Comparison of survival outcomes according of patients with metastatic gastric cancer receiving trastuzumab with systemic chemotherapy

Gi-Young Ha; Sung-Hyun Yang; Hye-Jin Kang; Hyo-Lak Lee; Jin Kim; Yun-Ju Kim; Hang-Jong Yu; Jong-Inn Lee; Sung-Ho Jin

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자료유형: 학술저널

저자정보: Gi-Young Ha (Korea Institute of Radiological and Medical Sciences) Sung-Hyun Yang (Korea Institute of Radiological and Medical Sciences) Hye-Jin Kang (Korea Institute of Radiological and Medical Sciences) Hyo-Lak Lee (Korea Institute of Radiological and Medical Sciences) Jin Kim (Korea Institute of Radiological and Medical Sciences) Yun-Ju Kim (Korea Institute of Radiological and Medical Sciences) Hang-Jong Yu (Korea Institute of Radiological and Medical Sciences) Jong-Inn Lee (Korea Institute of Radiological and Medical Sciences) Sung-Ho Jin (Korea Institute of Radiological and Medical Sciences)

저널정보: 대한종양외과학회 KOREAN JOURNAL OF CLINICAL ONCOLOGY Korean Journal of Clinical Oncology 제16권 제2호

발행연도: 2020.12

수록면: 63 - 70 (8page)

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Purpose: Currently, trastuzumab plus chemotherapy is the standard first-line therapy for human epidermal growth factor receptor 2 (HER2)-positive advanced or metastatic gastric cancer (mGC) or esophagogastric junction cancer. However, it is not clear whether the prognosis of HER2-positive mGC treated with trastuzumab plus chemotherapy is better than that of HER2-negative mGC treated with chemotherapy as the first-line therapy.
Methods: We performed a retrospective study comparing the prognosis of mGC according to first-line treatment with trastuzumab plus chemotherapy or chemotherapy only, at the Korea Cancer Center Hospital from 2011 to 2018. The Kaplan-Meier method and Cox proportional hazards model were used for univariate and multivariate survival analyses.
Results: The median overall survival of trastuzumab group was 26.1 months and that of chemotherapy group was 14.8 months (P=0.047). Trastuzumab group had a longer median progression-free survival than chemotherapy group (23.4 vs. 9.2 months, P=0.026). By univariate analysis, sex, age, World Health Organization (WHO) histology, HER2 status, primary tumor site, extent of disease, number of lesions, number of metastatic, measurability of disease, prior gastrectomy, and chemotherapy group are statistically significant. Using multivariate analysis, number of lesions, number of metastatic, prior gastrectomy, and trastuzumab group (hazard ratio, 0.594; 95% confidence interval, 0.384–0.921; P=0.020) were found to be independent prognostic factors of overall survival.
Conclusion: The result suggests prognosis of HER2-positive mGC treated by trastuzumab plus chemotherapy could be better than that of HER2-negative mGC treated by chemotherapy only. Well-designed prospective cohort studies are needed to confirm the results of this study. HER2 testing should be performed routinely in all patients newly diagnosed with mGC.

#Stomach #Esophagogastric junction #Drug therapy #Trastuzumab #Survival

참고문헌 (30)

참고문헌 신청

Ferlay J / 2015 / Cancer incidence and mortality worldwide : sources, methods and major patterns in GLOBOCAN 2012 / Int J Cancer 136:E359~86

정규원 / 2018 / Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2015 / Cancer Research and Treatment 50(2):303~316

Wagner AD / 2006 / Chemotherapy in advanced gastric cancer : a systematic review and meta-analysis based on aggregate data / J Clin Oncol 24:2903~2909

National Comprehensive Cancer Network (NCCN) / NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines 2018)

Cancer Genome Atlas Research Network / 2014 / Comprehensive molecular characterization of gastric adenocarcinoma / Nature 513:202~209

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