First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Authors

  • Selin Aktürk Esen Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
  • Yakup Ergun Department of Medical Oncology, Batman Training And Research Hospital, Batman, Turkey https://orcid.org/0000-0003-4784-6743
  • Cihan Erol Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0003-3155-8798
  • Rukiye Arikan Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey https://orcid.org/0000-0003-2688-1515
  • Muhammed Muhiddin Er Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey https://orcid.org/0000-0002-0583-0295
  • Muhammed Mustafa Atci Department of Medical Oncology, Prof. Dr. Cemil Taşcioğlu City Hospital, Istanbul, Turkey
  • Atakan Topçu Department of Medical Oncology, Faculty of Medicine, Bezmialem Vakif University Istanbul, Turkey https://orcid.org/0000-0002-3634-4820
  • Gökhan Uçar Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0002-7649-1075
  • Baran Akagündüz Department of Medical Oncology, Erzincan Binali Yildirim University, Erzincan, Turkey
  • Musa Bariş Aykan Department of Medical Oncology, Gulhane Medical Faculty, Health Sciences University, Ankara, Turkey https://orcid.org/0000-0001-7538-9119
  • Miraç Özen Department of Medical Oncology, Faculty of Medicine, Sakarya University Sakarya, Turkey https://orcid.org/0000-0002-1934-0190
  • Naziyet Köse Baytemur Department of Medical Oncology, Memorial Ankara Hospital, Ankara, Turkey https://orcid.org/0000-0002-3587-2517
  • Melike Özçelik Department of Medical Oncology, Ümraniye Training And Research Hospital, İstanbul, Turkey https://orcid.org/0000-0003-0406-715X
  • Elif Şahin Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey https://orcid.org/0000-0002-1976-3951
  • Denizcan Güven Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey https://orcid.org/0000-0002-6924-9467
  • Serkan Menekşe Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey https://orcid.org/0000-0002-2134-2128
  • Naziye Ak Department of Medical Oncology, Yozgat City Hospital, Yozgat, Turkey https://orcid.org/0000-0001-5790-7066
  • Fatih Teker Department of Medical Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
  • Engin Kut Department of Medical Oncology, Manisa City Hospital, Manisa, Turkey https://orcid.org/0000-0002-5328-5607
  • Teoman Şakalar Department of Medical Oncology, Kahramanmaraş Necip Fazil City Hospital, Kahramanmaraş, Turkey https://orcid.org/0000-0003-2749-9414
  • Özkan Alan Department of Medical Oncology, Tekirdağ İsmail Fehmi Cumalioğlu City Hospital, Tekirdağ, Turkey https://orcid.org/0000-0002-6635-2012
  • Turgut Kaçan Department of Medical Oncology, Yüksek İhtisas Training And Research Hospital, Health Sciences University Bursa, Bursa, Turkey
  • Nazim Serdar Turhal Department of Medical Oncology, Anadolu Health Center, İstanbul, Turkey https://orcid.org/0000-0002-1013-5676
  • Saadettin Kiliçkap Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey https://orcid.org/0000-0003-1637-7390
  • Sema Türker Department of Medical Oncology, Zonguldak Atatürk State Hospital, Zonguldak, Turkey https://orcid.org/0000-0001-9040-7266
  • Mehmet Ali Nahit Şendur Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0001-7021-6139
  • Osman Köstek Department of Medical Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey https://orcid.org/0000-0002-1901-5603
  • Mustafa Karaağaç Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey https://orcid.org/0000-0003-4533-0620
  • Abdullah Sakin Department of Medical Oncology, Prof. Dr. Cemil Taşcioğlu City Hospital, Istanbul, Turkey https://orcid.org/0000-0003-2538-8569
  • Haci Mehmet Türk Department of Medical Oncology, Faculty of Medicine, Bezmialem Vakif University Istanbul, Turkey https://orcid.org/0000-0003-2206-8148
  • Dilek Çağlayan Department of Medical Oncology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey https://orcid.org/0000-0003-4629-6815
  • Şener Cihan Department of Medical Oncology, Prof. Dr. Cemil Taşcioğlu City Hospital, Istanbul, Turkey
  • Yusuf Açikgöz Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0002-0360-7938
  • Doğan Uncu Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey https://orcid.org/0000-0002-0929-3271

DOI:

https://doi.org/10.17305/bjbms.2021.7069

Keywords:

CF, FOLFOX, gastric cancer, gastroesophageal junction cancer, trastuzumab

Abstract

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, mFOLFOX+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.

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First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

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Published

2022-09-16

How to Cite

1.
Aktürk Esen S, Ergun Y, Erol C, Arikan R, Er MM, Atci MM, Topçu A, Uçar G, Akagündüz B, Aykan MB, Özen M, Baytemur NK, Özçelik M, Şahin E, Güven D, Menekşe S, Ak N, Teker F, Kut E, Şakalar T, Alan Özkan, Kaçan T, Turhal NS, Kiliçkap S, Türker S, Şendur MAN, Köstek O, Karaağaç M, Sakin A, Türk HM, Çağlayan D, Cihan Şener, Açikgöz Y, Uncu D. First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer. Bosn J of Basic Med Sci [Internet]. 2022Sep.16 [cited 2022Sep.25];22(5):818-25. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/7069

Issue

Section

Translational and Clinical Research