Impact of HER2 status in resected gastric or gastroesophageal junction adenocarcinoma in a Western population

Lago, Nieves Martínez; Villar, M. Vieito; Ponte, Rafael Varela; Abdulkader-Nallib, Ihab; Alvarez, Juan José Carrera; López, José Ramón Antúnez; López‐López, Rafael; Iruegas, María Elena Padin

doi:10.3332/ecancer.2020.1020

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…Patients with HER2‐positive GC tended to relapse in distant sites other than peritoneal or local recurrence. 31 , 32 Brain metastasis from GC is uncommon, and the incidence rate is 0.47%–0.7%. 33 , 34 In patients with breast cancer, there is a positive correlation between HER2 overexpression and a higher risk of brain metastasis.…”

Section: Discussionmentioning

confidence: 99%

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Real‐world clinical outcomes of the combination of anti‐PD‐1 antibody, trastuzumab, and chemotherapy for HER2‐positive gastric/gastroesophageal junction cancer

et al. 2023

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Background Previous clinical trials indicated the addition of anti‐PD‐1 antibody remarkably improved the efficacy of trastuzumab and chemotherapy in patients with HER2‐positive gastric/gastroesophageal junction (GEJ) cancer. However, no real‐world experiences have been reported yet. Methods We retrospectively analyzed 1212 patients with gastric/GEJ cancer treated at Nanjing Drum Tower Hospital between 2019 and 2022. Among 138 patients with HER2‐positive gastric/GEJ cancer, 47 patients receiving at least two doses of the combination regimen with anti‐PD‐1 antibody, trastuzumab, and chemotherapy were recruited in the study population, and 38 out of 47 patients with measurable disease were included in the efficacy population. Progression‐free survival (PFS), objective response rate (ORR), disease control rate (DCR), and toxicity profiles were reported. Results In the study population, 37 (78.7%) received the study therapy as a first‐line treatment. In the efficacy population, the ORR and DCR were 76.3% and 94.7%, respectively. The overall median PFS was 9.1 months (95% confidence interval [CI] 6.3–11.9 months). For the first‐line treatment, the mPFS was 10 months, and 7 months for the second‐line. Among 14 patients who failed the study treatment, three (21.4%) developed brain metastasis as the first failure site. No significant association was found between PFS and the expression of PD‐L1. 22.2% of patients developed grade 3 treatment‐related adverse events (TRAEs). No treatment‐related grade ≥4 adverse events or deaths occurred. Conclusion This real‐world study validated the combination regimen's high efficacy and good tolerance in patients with HER2‐positive gastric/GEJ cancer. An increased incidence of brain metastasis was observed in patients who failed this regimen.

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Section: Discussionmentioning

confidence: 99%

“…Patients with HER2‐positive GC tended to relapse in distant sites other than peritoneal or local recurrence 31,32 . Brain metastasis from GC is uncommon, and the incidence rate is 0.47%–0.7% 33,34 .…”

Section: Discussionmentioning

confidence: 99%

Real‐world clinical outcomes of the combination of anti‐PD‐1 antibody, trastuzumab, and chemotherapy for HER2‐positive gastric/gastroesophageal junction cancer

et al. 2023

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“…HER-2 testing was done only in a subset of 23 patients, and no complementary FISH assay could be performed for two cases with equivocal findings. Interestingly, three of four patients with HER2 immunohistochemistry (IHC) 3+ staining are still alive, thus raising the question about the prognostic impact of HER2 positivity in GC treated with perioperative chemotherapy, as these patients were excluded in the recent report by Martinez Lago [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Perioperative chemotherapy in locally advanced gastric cancer in Chile: from evidence to daily practice

