Namikawa Tsutomu, Munekage Eri, Munekage Masaya, Maeda Hiromichi, Yatabe Tomoaki, Kitagawa Hiroyuki, Sakamoto Kouichi, Obatake Masayuki, Kobayashi Michiya, Hanazaki Kazuhiro
Department of Surgery, Kochi Medical School, Kochi 783-8505, Japan.
Cancer Treatment Center, Kochi Medical School Hospital, Kochi 783-8505, Japan.
Mol Clin Oncol. 2016 Jul;5(1):74-78. doi: 10.3892/mco.2016.892. Epub 2016 May 10.
The present study aimed to evaluate the efficacy and safety of trastuzumab plus chemotherapy for patients with unresectable advanced or recurrent gastric cancer. A retrospective analysis of 213 patients with unresectable advanced or recurrent gastric cancer who received systemic chemotherapy, including 15 patients who were also administered trastuzumab, at Kochi Medical School between 2007 and 2013 was performed. The overall survival was compared between patients who received trastuzumab plus chemotherapy and patients who received chemotherapy alone, and the safety and efficacy of the trastuzumab-containing regimen was evaluated. Human epidermal growth factor receptor (HER)2 status was examined in 86 patients, of whom 15 (17.4%) exhibited strong positive HER2 expression. The rate of strong positive HER2 expression was significantly higher for intestinal type tumors compared with diffuse type tumors [23.6 (13/55) vs. 6.5% (2/31); P=0.044]. The median overall survival of the patients treated with trastuzumab was significantly longer compared with that for patients who were not treated with trastuzumab (22.9 vs. 11.6 months; P=0.014). The objective response rate and disease control rate for trastuzumab plus chemotherapy were 46.7 and 86.7%, respectively. Frequently encountered grade 3-4 toxicities included neutropenia (26.7%; 4/15), anemia (13.3%; 2/15) and fatigue (13.3%; 2/15). Trastuzumab plus chemotherapy is effective for patients with HER2-positive advanced or recurrent gastric cancer, and the frequencies of hematological and non-hematological toxicities experienced by patients in the present study indicated that it can be safely administered clinically.
本研究旨在评估曲妥珠单抗联合化疗治疗不可切除的晚期或复发性胃癌患者的疗效和安全性。对2007年至2013年在高知医科大学接受全身化疗的213例不可切除的晚期或复发性胃癌患者进行了回顾性分析，其中15例患者还接受了曲妥珠单抗治疗。比较了接受曲妥珠单抗联合化疗的患者与单纯接受化疗的患者的总生存期，并评估了含曲妥珠单抗方案的安全性和疗效。对86例患者检测了人表皮生长因子受体（HER）2状态，其中15例（17.4%）表现为HER2强阳性表达。肠型肿瘤的HER2强阳性表达率显著高于弥漫型肿瘤[23.6%（13/55）对6.5%（2/31）；P=0.044]。接受曲妥珠单抗治疗的患者的中位总生存期显著长于未接受曲妥珠单抗治疗的患者（22.9个月对11.6个月；P=0.014）。曲妥珠单抗联合化疗的客观缓解率和疾病控制率分别为46.7%和86.7%。常见的3-4级毒性包括中性粒细胞减少（26.7%；4/15）、贫血（13.3%；2/15）和疲劳（13.3%；2/15）。曲妥珠单抗联合化疗对HER2阳性的晚期或复发性胃癌患者有效，本研究中患者经历的血液学和非血液学毒性发生率表明其在临床上可安全应用。
