Effect of XELOX combined with trastuzumab in the treatment of HER2 positive elderly patients with advanced gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YE Chun , QI Xingshun , LI Qianqian , LI Da , GAO Guangrong ,  ZHANG Cheng

Department of General Surgery, General Hospital of Northern Theater Command of the Chinese People’s Liberation Army, Shenyang 110016, P. R. China;

Corresponding author：

ZHANG Cheng, Email: 504939357@qq.com

Keywords：

gastric cancer; HER2 positive; elderly patient; trastuzumab; transformation therapy

DOI：

10.7507/1007-9424.202206047

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the preliminary efficacy and safety of XELOX combined with trastuzumab in the transformation therapy of human epidermal growth factor receptor 2 (HER2) positive elderly patients with advanced gastric cancer. Methods The clinical and surgical data of 21 patients with HER2 positive elderly patients with advanced gastric cancer who were treated with XELOX combined with trastuzumab in our Hospital from February 2019 to February 2021 were retrospectively analyzed, and the remission of patients after conversion therapy and the relevant indicators during and after surgery were observed. Results After the conversion therapy, there were 2 cases (9.5%) of complete remission, 13 cases (61.9%) of partial remission, and 6 cases (28.6%) of stable disease, the remission rate of the conversion therapy was 71.4% (15/21). After conversion treatment, 21 patients underwent laparoscopic exploration, of which 20 patients (95.2%) underwent R0 resection, simple exploration 1 case. In all 21 cases, the operative time was 124–185 min, with a median of 152 min. The intraoperative blood loss was 100–210 mL, with a median of 120 mL. The number of lymph nodes cleared was 12–54, with a median of 32. The duration of indwelling gastrointestinal decompression was 51–134 h, with a median of 102 h. The recovery time of gastrointestinal function was 70–98 h, with a median of 78 h. The drainage time in the abdominal operation area was 4–9 days, with a median of 6 days. Postoperative hospital stay was 7–13 days, with a median of 8 days. There were 2 cases of Grade IIIA complications (1 case of incomplete intestinal obstruction and 1 case of pulmonary infection) and 2 cases of Grade II complications (1 case of incision fat liquefaction and 1 case of jugular catheter infection) after operation. All patients were followed up for 3–36 months, with a median of 16.8 months. The median progression-free survival time was 12.4 months and the median overall survival time was 20.5 months. Conclusion For HER2 positive elderly patients with advanced gastric cancer, XELOX combined with trastuzumab transformation therapy is effective and safe.

Citation： YE Chun, QI Xingshun, LI Qianqian, LI Da, GAO Guangrong, ZHANG Cheng. Effect of XELOX combined with trastuzumab in the treatment of HER2 positive elderly patients with advanced gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(12): 1623-1627. doi: 10.7507/1007-9424.202206047 Copy

1.	Hironaka S, Sugimoto N, Yamaguchi K, et al. S-1 plus leucovorin versus S-1 plus leucovorin and oxaliplatin versus S-1 plus cisplatin in patients with advanced gastric cancer: a randomised, multicentre, openlabel, phase 2 trial. Lancet Oncol, 2016, 17(1): 99-108.
2.	Verstegen MH, Harker M, van de Water C, et al. Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology. World J Gastroenterol, 2020, 26(39): 6037-6046.
3.	陈俊良, 王风华. 2021 版 CSC0 胃癌诊疗指南转移性胃癌更新解读. 中国肿瘤临床, 2022, 49(7): 325-330.
4.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
5.	Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018 (5th edition). Gastric Cancer, 2021, 24(1): 1-21.
6.	Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1. 1). Eur J Cancer, 2009, 45(2): 228-247.
7.	Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer, 2003, 98(7): 1521-1530.
8.	Wang CW, Lai JC. Reporting functional status in UNOS: The weakness of the Karnofsky Performance Status Scale. Clin Transplant, 2017, 31(7). doi: 10.1111/ctr.13004.
9.	Li K, Li J. Current molecular targeted therapy in advanced gastric cancer: A comprehensive review of therapeutic mechanism, clinical trials, and practical application. Gastroenterol Res Pract, 2016, 2016: 4105615. doi: 10.1155/2016/4105615.
10.	Yamaguchi K, Yoshida K, Tanahashi T, et al. The long-term survival of stage Ⅳ gastric cancer patients with conversion therapy. Gastric Cancer, 2018, 21(2): 315-323.
11.	Ishigami H, Yamaguchi H, Yamashita H, et al. Surgery after intraperitoneal and systemic chemotherapy for gastric cancer with peritoneal metastasis or positive peritoneal cytology findings. Gastric Cancer, 2017, 20(Suppl 1): 128-134.
12.	Ishigami H, Fujiwara Y, Fukushima R, et al. Phase Ⅲ trial comparing intraperitoneal and intravenous paclitaxel plus S-1 versus cisplatin plus S-1 in patients with gastric cancer with peritoneal metastasis: PHOENIX-GC trial. J Clin Oncol, 2018, 36(19): 1922-1929.
13.	Morgagni P, Solaini L, Framarini M, et al. Conversion surgery for gastric cancer: A cohort study from a western center. Int J Surg, 2018, 53: 360-365.
14.	吴杨, 姚寒晖, 梁伟, 等. 腹腔镜辅助胃癌D2根治术治疗老年进展期远端胃癌患者的临床价值及近期预后. 安徽医学, 2018, 39(8): 903-906.
15.	Wang H, Li B, Liu Z, et al. HER2 copy number of circulating tumour DNA functions as a biomarker to predict and monitor trastuzumab efficacy in advanced gastric cancer. Eur J Cancer, 2018, 88: 92-100.
16.	Kimura Y, Fujii M, Masuishi T, et al. Multicenter phase Ⅱ study of trastuzumab plus S-1 alone in elderly patients with HER2-positive advanced gastric cancer (JACCRO GC-06). Gastric Cancer, 2018, 21(3): 421-427.

