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• W4382799140 abstract "Gastric adenocarcinoma (GA) and esophagogastric junction adenocarcinoma (EGA) are the 3rd cause of death worldwide, the prognosis for patients with advanced GC remains challenging, with a life expectancy of less than a year. Nevertheless, molecular subtypes overexpressing human epidermal growth factor 2 (HER2) have shown a different outcome following the successful approbation of a monoclonal antibody targeting HER2, for the treatment of advanced gastric cancer. The aim of the study is to analyze the prevalence of HER2 determination and its impact on the overall survival of patients with advanced gastric adenocarcinoma treated at the National Cancer Institute. Retrospective, observational study. Included patients diagnosed GA and EGA treated at the National Cancer Institute between 2010 and 2021. Statistical analysis required: X2 and t test, Kaplan Meier, Log Rank, and Cox Regression. Statistical significance differences were assessed when p was bilaterally < 0.05. 1327 patients diagnosed with metastatic GA and EGA were included in the present study. The 55% (n=728) were male with a median age of 55 years (18 – 88), regarding tumor location, the 94% (n= 1248) were stomach, histological features observed included intestinal (32% n= 428), diffuse (49% n= 653), signet ring cells (62% n= 827), and poor-differentiation 82% (n= 1088). Her2 determination was observed in 38% (n=506) of the cases, among them HER2 positive (+++) was identified in 80 cases 18% and 5% for EGA and GA respectively. An analysis considering the correlation between HER2 and clinicopathological features was performed, male gender (p < 0.001), EG tumor location (p < 0.001), intestinal (p < 0.001), diffuse type (p < 0.001), signet ring cell (p < 0.001), mucinous (p=0.033), poor grade (p < 0.001) showed correlation with HER2 positive (+++). Regarding treatment received, 58% (n=771) of patients received chemotherapy, nevertheless only 11 patients with HER2 overexpression received trastuzumab. In survival analysis, patients with HER2 overexpression reported a median OS of 6 months versus 10 months for patients with HER2 negative expression (p < 0.001; HR 1.73, 95% CI 1.37-2.28). However, a sub-analysis was performed considering the patients with HER2 positive (+++) and trastuzumab treatment; patients treated with trastuzumab had a median OS of 11 months compared to 3 months for patients with chemotherapy (p= 0.044). At Cox Regression analysis only poor grade of differentiation (p= 0.012; HR 1.33, 95% CI 1.24-1.66), and HER2 (+++) (p < 0.001; HR 1.80, 95% CI 1.39-2.34) remained predictors of OS. HER2 overexpression along the grade differentiation has remained an independent predictor of OS, and the number of patients treated with trastuzumab is low compared with other countries. The use of molecular-targeted treatments in HER2-positive gastric cancer is fundamental to improving OS. Nevertheless, despite several progress in prolonging these patients' OS, access to molecular treatments remains a challenge for Latin America. Therefore, a significant effort to promote the accessibility of these therapies is crucial to overcome this major limitation." @default.
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• W4382799140 date "2023-06-01" @default.
• W4382799140 modified "2023-10-14" @default.
• W4382799140 title "P-148 Her2 positive as the main biomarker for overall survival of advanced gastric adenocarcinoma: Latin American reality and challenges" @default.
• W4382799140 doi "https://doi.org/10.1016/j.annonc.2023.04.204" @default.
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