Department of Medical Oncology, Ankara University Faculty of Medicine, Ankara, Turkey.
Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey.
Tumori. 2021 Oct;107(5):416-423. doi: 10.1177/0300891620969823. Epub 2020 Nov 9.
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.
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.
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 ( = 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 ( = 0.03). Repeated analysis excluding patients given any previous therapy revealed similar results. The intensified group had more fever and febrile neutropenia.
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.
紫杉烷类药物联合化疗方案被推荐用于晚期胃癌的一线治疗。目前尚不清楚对于 HER2 阳性患者，哪种化疗方案联合曲妥珠单抗的疗效最佳。本研究旨在比较紫杉烷类药物强化化疗与标准化疗联合曲妥珠单抗治疗 HER2 阳性晚期胃腺癌的疗效。
这是一项由土耳其肿瘤学会进行的回顾性多中心研究。共纳入 16 个不同肿瘤中心的 130 例不可切除的局部晚期、复发或转移性胃腺癌 HER2 阳性患者，一线接受化疗联合曲妥珠单抗治疗。比较曲妥珠单抗联合强化化疗（包括紫杉烷类药物）与标准化疗方案在无进展生存期（PFS）、总生存期（OS）和毒性方面的差异。
标准组和强化组分别有 108 例和 22 例患者。标准组和强化组的 PFS 分别为 5.6 个月（95%置信区间 [CI] 4.8-6.4）和 5.3 个月（95% CI 2.6-8）（ = 0.70）。标准组和强化组的 OS 分别为 11.1 个月（95% CI 8.3-13.9）和 15.2 个月（95% CI 12.7-17.7）（ = 0.03）。排除接受过任何既往治疗的患者后进行重复分析，结果相似。强化组发热和发热性中性粒细胞减少的发生率更高。
曲妥珠单抗联合强化化疗方案可为 HER2 阳性晚期胃癌的一线治疗提供更好的 OS。应在 HER2 阳性患者中开展进一步的大规模研究。