1. Hironaka S, Sugimoto N, Yamaguchi K, et al. S-1 plus leucovorin versus S-1 plus leucovorin and oxaliplatin versus S-1 plus cisplatin in patients with advanced gastric cancer: a randomised, multicentre, openlabel, phase 2 trial. Lancet Oncol, 2016, 17(1): 99-108.
2. Verstegen MH, Harker M, van de Water C, et al. Metastatic pattern in esophageal and gastric cancer: Influenced by site and histology. World J Gastroenterol, 2020, 26(39): 6037-6046.
3. 陈俊良, 王风华. 2021 版 CSC0 胃癌诊疗指南转移性胃癌更新解读. 中国肿瘤临床, 2022, 49(7): 325-330.
4. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
5. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2018 (5th edition). Gastric Cancer, 2021, 24(1): 1-21.
6. Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1. 1). Eur J Cancer, 2009, 45(2): 228-247.
7. Becker K, Mueller JD, Schulmacher C, et al. Histomorphology and grading of regression in gastric carcinoma treated with neoadjuvant chemotherapy. Cancer, 2003, 98(7): 1521-1530.
8. Wang CW, Lai JC. Reporting functional status in UNOS: The weakness of the Karnofsky Performance Status Scale. Clin Transplant, 2017, 31(7). doi: 10.1111/ctr.13004.
9. Li K, Li J. Current molecular targeted therapy in advanced gastric cancer: A comprehensive review of therapeutic mechanism, clinical trials, and practical application. Gastroenterol Res Pract, 2016, 2016: 4105615. doi: 10.1155/2016/4105615.
10. Yamaguchi K, Yoshida K, Tanahashi T, et al. The long-term survival of stage Ⅳ gastric cancer patients with conversion therapy. Gastric Cancer, 2018, 21(2): 315-323.
11. Ishigami H, Yamaguchi H, Yamashita H, et al. Surgery after intraperitoneal and systemic chemotherapy for gastric cancer with peritoneal metastasis or positive peritoneal cytology findings. Gastric Cancer, 2017, 20(Suppl 1): 128-134.
12. Ishigami H, Fujiwara Y, Fukushima R, et al. Phase Ⅲ trial comparing intraperitoneal and intravenous paclitaxel plus S-1 versus cisplatin plus S-1 in patients with gastric cancer with peritoneal metastasis: PHOENIX-GC trial. J Clin Oncol, 2018, 36(19): 1922-1929.
13. Morgagni P, Solaini L, Framarini M, et al. Conversion surgery for gastric cancer: A cohort study from a western center. Int J Surg, 2018, 53: 360-365.
14. 吴杨, 姚寒晖, 梁伟, 等. 腹腔镜辅助胃癌D2根治术治疗老年进展期远端胃癌患者的临床价值及近期预后. 安徽医学, 2018, 39(8): 903-906.
15. Wang H, Li B, Liu Z, et al. HER2 copy number of circulating tumour DNA functions as a biomarker to predict and monitor trastuzumab efficacy in advanced gastric cancer. Eur J Cancer, 2018, 88: 92-100.
16. Kimura Y, Fujii M, Masuishi T, et al. Multicenter phase Ⅱ study of trastuzumab plus S-1 alone in elderly patients with HER2-positive advanced gastric cancer (JACCRO GC-06). Gastric Cancer, 2018, 21(3): 421-427.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of XELOX combined with trastuzumab in the treatment of HER2 positive elderly patients with advanced gastric cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content