Real-World Treatment Patterns, HER2 Testing Practices, and Clinical Outcomes in HER2-Positive Locally Advanced or
Yakun Wang1, Bo Liu2, Jingdong Zhang3
1State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, Beijing, China.
Introduction:
This study aimed to assess real-world treatment patterns, human epidermal growth factor receptor 2 (HER2) testing, and clinical outcomes in patients with HER2-positive locally advanced unresectable or metastatic gastric or gastroesophageal junction cancer (GC/GEJC) in China.
Methods:
A multicenter retrospective study (REHEARSAL Study; NCT06585501) was conducted across nine hospitals in China. Patients with HER2-positive, locally advanced unresectable or metastatic GC/GEJC who initiated first-line therapy were included. Treatment patterns in the first, second, and third lines, HER2 testing practice, and real-world clinical outcomes were assessed.
Results:
In total, 805 patients were included (median age of 62.00 years; 77.14% male and 22.86% female). From 2018 to 2023, the first-line treatment pattern showed an increase in the use of anti-HER2 therapies-from 60.83 to 90.19%. There was a notable increased application of HER2 monoclonal antibody (mAb) with immunotherapy (from 0.83 to 60.78%) in the first line. In the second line, 12.28% of patients were administered vascular endothelial growth factor receptor inhibitor in 2023. HER2-antibody-drug conjugate monotherapy and combination therapy had become the predominant third-line treatment (50.00%) in 2023. Tissue biopsy was the primary sample type for HER2 testing (99.25%). Re-biopsy was performed in 6.96% of cases. Anti-HER2 therapies exhibited benefits with a median real-world progression-free survival of 8.94, 5.52, and 4.96 months in the first-, second-, and third-line settings, respectively.
Conclusion:
In China, HER2 mAb with or without immunotherapy remained the main first-line option for HER2-positive locally advanced unresectable or metastatic GC/GEJC, with a rising trend toward combination with immunotherapy. The second-line outcomes highlight the urgent need for effective treatment options, underscoring the importance of further real-world studies to better define their role.
Trial Registration:
ClinicalTrials.gov identifier, NCT06585501.
Related Concept Videos
01:21Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
02:56Treatment Resistent Cancers
02:56Treatment Resistant Cancers