Phase II Study of Continued Trastuzumab Plus Irinotecan in Patients with HER2-positive Gastric Cancer Previously Treated with Trastuzumab (HGCSG 1201).

Abstract

BACKGROUND:

The efficacy of irinotecan plus continuous trastuzumab beyond progression in patients with gastric cancer previously treated with trastuzumab plus standard first-line chemotherapy has not been reported.

METHODS:

Patients with human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer who were previously treated with trastuzumab received trastuzumab every 3 weeks and irinotecan every 2 weeks. The primary endpoint was the overall response rate (ORR), and the secondary endpoints included progression-free survival (PFS), 6-month survival rates, safety, and subgroup analysis by HER2 status.

RESULTS:

Sixteen patients were enrolled in a 3-year pre-planned registration period. This study was prematurely closed due to poor patient accrual. The ORR and disease control rate were 6.7% (95% CI, 0.2-32.0) and 53.3% (95% CI, 26.6-78.7). The median PFS and overall survival (OS) were 2.4 months (95% CI, 0.0-5.2) and 9.7 months (95% CI, 8.2-11.2), respectively. The most frequently reported grades 3-4 adverse events were neutropenia (40%), anemia (27%), anorexia (33%), and fatigue (33%).

CONCLUSION:

With only 16 patients enrolled, the present study has very low power to detect any clinical benefit of trastuzumab plus irinotecan beyond disease progression in patients with HER2-positive advanced gastric cancer who previously received trastuzumab.Trial Identifier: UMIN000007636.

• Authors: Yasuyuki Kawamoto, Satoshi Yuki, Takashi Meguro, Kazuteru Hatanaka, Minoru Uebayashi, Michio Nakamura, Hiroyuki Okuda, Ichiro Iwanaga, Takashi Kato, Shintaro Nakano, Atsushi Sato, Kazuaki Harada, Koji Oba, Yuh Sakata, Naoya Sakamoto, Yoshito Komatsu
• Journal: The oncologist (Oncologist) Vol. 27 Issue 5 Pg. 340-e374 (05 06 2022) ISSN: 1549-490X [Electronic] England
• PMID: 35303078 (Publication Type: Clinical Trial, Phase II, Journal Article)
• Copyright: © The Author(s) 2022. Published by Oxford University Press.

Chemical References

• Irinotecan
• Receptor, ErbB-2
• Trastuzumab

Topics

• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Breast Neoplasms (drug therapy)
• Female
• Humans
• Irinotecan (therapeutic use)
• Receptor, ErbB-2 (metabolism)
• Stomach Neoplasms (drug therapy, genetics)
• Survival Rate
• Trastuzumab