Meta-analysis of Six Randomized Control Trials of Chemotherapy Plus Anti-HER Monoclonal Antibody for Advanced Gastric and Gastroesophageal Cancer

Abstract

Background: A meta-analysis was performed to examine the benefit/risk ratio for the addition of anti-HER MoAbs to chemotherapy in patients with advanced gastric and gastroesophageal cancer from six randomized phase II/III trials.

The clinicopathological parameters and prognostic significance of HER2 expression in gastric cancer patients: a meta-analysis of literature

“…HER2 expression has been found in gastric cancer. Inhibition of the HER2 receptor is a promising treatment target [4, 5] in breast cancers. Trastuzumab is a monoclonal antibody which specifically targets the HER2 protein by directly binding to the extracellular domain of the receptor.…”

The relative efficacy and safety of targeted agents used in combination with chemotherapy in treating patients with untreated advanced gastric cancer: a network meta-analysis

“…Actually, trastuzumab has been reported to be effective in combination with first-line fluoropyrimidine and cisplatin therapy [33]. And the addition of trastuzumab to chemotherapy for gastric and gastroesophageal cancer significantly yielded survival benefits compared to other antibodies [34]. It was also reported that the association of trastuzumab with oxaliplatin and fluoropyrimidin could reduce the toxicity of therapy compared with the addition of fluoropyrimidin and cisplatin [35], which was consistent with the results of our NMA to some extent.…”

Los receptores epidérmicos humanos en el cáncer gástrico: alteraciones moleculares y su papel como diana terapéutica

“…El matuzumab es un anticuerpo monoclonal IgG1 humanizado contra HER1. En un ensayo aleatorizado de fase II realizado en pacientes con CG avanzado con sobreexpresión de HER1 se evaluó matuzumab + epirubicina + cisplatino + capecitabina como tratamiento de primera línea, y los resultados mostraron que la combinación de matuzumab con quimioterapia no mejora las tasas de sobrevida (Tabla 2); por lo tanto, el matuzumab no fue probado en ensayos de fase III 69,85 . El nimotuzumab es una IgG1 humanizada que ha demostrado eficacia sin toxicidad grave de la piel como la causada por otras terapias de unión a HER1; sin embargo, la sobrevida es similar a la observada con otros fármacos [70][71][72] (Tabla 2).…”

“…Un metaanálisis sugirió que las terapias basadas en anticuerpos monoclonales anti-HER1 para pacientes con CG resultan en tasas de sobrevida menores que las terapias anti-HER2. Sin embargo, la quimioterapia junto con la terapia dirigida anti-HER2 incrementa significativamente el riesgo de presentar diarrea, hipocalcemia, mucositis y exantema en comparación con la quimioterapia sola 85 . El trastuzumab emtansina (T-DM1) es un anticuerpo que combina trastuzumab y un inhibidor de microtú-bulos derivado de maitansina (DM1).…”