Combination of trastuzumab and taxane-containing intensified chemotherapy in first-line treatment of HER2-positive advanced gastric cancer

Purpose: Taxane-containing combinations are recommended for the first-line therapy of advanced gastric cancer. It is not known which chemotherapy regimen is the best with trastuzumab for HER2-positive patients. The aim of this study was to compare taxane-containing intensified chemotherapy versus st...

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Published in:	Tumori 2021-10, Vol.107 (5), p.416-423
Main Authors:	Gürbüz, Mustafa, Akkuş, Erman, Sakin, Abdullah, Urvay, Semiha, Demiray, Atike Gökçen, Şahin, Süleyman, Şakalar, Teoman, Erol, Cihan, Şendur, Mehmet ali Nahit, Şahin, Ahmet Bilgehan, Çubukçu, Erdem, Güven, Deniz Can, Kılıçkap, Saadettin, Ergün, Yakup, Uncu, Doğan, Turhal, Nazım Serdar, Üskent, Necdet, Yeşil Çınkır, Havva, Demir, Atakan, Acar, Ramazan, Karadurmuş, Nuri, Türker, Sema, Altınbaş, Mustafa, Karaoğlan, Mert, Çay Şenler, Filiz
Format:	Article
Language:	eng
Subjects:	Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Bridged-Ring Compounds - administration & dosage Bridged-Ring Compounds - adverse effects Female Humans Male Middle Aged Receptor, ErbB-2 - analysis Retrospective Studies Stomach Neoplasms - chemistry Stomach Neoplasms - drug therapy Stomach Neoplasms - mortality Taxoids - administration & dosage Taxoids - adverse effects Trastuzumab - administration & dosage Trastuzumab - adverse effects Young Adult
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Summary:	Purpose: Taxane-containing combinations are recommended for the first-line therapy of advanced gastric cancer. It is not known which chemotherapy regimen is the best with trastuzumab for HER2-positive patients. The aim of this study was to compare taxane-containing intensified chemotherapy versus standard chemotherapy in combination with trastuzumab in the first-line treatment of HER2-positive advanced gastric adenocarcinoma. Methods: This study is a retrospective multicenter study of the Turkish Oncology Group. A total of 130 HER2-positive patients with inoperable locally advanced, recurrent, or metastatic gastric adenocarcinoma being given chemotherapy plus trastuzumab as the first-line treatment were included from 16 different oncology centers. Trastuzumab combination with intensified chemotherapy including taxane or standard chemotherapy was compared in terms of progression-free survival (PFS), overall survival (OS), and toxicity. Results: There were 108 patients in the standard and 22 patients in the intensified chemotherapy group. PFS of the standard and intensified group were 5.6 months (95% confidence interval [CI] 4.8–6.4) and 5.3 months (95% CI 2.6–8), respectively (p = 0.70). OS of the standard and intensified group were 11.1 months (95% CI 8.3–13.9) and 15.2 months (95% CI 12.7–17.7), respectively (p = 0.03). Repeated analysis excluding patients given any previous therapy revealed similar results. The intensified group had more fever and febrile neutropenia. Conclusion: Trastuzumab combination with intensified chemotherapy provides better OS in first-line treatment of HER2-positive advanced gastric cancer. Further large-scale studies should be performed in HER2-positive patients.
ISSN:	0300-8916 2038-2529