Open AccessFirst-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal carcinoma
Author(s) -
Seli̇n Aktürk Esen,
Yakup Ergün,
Cihan Erol,
Rukiye Arıkan,
Muhammed Muhiddin Er,
Muhammed Mustafa Atçı,
Atakan Topçu,
Gökhan Uçar,
Baran Akagündüz,
Musa Barış Aykan,
Miraç Özen,
Naziyet Köse Baytemür,
Melike Özçelik,
Elif Şahin,
Deniz Can Güven,
Serkan Menekşe,
Naziye Ak,
Fatih Teker,
Engin Kut,
Teoman Şakalar,
Özkan Alan,
Turgut Kaçan,
Nazım Serdar Turhal,
Sadettin Kılıçkap,
Sema Türker,
Mehmet Ali Nahit Şendur,
Osman Köstek,
Mustafa Karaağaç,
Abdullah Sakin,
Hacı Mehmet Türk,
Dilek Çağlayan,
Şener Cihan,
Yusuf Açıkgöz,
Doğan Uncu
Publication year - 2022
Publication title -
bosnian journal of basic medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 25
eISSN - 1840-4812
pISSN - 1512-8601
DOI - 10.17305/bjbms.2021.7069
Subject(s) - trastuzumab , medicine , oxaliplatin , oncology , cisplatin , chemotherapy , fluorouracil , cancer , colorectal cancer , breast cancer
Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, FOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens.