hong-Li Qiao 1, Hao-Jun Miao 1 and Zheng-Quan Feng 1*  \n1 Department of Oncology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China,  \n2College of Integrated Traditional Chinese and Western Medicine Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China, 3 Department of Pathology, Tongde Hospital of Zhejiang Province, Hangzhou, China  \nThis case report presents a rare instance of synchronous multiple primary cancers involving lung adenocarcinoma with bone metastasis, gastric signetring cell carcinoma, and rectal cancer. The 64-year-old male patient was treated with a combination of sintilimab, chemotherapy, and targeted therapy. Following a multidisciplinary team consultation, systemic treatment with sintilimab, oxaliplatin, and capecitabine was initiated concurrently while furmonertinib targeted therapy continued. After six cycles, the lung lesions showed significant reduction, while the gastric and intestinal tumors remained stable. The patient transitioned to maintenance therapy and achieved sustained disease control without severe adverse effects. This case highlights the potential of an integrated immunotherapy and chemotherapy approach for treating multiple primary malignancies with distinct [pathological origins. report](pathological origins. report) also underscores the need for individualized, biomarker-driven treatment strategies and further research on optimal therapeutic combinations for synchronous multiple primary cancers.  \nKEYWORDS  \nchemotherapy, immunotherapy, multiple primary cancers, sintilimab, targeted therapy  \n1 Introduction  \nMultiple primary cancers—also known as compound or repeated cancers—refer to the occurrence of two or more independent primary cancers in the same individual, either simultaneously or sequentially. Based on the time interval between occurrences, they are classified as metachronous or synchronous multiple primary cancers (1). Multiple primary  \nFrontiers in Immunology 01 [frontiersin.org](frontiersin.org)  \ncancers are defined according to guidelines from the Surveillance Epidemiology and End Results (SEER) Program and the International Association of Cancer Registries (IACR) along with the International Agency for Research on Cancer (IARC) (2–4) . The incidence of multiple primary cancers in the cancer population ranges from 2.4–8%, and can reach as high as 17% after 20 years of follow-up (5) . Currentl","cbCaihtEa8bhNFsC","https://ap.wps.com/l/cbCaihtEa8bhNFsC","pdf",15790759,"English","# 1 Introduction\n## 2 Case summary","[{\"question\":\"What condition does the case report describe?\",\"answer\":\"It reports a rare synchronous multiple primary cancers case involving lung adenocarcinoma with bone metastasis, gastric signet-ring cell carcinoma, and rectal cancer.\"},{\"question\":\"Which treatment regimen was used and how was it initiated?\",\"answer\":\"The patient received sintilimab with chemotherapy (oxaliplatin and capecitabine) while furmonertinib targeted therapy was continued, initiated concurrently after a multidisciplinary team consultation.\"},{\"question\":\"What were the treatment outcomes after six cycles?\",\"answer\":\"After six cycles, lung lesions showed significant reduction, while gastric and intestinal tumors remained stable, followed by maintenance therapy for sustained disease control without severe adverse effects.\"}]","Case Report - Case Report - Successful treatment of triple primary cancers (lung, stomach, and intestine) using sintilimab combined with chemotherapy and targeted therapy | PDF",1790190668,25]