학술논문
External validity of clinical trials with diverse trastuzumab-based chemotherapy regimens in advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry
Document Type
article
Author
Paula Jimenez-Fonseca; Alberto Carmona-Bayonas; Alba Martinez-Torron; Maria Alsina; Ana Custodio; Olbia Serra; Diego Cacho Lavin; María Luisa Limón; Tamara Sauri; Flora López; Laura Visa; Mónica Granja; Nieves Martínez Lago; Virginia Arrazubi; Rosario Vidal Tocino; Raquel Hernandez; Gema Aguado; Juana María Cano; Alfonso Martín Carnicero; Monserrat Mangas; Paola Pimentel; Ana Fernández Montes; Ismael Macias Declara; Federico Longo; Avinash Ramchandani; Marta Martín Richard; Alicia Hurtado; Aitor Azkarate; Carolina Hernández Pérez; Raquel Serrano; Javier Gallego
Source
Therapeutic Advances in Medical Oncology, Vol 13 (2021)
Subject
Language
English
ISSN
1758-8359
17588359
17588359
Abstract
Background: Trastuzumab combined with cisplatin and fluoropyrimidines, either capecitabine or 5-fluorouracile (XP/FP), is the standard first-line treatment for advanced, HER2-positive, gastric cancer patients based on the ToGA trial. Despite the lack of phase III trials, many clinicians administer trastuzumab with alternative regimens. One meta-analysis suggests that substituting cisplatin for oxaliplatin might lead to greater efficacy and less toxicity. Methods: 594 patients with HER2-positive gastroesophageal adenocarcinoma were recruited from the AGAMENON-SEOM registry. The objective was to evaluate the external validity of clinical trials with chemotherapy and trastuzumab. Results: The regimens used in at least 5% of the patients were XP (27%), oxaliplatin and capecitabine (CAPOX) (26%), oxaliplatin and 5-fluorouracil (FOLFOX) (14%), FP (14%), triplet with anthracycline/docetaxel (7%), and carboplatin-FU (5%). Median exposure to trastuzumab was longer with FOLFOX (11.4 months, 95% CI, 9.1–21.0) versus ToGA regimens (7.5, 6.4–8.5), p