%0 Journal Article
%A Jimenez-Fonseca, Paula
%A Carmona-Bayonas, Alberto
%A Martinez-Torron, Alba
%A Alsina, Maria
%A Custodio, Ana
%A Serra, Olbia
%A Cacho Lavin, Diego
%A Limón, María Luisa
%A Sauri, Tamara
%A López, Flora
%A Visa, Laura
%A Granja, Mónica
%A Martínez Lago, Nieves
%A Arrazubi, Virginia
%A Vidal Tocino, Rosario
%A Hernandez, Raquel
%A Aguado, Gema
%A Cano, Juana María
%A Martín Carnicero, Alfonso
%A Mangas, Monserrat
%A Pimentel, Paola
%A Fernández Montes, Ana
%A Macias Declara, Ismael
%A Longo, Federico
%A Ramchandani, Avinash
%A Martín Richard, Marta
%A Hurtado, Alicia
%A Azkarate, Aitor
%A Hernández Pérez, Carolina
%A Serrano, Raquel
%A Gallego, Javier
%A AGAMENON-SEOM study group
%T External validity of clinical trials with diverse trastuzumab-based chemotherapy regimens in advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry.
%D 2021
%@ 1758-8340
%U https://hdl.handle.net/10668/27514
%X Trastuzumab combined with cisplatin and fluoropyrimidines, either capecitabine or 5-fluorouracile (XP/FP), is the standard first-line treatment for advanced, HER2-positive, gastric cancer patients based on the ToGA trial. Despite the lack of phase III trials, many clinicians administer trastuzumab with alternative regimens. One meta-analysis suggests that substituting cisplatin for oxaliplatin might lead to greater efficacy and less toxicity. 594 patients with HER2-positive gastroesophageal adenocarcinoma were recruited from the AGAMENON-SEOM registry. The objective was to evaluate the external validity of clinical trials with chemotherapy and trastuzumab. The regimens used in at least 5% of the patients were XP (27%), oxaliplatin and capecitabine (CAPOX) (26%), oxaliplatin and 5-fluorouracil (FOLFOX) (14%), FP (14%), triplet with anthracycline/docetaxel (7%), and carboplatin-FU (5%). Median exposure to trastuzumab was longer with FOLFOX (11.4 months, 95% CI, 9.1-21.0) versus ToGA regimens (7.5, 6.4-8.5), p  We have updated the external validity of clinical trials with trastuzumab in first-line treatment of gastric cancer. Our data confirm the comparable outcomes of ToGA regimens and CAPOX-trastuzumab in clinical practice and point toward a possible benefit of FOLFOX-trastuzumab, contingent on the subtypes typically less sensitive to trastuzumab, to be confirmed in clinical trials.
%K HER2
%K chemotherapy
%K external validity
%K gastric cancer
%K oxaliplatin
%K trastuzumab
%~