A Retrospective Analysis for Patients with HER2-Positive Gastric Cancer Who Were Treated with Trastuzumab-Based Chemotherapy: In the Perspectives of Ethnicity and Histology

作者：Yi Jun Ho; Kang Jung Hun; Hwang In Gyu; Ahn Hee Kyung; Baek Hyun Jin; Lee Soon Il; Lim Do Hyoung; Won Young Woong; Ji Jun Ho; Kim Hyo Song; Rha Sun Young; Oh Sung Yong; Lee Kyung Eun; Lim Taekyu; Maeng Chi Hoon; Kim Moon Jin; Kim Seung Tae; Lee Jeeyun; Park Joon Oh; Park Young Suk; Lim Ho Yeong; Kang Won Ki; Park Se Hoon^*

来源：Cancer Research and Treatment, 2016, 48(2): 553-560.

DOI：10.4143/crt.2015.155

• Stomach neoplasms
• ErbB-2 receptor
• Trastuzumab
• Histology
• Ethnic groups

Purpose
While the Trastuzumab for Gastric Cancer (ToGA) trial demonstrated the efficacy and safety of trastuzumab-based chemotherapy in HER2-positive metastatic gastric cancer, the overall survival (OS) benefit was not found in Asian and diffuse-type cancer patients. The aim of the study is to investigate predictive markers for trastuzumab-based chemotherapy.
Materials and Methods
Data of patients with HER2-positive gastric cancer treated with trastuzumab-based chemotherapy were analyzed retrospectively.
Results
A total of 168 Asian patients were included. The median age was 60 years (range, 27 to 85 years) and the male:female ratio was 118 (70.2%):50 (29.8%). Fourteen (8.3%), 63 (37.5%), 75 (44.6%), and 11(6.5%) patients had well, moderately, poorly-differentiated tubular adenocarcinoma and signet ring cell carcinoma, respectively. With 14 complete responses and 73 partial responses, the response rate was 50.6%. The mediari progression-free survival (PFS) was 10.2 months (95% confidence interval [CI], 8.7 to 11.7), and the median OS was 18.5 months (95% CI, 16.4 to 50.6). Next, we investigated the effect of poorly-differentiated histology (PDH, poorly-differentiated tubular adenocarcinoma+signet ring cell carcinoma) on clinical outcomes. The median PFS (8.9 months vs. 11.5 months, p=0.16) was slightly inferior in PDH patients, and the median OS was significantly shorter in PDH patients (14.6 months vs. 19.0 months, p=0.025).
Conclusion
While subset analysis of the ToGA trial demonstrated that trastuzumab-based chemotherapy may not be beneficial for Asians and patients with PDH, our data may suggest that even in Asian patients and patients with PDH, trastuzumab-based chemotherapy could be associated with improved clinical outcomes in patients with HER2-positive gastric cancer.

• 出版日期2016-4