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• W2072316165 abstract "Background Elderly patients often present with concomitant co-morbidities and age-associated physiologic problems, such as impaired organ function and functional changes that make the selection of optimal treatment difficult. We report the treatment outcome in 13 elderly patients with HER2-positive advanced gastric cancer who were given low-dose capecitabine plus trastuzumab. Methods Patients older than 75 years with gastric cancer were eligible for inclusion if their tumours showed overexpression of HER2 protein by immunohistochemistry (IHC 3+), or gene amplification by FISH and IHC 2+. Capecitabine 1000 mg/m2 was given orally twice a day for 14 days followed by a 1-week rest. Trastuzumab was given as an intravenous infusion of 8 mg/kg on day 1 of the first cycle, followed by 6 mg/kg every 3 weeks. Chemotherapy was given every 3 weeks for eight cycles. Findings Between December 2011 and July 2013, 13 consecutive patients (seven with IHC 3+ and six with IHC 2+ and FISH+) with a median age of 79 years (range 75–92) were enrolled. Eastern Cooperative Oncology Group (ECOG) performance status was 0 in one patient, 1 in seven patients, and 2 in five patients. A total of 54 cycles of capecitabine plus trastuzumab were administered (median of three cycles; range 2–8). Of the 12 patients with measurable lesions, the overall response rate was 41.6% (95% confidence interval [CI] 13.7–69.5). Disease control was achieved in 75.0% of patients. Median progression-free survival was 8.2 months (95% CI 2.5–13.7) and median overall survival was 10.9 months (95% CI 1.4–20.4). Grade 3–4 toxicities were stomatitis (7.6%) and anaemia (7.6%). No treatment-related deaths or symptomatic congestive heart failure were observed. Interpretation Our findings suggest that low-dose capecitabine plus trastuzumab is effective and well tolerated in elderly patients with advanced HER2-positive gastric cancer who are considered ineligible for combination chemotherapy. Prospective trials investigating this regimen in elderly patients with advanced gastric cancer are warranted. Elderly patients often present with concomitant co-morbidities and age-associated physiologic problems, such as impaired organ function and functional changes that make the selection of optimal treatment difficult. We report the treatment outcome in 13 elderly patients with HER2-positive advanced gastric cancer who were given low-dose capecitabine plus trastuzumab. Patients older than 75 years with gastric cancer were eligible for inclusion if their tumours showed overexpression of HER2 protein by immunohistochemistry (IHC 3+), or gene amplification by FISH and IHC 2+. Capecitabine 1000 mg/m2 was given orally twice a day for 14 days followed by a 1-week rest. Trastuzumab was given as an intravenous infusion of 8 mg/kg on day 1 of the first cycle, followed by 6 mg/kg every 3 weeks. Chemotherapy was given every 3 weeks for eight cycles. Between December 2011 and July 2013, 13 consecutive patients (seven with IHC 3+ and six with IHC 2+ and FISH+) with a median age of 79 years (range 75–92) were enrolled. Eastern Cooperative Oncology Group (ECOG) performance status was 0 in one patient, 1 in seven patients, and 2 in five patients. A total of 54 cycles of capecitabine plus trastuzumab were administered (median of three cycles; range 2–8). Of the 12 patients with measurable lesions, the overall response rate was 41.6% (95% confidence interval [CI] 13.7–69.5). Disease control was achieved in 75.0% of patients. Median progression-free survival was 8.2 months (95% CI 2.5–13.7) and median overall survival was 10.9 months (95% CI 1.4–20.4). Grade 3–4 toxicities were stomatitis (7.6%) and anaemia (7.6%). No treatment-related deaths or symptomatic congestive heart failure were observed. Our findings suggest that low-dose capecitabine plus trastuzumab is effective and well tolerated in elderly patients with advanced HER2-positive gastric cancer who are considered ineligible for combination chemotherapy. Prospective trials investigating this regimen in elderly patients with advanced gastric cancer are warranted." @default.
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• W2072316165 date "2014-05-01" @default.
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• W2072316165 title "P208 A pilot study of low-dose capecitabine plus trastuzumab as first-line treatment for patients older than 75 years with HER2-positive advanced gastric cancer" @default.
• W2072316165 doi "https://doi.org/10.1016/j.ejca.2014.03.252" @default.
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