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No Benefit With Trastuzumab Beyond Progression for HER2-Positive Gastric, GEJ Cancer
The addition of trastuzumab to paclitaxel did not significantly improve survival or overall response rates in patients with HER2-positive advanced gastric or gastroesophageal junction (GEJ) cancer, according to results from the phase 2 T-ACT study (J Clin Oncol. 2020 Mar 24. Epub ahead of print).
In T-ACT, Akitaka Makiyama, MD, PhD, Department of Hematology/Oncology, Japan Community Healthcare Organization Kyushu Hospital, Fukuoka, Japan, and co-investigators sought to evaluate the continuous use of trastuzumab beyond progression in 91 patients with HER2-positive advanced gastric or GEJ cancer.
All patient had disease refractory to first-line chemotherapy with trastuzumab plus fluoropyrimidine and platinum, and were randomized to receive paclitaxel 80 mg/m2 on days 1, 8, and 15 every 4 weeks (n = 46) or paclitaxel plus trastuzumab (initially 8 mg/kg followed by 6 mg/kg) every 3 weeks (n = 45).
The primary end point was progression-free survival (PFS), and secondary end points included overall survival (OS), overall response rate, and safety.
The median PFS in the paclitaxel arm was 3.2 months versus 3.7 months in the paclitaxel plus trastuzumab arm, and the median OS in both arms was 10 months. The overall response rates were 32% and 33% in the paclitaxel and paclitaxel plus trastuzumab arms, respectively.
The treatment strategy involving trastuzumab beyond progression did not improve PFS in patients with HER2-positive advanced gastric or GEJ cancer, Dr Makiyama and co-investigators concluded.—Kaitlyn Manasterski
