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Local and Central Evaluation of HER2 Positivity and Clinical Outcome in Advanced Gastric and Gastroesophageal Cancer—Results from the AGMT GASTRIC-5 Registry
Trastuzumab in combination with a platinum and fluorouracil is the treatment of choice for patients with advanced human epidermal growth factor receptor 2 (HER2) positive gastric cancer and gastroesophageal junction (GEJ) cancer. Pathological assessment of the HER2 status in gastric/GEJ cancer, howe...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230156/ https://www.ncbi.nlm.nih.gov/pubmed/32235305 http://dx.doi.org/10.3390/jcm9040935 |
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author | Huemer, Florian Weiss, Lukas Regitnig, Peter Winder, Thomas Hartmann, Bernd Thaler, Josef Piringer, Gudrun Schmitt, Clemens A. Eisterer, Wolfgang Gänzer, Hannes Wüstner, Alois Andel, Johannes Jagdt, Björn Ulmer, Hanno Greil, Richard Wöll, Ewald |
author_facet | Huemer, Florian Weiss, Lukas Regitnig, Peter Winder, Thomas Hartmann, Bernd Thaler, Josef Piringer, Gudrun Schmitt, Clemens A. Eisterer, Wolfgang Gänzer, Hannes Wüstner, Alois Andel, Johannes Jagdt, Björn Ulmer, Hanno Greil, Richard Wöll, Ewald |
author_sort | Huemer, Florian |
collection | PubMed |
description | Trastuzumab in combination with a platinum and fluorouracil is the treatment of choice for patients with advanced human epidermal growth factor receptor 2 (HER2) positive gastric cancer and gastroesophageal junction (GEJ) cancer. Pathological assessment of the HER2 status in gastric/GEJ cancer, however, still remains difficult. However, it is a crucial prerequisite for optimal treatment. The GASTRIC-5 registry was designed as an observational, multi-center research initiative comparing local and central HER2 testing. HER2 status was assessed by immunohistochemistry (IHC) and in equivocal cases (IHC score 2+) by additional in-situ hybridization. Between May 2011 and August 2018, tumor samples of 183 patients were tested in local and central pathology laboratories, respectively. Central testing revealed HER2 positivity in 38 samples (21%). Discordant HER2 results were found in 12% (22 out of 183) with locally HER2 positive/centrally HER2 negative results (9%, 17 out of 183), exceeding locally HER2 negative/centrally HER2 positive results (3%, 5 out of 183). Centrally confirmed HER2 positive patients receiving trastuzumab-based palliative first-line therapy showed a longer median overall survival compared to centrally HER2 positive patients not receiving trastuzumab (17.7 months (95% CI: 10,870–24,530) vs. 6.9 months (95% CI: 3.980–9.820), p = 0.016). The findings of the GASTRIC-5 registry corroborate the challenge of HER2 testing in gastric/GEJ cancer and highlight the necessity for central quality control to optimize individual treatment options. Centrally HER2 positive patients not receiving trastuzumab had the worst outcome in a Western real-world gastric/GEJ cancer cohort. |
format | Online Article Text |
id | pubmed-7230156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-72301562020-05-28 Local and Central Evaluation of HER2 Positivity and Clinical Outcome in Advanced Gastric and Gastroesophageal Cancer—Results from the AGMT GASTRIC-5 Registry Huemer, Florian Weiss, Lukas Regitnig, Peter Winder, Thomas Hartmann, Bernd Thaler, Josef Piringer, Gudrun Schmitt, Clemens A. Eisterer, Wolfgang Gänzer, Hannes Wüstner, Alois Andel, Johannes Jagdt, Björn Ulmer, Hanno Greil, Richard Wöll, Ewald J Clin Med Article Trastuzumab in combination with a platinum and fluorouracil is the treatment of choice for patients with advanced human epidermal growth factor receptor 2 (HER2) positive gastric cancer and gastroesophageal junction (GEJ) cancer. Pathological assessment of the HER2 status in gastric/GEJ cancer, however, still remains difficult. However, it is a crucial prerequisite for optimal treatment. The GASTRIC-5 registry was designed as an observational, multi-center research initiative comparing local and central HER2 testing. HER2 status was assessed by immunohistochemistry (IHC) and in equivocal cases (IHC score 2+) by additional in-situ hybridization. Between May 2011 and August 2018, tumor samples of 183 patients were tested in local and central pathology laboratories, respectively. Central testing revealed HER2 positivity in 38 samples (21%). Discordant HER2 results were found in 12% (22 out of 183) with locally HER2 positive/centrally HER2 negative results (9%, 17 out of 183), exceeding locally HER2 negative/centrally HER2 positive results (3%, 5 out of 183). Centrally confirmed HER2 positive patients receiving trastuzumab-based palliative first-line therapy showed a longer median overall survival compared to centrally HER2 positive patients not receiving trastuzumab (17.7 months (95% CI: 10,870–24,530) vs. 6.9 months (95% CI: 3.980–9.820), p = 0.016). The findings of the GASTRIC-5 registry corroborate the challenge of HER2 testing in gastric/GEJ cancer and highlight the necessity for central quality control to optimize individual treatment options. Centrally HER2 positive patients not receiving trastuzumab had the worst outcome in a Western real-world gastric/GEJ cancer cohort. MDPI 2020-03-29 /pmc/articles/PMC7230156/ /pubmed/32235305 http://dx.doi.org/10.3390/jcm9040935 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Huemer, Florian Weiss, Lukas Regitnig, Peter Winder, Thomas Hartmann, Bernd Thaler, Josef Piringer, Gudrun Schmitt, Clemens A. Eisterer, Wolfgang Gänzer, Hannes Wüstner, Alois Andel, Johannes Jagdt, Björn Ulmer, Hanno Greil, Richard Wöll, Ewald Local and Central Evaluation of HER2 Positivity and Clinical Outcome in Advanced Gastric and Gastroesophageal Cancer—Results from the AGMT GASTRIC-5 Registry |
title | Local and Central Evaluation of HER2 Positivity and Clinical Outcome in Advanced Gastric and Gastroesophageal Cancer—Results from the AGMT GASTRIC-5 Registry |
title_full | Local and Central Evaluation of HER2 Positivity and Clinical Outcome in Advanced Gastric and Gastroesophageal Cancer—Results from the AGMT GASTRIC-5 Registry |
title_fullStr | Local and Central Evaluation of HER2 Positivity and Clinical Outcome in Advanced Gastric and Gastroesophageal Cancer—Results from the AGMT GASTRIC-5 Registry |
title_full_unstemmed | Local and Central Evaluation of HER2 Positivity and Clinical Outcome in Advanced Gastric and Gastroesophageal Cancer—Results from the AGMT GASTRIC-5 Registry |
title_short | Local and Central Evaluation of HER2 Positivity and Clinical Outcome in Advanced Gastric and Gastroesophageal Cancer—Results from the AGMT GASTRIC-5 Registry |
title_sort | local and central evaluation of her2 positivity and clinical outcome in advanced gastric and gastroesophageal cancer—results from the agmt gastric-5 registry |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230156/ https://www.ncbi.nlm.nih.gov/pubmed/32235305 http://dx.doi.org/10.3390/jcm9040935 |
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