Trastuzumab in Esophagogastric Cancer: HER2-Testing and Treatment Reality outside Clinical Studies in Germany

Abstract EN

We analysed trends over time in palliative first-line chemotherapy in patients with locally advanced or metastatic esophagogastric cancer.

Special focus was on frequency and quality of HER2-testing and trends in drug use in combination with trastuzumab.

Earlier published data about patients treated outside clinical studies showed a relatively low rate of HER2-testing and insufficient test quality.

A total of 2,808 patients retrospectively documented in Therapiemonitor ® from 2006 to 2013 were analysed regarding treatment intensity and trends in used drugs.

Data on HER2-testing and therapies were analysed in two cohorts documented in 2010 and 2011 (1) compared to 2012 and 2013 (2).

Treatment intensity increased: 49.3% of patients received at least a triplet in 2013 compared to 10.1% in 2006.

In cohort 2 HER2 expression was tested in 79.1% of the cases.

Still, in 26.9% testing was not done as requested by guidelines.

Good performance status, multiple metastases, age ≤ 65 years, the objective “to prevent progression,” good cognitive capabilities, estimated good compliance, and social integration positively influenced the probability of HER2-testing; comorbidities negatively affected it.

Usage of the combination of fluoropyrimidines and cisplatin with trastuzumab declined from 67% in cohort 1 to 50% in cohort 2.