Gastric cancer is the fourth most commonly diagnosed cancer and the second most common cause of cancer-related deaths worldwide. Previous study has found that patients with operable disease have a 5-year survival rate of 36%. In patients with advanced or metastatic gastric cancer, however, the 5-year survival is only 5-20% with median overall survival of less than 1 year.
Fluoropyrimidine and platinum compounds are the typical therapeutic options for these patients, but a new study indicated that trastuzumab (Herceptin) plus chemotherapy may be more effective in patients with HER2-postivie advanced gastric or gastro-esophageal junction cancer.
The study randomized 594 HER2-positive gastric or gastro-esophageal cancer to receive either chemotherapy (capecitabien(Xeloda) plus cisplatin) or chemotherapy (fluorouracil plus cisplatin) plus trastuzumab every 3 weeks for six cycles.
Patients who were assigned to chemotherapy plus trastruzumab group has a longer median overall survival (13.8 months) than patients assigned to chemotherapy alone (11.1 months) (p=0.046).
The most common adverse events in both groups were nausea (63%-67%), vomiting (46%-50%) and neutropenia (53%-57%).
This new study indicated that trastuzumab in combination with chemotherapy can be a new option for patients with HER2-postiive advanced gastric or gastro-esophageal junction cancer.
Source: Lancet 2010; 376:687-97
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