Al-Batran Salah-Eddin, Hozaeel Wael, Jäger Elke
Institute of Clinical Research at the Krankenhaus Nordwest and Department of Oncology and Hematology, University Cancer Center Frankfurt, Frankfurt/M., Germany.
Onkologie. 2012;35(9):505-8. doi: 10.1159/000341841. Epub 2012 Aug 17.
Trastuzumab in combination with doublet chemotherapy (cisplatin and fluoropyrimidine) is a standard treatment for patients with HER2-positive advanced gastric cancer. There have been no studies evaluating trastuzumab with more intensive triplet chemotherapy regimens in this setting. We report the treatment outcome in 3 patients with HER2-positive metastatic gastric cancer who were treated with trastuzumab plus the triplet FLOT regimen (5-fluorouracil/leucovorin, oxaliplatin, and docetaxel).
3 patients with HER2-positive metastatic gastric cancer received trastuzumab plus FLOT. Trastuzumab 4 mg/kg was given with the 2nd chemotherapy cycle and was continued at 2 mg/kg every week with subsequent cycles.
All 3 patients had a dismal prognosis because of their heavy disease burden, most notably extensive hepatic metastatic involvement. Patients tolerated the triple-drug plus trastuzumab combination well. All patients exhibited a dramatic clinical response.
This report provides the first evidence that the addition of trastuzumab to a docetaxel-based, triple-drug chemotherapy combination is feasible and highly active in patients with HER2-positive metastatic gastric cancer.
曲妥珠单抗联合双药化疗（顺铂和氟嘧啶）是HER2阳性晚期胃癌患者的标准治疗方案。目前尚无研究评估曲妥珠单抗联合更强效的三药化疗方案用于该情况。我们报告了3例HER2阳性转移性胃癌患者接受曲妥珠单抗联合FLOT三药方案（5-氟尿嘧啶/亚叶酸钙、奥沙利铂和多西他赛）治疗的结果。
3例HER2阳性转移性胃癌患者接受曲妥珠单抗联合FLOT治疗。曲妥珠单抗4mg/kg在第2个化疗周期给药，并在随后的周期中每周以2mg/kg持续给药。
由于疾病负担重，所有3例患者预后不佳，最显著的是广泛的肝转移。患者对三药加曲妥珠单抗联合方案耐受性良好。所有患者均表现出显著的临床反应。
本报告首次证明，在HER2阳性转移性胃癌患者中，在基于多西他赛的三药化疗方案中加入曲妥珠单抗是可行的且活性很高。
