Efficacy and safety of trastuzumab in combination with oxaliplatin and fluorouracil-based chemotherapy for patients with HER2-positive metastatic gastric and gastro-oesophageal junction adenocarcinoma patients: a retrospective study.

Trastuzumab with 5-fluorouracil (5-FU) and cisplatin offers prolonged survival in patients with HER2-overexpressing advanced gastric cancer (AGC) and advanced gastro-oesophageal junction cancer (AGOJ). Oxaliplatin in combination with intravenous 5-FU plus leucovorin (LV; modified [m]FOLFOX6) or capecitabine (XELOX) improves tolerability compared with 5-FU/cisplatin regimen. There are few data available on the efficacy and safety of trastuzumab-oxaliplatin-based chemotherapy in previously untreated HER2-positive AGC and AGOJ patients.
Clinical data were retrospectively analysed in patients receiving trastuzumab plus mFOLFOX6 or XELOX as first-line therapy between July 2009 and December 2012. Eligible patients had histologically proven AGC or AGOJ, HER2 overexpression, and no prior chemotherapy for metastatic disease.
Thirty-four patients met the eligibility criteria. Median age was 63 years, 79% of patients had ECOG PS score of 0-1, and all had metastatic disease. Median duration of treatment was 7.5 months. Overall response rate was 41% (95% CI: 25-56). Median progression-free survival and overall survival were 9.0 months (95% CI: 5.6-12) and 17.3 months (95% CI: 13.5-32.3), respectively. Tolerability was acceptable. The most frequent grade 3-4 toxicities were neutropenia (8.8%) and neuropathy (17.6%).
mFOLFOX6-trastuzumab combination is an efficient regimen with an acceptable safety profile for AGC and AGOJ patients. These results warrant further prospective study.
AuthorsÉmilie Soularue, Romain Cohen, Christophe Tournigand, Aziz Zaanan, Christophe Louvet, Jean-Baptiste Bachet, Olivia Hentic, Emmanuelle Samalin, Benoist Chibaudel, Aimery de Gramont, Thierry André,
JournalBulletin du cancer (Bull Cancer) Vol. 102 Issue 4 Pg. 324-31 (Apr 2015) ISSN: 1769-6917 [Electronic] France
PMID25744576 (Publication Type: Journal Article, Multicenter Study)
CopyrightCopyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
Chemical References
  • Antibodies, Monoclonal, Humanized
  • Organoplatinum Compounds
  • Deoxycytidine
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Trastuzumab
  • Leucovorin
  • Fluorouracil
  • Adenocarcinoma (drug therapy, metabolism, mortality, pathology)
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized (administration & dosage, adverse effects)
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
  • Deoxycytidine (administration & dosage, adverse effects, analogs & derivatives)
  • Esophageal Neoplasms (chemistry, drug therapy, metabolism, mortality)
  • Esophagogastric Junction
  • Female
  • Fluorouracil (administration & dosage, adverse effects, analogs & derivatives)
  • Humans
  • Leucovorin (adverse effects)
  • Male
  • Middle Aged
  • Organoplatinum Compounds (adverse effects)
  • Receptor, ErbB-2 (metabolism)
  • Retrospective Studies
  • Stomach Neoplasms (chemistry, drug therapy, metabolism, mortality)
  • Trastuzumab

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