Müller¹,

Garcı́a²,

Sola³

et al. 2021

ecancer

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Gastric cancer (GC) is a leading cause of cancer death in Chile. Although recommended in international guidelines since 2006, perioperative chemotherapy was not available to patients in the public health system in Chile until 2016. We conducted an observational study to assess the feasibility of this strategy in public hospitals in Chile (Observational Study of Perioperative Chemotherapy in Locally Advanced Gastric Cancer -PRECISO). Patients with locally advanced, operable GC were offered to receive preoperative chemotherapy with Epirubicin + Cisplatin + Capecitabine (ECX) for three cycles followed by curative surgery. Staging included abdominal CT scan and laparoscopy if peritoneal carcinomatosis was suspected. Postoperative ECX for three cycles was recommended. Between August 2010 and March 2013, 110 patients were screened and 61 enrolled. Median age was 62 years (23-76 years) and most patients had good performance status at baseline (Eastern Cooperative Oncology Group performance status score (ECOG) 0: 42, ECOG 1: 19). Tumour site was proximal in 32 (52%) and medial and distal in 29 (48%) patients. All but four patients (n = 57, 93%) completed three cycles of preoperative chemotherapy. Fifty-six patients were operated and 54 (89%) had a curative resection. Thirty-three patients (54%) had pT0-2, and 18 (30%) had pN0 tumours, with two patients achieving a complete response. As of 20 December 2020, 39 patients died, 32 due to GC, one within 30 days of surgery, two due to intestinal obstruction at 5 and 3 months after surgery and four due to other causes. Five-year survival rate was 38%. We conclude that perioperative chemotherapy is feasible in public hospitals in Chile and should be offered to patients with locally advanced GC.

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“…Among these genes, HER2 amplification has significant clinical implications, serving as an indication for treatment with trastuzumab in advanced HER2-positive GC patients [ 95 , 96 ]. HER2 amplification occurs in 10–15% of patients with advanced GC, with a higher prevalence in intestinal-type GC and a lower prevalence in diffuse GC [ 97 , 98 , 99 ]. The most frequent copy number variation is the amplification of FGFR2 , which is observed in 15% of patients and associated with high-grade tumors and a poorer prognosis [ 93 ].…”

Section: Gastric Cancer Characterization Prognosis and Management In ...mentioning

confidence: 99%

Molecular Classifications in Gastric Cancer: A Call for Interdisciplinary Collaboration

Díaz del Arco,

Fernández Aceñero,

Ortega Medina

2024

IJMS

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Gastric cancer (GC) is a heterogeneous disease, often diagnosed at advanced stages, with a 5-year survival rate of approximately 20%. Despite notable technological advancements in cancer research over the past decades, their impact on GC management and outcomes has been limited. Numerous molecular alterations have been identified in GC, leading to various molecular classifications, such as those developed by The Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG). Other authors have proposed alternative perspectives, including immune, proteomic, or epigenetic-based classifications. However, molecular stratification has not yet transitioned into clinical practice for GC, and little attention has been paid to alternative molecular classifications. In this review, we explore diverse molecular classifications in GC from a practical point of view, emphasizing their relationships with clinicopathological factors, prognosis, and therapeutic approaches. We have focused on classifications beyond those of TCGA and the ACRG, which have been less extensively reviewed previously. Additionally, we discuss the challenges that must be overcome to ensure their impact on patient treatment and prognosis. This review aims to serve as a practical framework to understand the molecular landscape of GC, facilitate the development of consensus molecular categories, and guide the design of innovative molecular studies in the field.

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Impact of HER2 status in resected gastric or gastroesophageal junction adenocarcinoma in a Western population

Cited by 4 publications

References 23 publications

Real‐world clinical outcomes of the combination of anti‐PD‐1 antibody, trastuzumab, and chemotherapy for HER2‐positive gastric/gastroesophageal junction cancer

Real‐world clinical outcomes of the combination of anti‐PD‐1 antibody, trastuzumab, and chemotherapy for HER2‐positive gastric/gastroesophageal junction cancer

Perioperative chemotherapy in locally advanced gastric cancer in Chile: from evidence to daily practice

Molecular Classifications in Gastric Cancer: A Call for Interdisciplinary Collaboration

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