Abstract 1770
Background
Addition of trastuzumab to first-line palliative chemotherapy in esophagogastric cancer patients with HER2 overexpression has shown to improve survival and is therefore considered standard of care. The aim of this study was to assess HER2 testing, trastuzumab administration and overall survival (OS) in a nationwide cohort of metastatic esophagogastric cancer patients.
Methods
Patients with synchronous metastatic esophagogastric adenocarcinoma diagnosed between 2010-2016 that received palliative systemic treatment (N = 2846) were identified from the Netherlands Cancer Registry. Details on HER2 assessment were extracted from pathology reports from the Dutch Pathology Registry. For determination of HER2 positivity or negativity, the criteria on HER2 assessment of the ToGA trial were used. Proportions of HER2 tested patients were analyzed between hospital volume categories using Chi-square tests, and over time using trend analysis. OS was tested using the Kaplan Meier method and log rank test.
Results
HER2 assessment was performed in 54% of all 2846 patients that received palliative chemotherapy, and increased from 18% to 88% between 2010 and 2016 (P < 0.01). Median OS of all patients increased from 6.9 (IQR 3.5-12.0) months in 2010-2013 to 7.9 (IQR 3.6-13.6) months in 2014-2016 (P < 0.001). Between the hospitals, the proportion of tested patients varied between 29-100%, and was the highest in high-volume hospitals (P < 0.01). HER2 status was positive in 19%, negative in 67% and unknown in 14% of the 1524 tested patients. Overall, 77% of the HER2 positive patients received trastuzumab. Median OS was significantly higher in patients with both positive (8.8 months) and negative (7.4 months) HER2 status that were diagnosed in 2015-2016, compared with non-tested patients (5.6 months; P < 0.05).
Conclusions
Daily practice management of metastatic esophagogastric cancer patients has changed due to increased determination of HER2 status and administration of trastuzumab, which might have contributed to the improved survival in these patients. Advances in clinical practice could include a further increase in awareness of HER2 testing among pathologists and clinicians, especially in low-volume hospitals, and in the administration of trastuzumab in case of HER2 overexpression.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Roche.
Disclosure
R.H.A. Verhoeven: Research grant / Funding (institution): BMS; Research grant / Funding (institution): Roche. N. Haj Mohammad: Advisory / Consultancy: BMS; Advisory / Consultancy: MSD. J. de Vos-Geelen: Non-remunerated activity/ies: BTG; Research grant / Funding (institution), Non-remunerated activity/ies: Servier; Advisory / Consultancy: Shire. T. Van Voorthuizen: Non-remunerated activity/ies: Astellas; Non-remunerated activity/ies: Ipsen; Non-remunerated activity/ies: Roche; Non-remunerated activity/ies: Bayer. M. van Oijen: Research grant / Funding (institution): Roche; Research grant / Funding (institution): Lilly; Research grant / Funding (institution): Merck Serono; Research grant / Funding (institution): Nordic; Research grant / Funding (institution): Servier; Research grant / Funding (institution): Amgen. H.W.M. van Laarhoven: Research grant / Funding (institution): Bayer; Advisory / Consultancy, Research grant / Funding (institution): BMS; Advisory / Consultancy, Research grant / Funding (institution): Celgene; Advisory / Consultancy, Research grant / Funding (institution): Lilly; Research grant / Funding (institution): Merck Serono; Research grant / Funding (institution): MSD; Advisory / Consultancy, Research grant / Funding (institution): Nordic; Research grant / Funding (institution): Philips; Research grant / Funding (institution): Roche. All other authors have declared no conflicts of interest.
Resources from the same session
5472 - Early response evaluation and CEA response in patients treated in a Danish randomized study comparing trifluridine/tipiracil (TAS-102) with or without bevazicumab in patients with chemorefractory metastatic colorectal cancer (mCRC)
Presenter: Camilla Qvortrup
Session: Poster Display session 2
Resources:
Abstract
2037 - Updated survival analysis of the randomized phase III trial comparing S-1 versus capecitabine in the first-line treatment of metastatic colorectal cancer (SALTO) by the Dutch Colorectal Cancer Group.
Presenter: Johannes Kwakman
Session: Poster Display session 2
Resources:
Abstract
3053 - JFMC51-1702-C7: Phase II study investigating efficacy and safety of trifluridine/tipiracil (FTD/TPI) plus bevacizumab (BEV) in patients (pts) with metastatic colorectal cancer (mCRC) refractory or intolerant to standard chemotherapies.
Presenter: Keisuke Kazama
Session: Poster Display session 2
Resources:
Abstract
3183 - Bevacizumab plus trifluridine/tipiracil in elderly patients with previously untreated metastatic colorectal cancer (KSCC 1602): A single-arm, Phase 2 study
Presenter: Akitaka Makiyama
Session: Poster Display session 2
Resources:
Abstract
3233 - Biweekly TAS-102 and Bevacizumab as a Third-Line Chemotherapy for metastatic colorectal cancer: A Phase II Multicenter Clinical Trial (TAS-CC4 study)
Presenter: Yoichiro Yoshida
Session: Poster Display session 2
Resources:
Abstract
5907 - Liquid biopsy concordance based on clonality and timing of testing in patients with metastatic colorectal cancer
Presenter: Pashtoon Kasi
Session: Poster Display session 2
Resources:
Abstract
1866 - Plasma clearance of RAS mutation under therapeutic pressure is a rare event in metastatic colorectal cancer
Presenter: Emilie Moati
Session: Poster Display session 2
Resources:
Abstract
2312 - High Circulating miR-1247 is a marker for poor prognosis in patients with metastatic colorectal cancer treated with chemotherapy and cetuximab
Presenter: Jakob Schou
Session: Poster Display session 2
Resources:
Abstract
5602 - Clinical relevance of circulating tumor (ct)DNA genotyping for first line cetuximab-based treatment monitoring in metastatic colorectal cancer (mCRC): a prospective multicentric study
Presenter: JOANA Vidal Barrull
Session: Poster Display session 2
Resources:
Abstract
3182 - Clonal hematopoiesis mutations in plasma cfDNA RAS/BRAF genotyping of metastatic colorectal cancer
Presenter: Beili Wang
Session: Poster Display session 2
Resources:
Abstract