4CPS-122 Efficacy of different chemotherapy regimens associated with trastuzumab in her2-positive advanced gastric cancer: data from the national register agamenon
التفاصيل البيبلوغرافية
العنوان:
4CPS-122 Efficacy of different chemotherapy regimens associated with trastuzumab in her2-positive advanced gastric cancer: data from the national register agamenon
Background The Phase III TOGA study confirmed an increased survival for patients with HER2-positive advanced gastric cancer (AGC) treated with trastuzumab in combination with cisplatin and fluoropyrimidine (CF). However, there is little information on trastuzumab activity in combination with other chemotherapy regimens. Purpose To provide an overview of the use and effectiveness of trastuzumab combined with different chemotherapy regimens. Material and methods AGAMENON is a national AGC registry that included patients treated with chemotherapy between 2008 and 2017. Patients were eligible for this substudy if their cancers showed overexpression of HER2 (immunohistochemistry (IHC)3+or IHC2+/fluorescence in situ hybridisation (FISH)+). Patients were treated with trastuzumab (6 mg/kg; loading dose 8 mg/kg) every 21 days in combination with a chemotherapy regimen grouped into: fluoropyrimidine, platinum and docetaxel or epirubicin (triplets-T), fluoropyrimidine and oxaliplatin or cisplatin (doublets-T), and non-standard regimens (other-T). The primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS). The Kaplan-Meier method was used to estimate OS and PFS. Results By October 2017, 1791 patients had been recruited, 305 (17%) were HER2-positive AGC of which 255 (84%) were treated with trastuzumab. The median age (range) was 65 (21–86) years; 79% males; ECOG-performance status ≥2.1%; oesophagus and gastroesophageal junction AGC, 31%;≥3 metastatic sites, 37%; intestinal subtype of Lauren, 66%; and HER-2 overexpression ICH3+, 69%. Most frequent chemotherapy regimens (% of total) used in combination with trastuzumab were: capecitabine +cisplatin or oxaliplatin, 31% and 30%, respectively in the Doublets-T group, epirrubicin or docetaxel +CF, 3% and 2%, respectively in the Triplets-T group and 5-fluorouracil+carboplatin (8%) in the Other-T group. Survival results are shown in the table. Conclusion In HER2-positive AGC, trastuzumab with a wide variety of chemotherapy regimens provides similar efficacy as that combined with CF. Trastuzumab with triplets does not provide additional OS benefits, and its combinations with non-standard regimens shows the poorest results. References and/or Acknowledgements We thank all the researchers of the AGAMENON registry for their contribution to this study No conflict of interest
