dc.contributor.author |
Jimenez-Fonseca, Paula |
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dc.contributor.author |
Carmona-Bayonas, Alberto |
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dc.contributor.author |
Martinez-Torron, Alba |
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dc.contributor.author |
Alsina, Maria |
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dc.contributor.author |
Custodio, Ana |
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dc.contributor.author |
Serra, Olbia |
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dc.contributor.author |
Cacho Lavin, Diego |
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dc.contributor.author |
Limón, María Luisa |
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dc.contributor.author |
Sauri, Tamara |
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dc.contributor.author |
López, Flora |
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dc.contributor.author |
Visa, Laura |
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dc.contributor.author |
Granja, Mónica |
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dc.contributor.author |
Martínez Lago, Nieves |
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dc.contributor.author |
Arrazubi, Virginia |
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dc.contributor.author |
Vidal Tocino, Rosario |
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dc.contributor.author |
Hernandez, Raquel |
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dc.contributor.author |
Aguado, Gema |
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dc.contributor.author |
Cano, Juana María |
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dc.contributor.author |
Martín Carnicero, Alfonso |
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dc.contributor.author |
Mangas, Monserrat |
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dc.contributor.author |
Pimentel, Paola |
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dc.contributor.author |
Fernández Montes, Ana |
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dc.contributor.author |
Macias Declara, Ismael |
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dc.contributor.author |
Longo, Federico |
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dc.contributor.author |
Ramchandani, Avinash |
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dc.contributor.author |
Martín Richard, Marta |
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dc.contributor.author |
Hurtado, Alicia |
|
dc.contributor.author |
Azkarate, Aitor |
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dc.contributor.author |
Hernández Pérez, Carolina |
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dc.contributor.author |
Serrano, Raquel |
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dc.contributor.author |
Gallego, Javier |
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dc.date.accessioned |
2021-07-08T07:56:53Z |
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dc.identifier.uri |
http://hdl.handle.net/11201/155645 |
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dc.description.abstract |
[eng] Background: 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. Methods: 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. Results: 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 < 0.001. Patients with HER2-IHC 3+ cancers had higher response rates than those with IHC 2+/FISH+, odds-ratio 1.97 (95% CI, 1.25-3.09). The results achieved with CAPOX-trastuzumab were comparable to those attained with ToGA regimens. FOLFOX-trastuzumab was superior to ToGA schemes in terms of overall survival (OS), with a greater magnitude of effect in IHC 2+/FISH+ tumors (HR 0.47, 0.24-0.92) compared with IHC 3+ (HR 0.69, 0.49-0.96), and in diffuse (HR 0.37, 0.20-0.69) versus intestinal-type tumors (HR 0.76, 0.54-1.06). Conclusion: 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. |
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dc.format |
application/pdf |
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dc.relation.isformatof |
https://doi.org/10.1177/17588359211019672 |
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dc.relation.ispartof |
Therapeutic Advances In Medical Oncology, 2021, vol. 13, p. 1-13 |
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dc.rights |
, 2021 |
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dc.subject.classification |
61 - Medicina |
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dc.subject.classification |
616 - Patologia. Medicina clínica. Oncologia |
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dc.subject.other |
61 - Medical sciences |
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dc.subject.other |
616 - Pathology. Clinical medicine |
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dc.title |
External validity of clinical trials with diverse trastuzumab-based chemotherapy regimens in advanced gastroesophageal adenocarcinoma: data from the AGAMENON-SEOM registry |
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dc.type |
info:eu-repo/semantics/article |
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dc.date.updated |
2021-07-08T07:56:55Z |
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dc.date.embargoEndDate |
info:eu-repo/date/embargoEnd/2026-12-31 |
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dc.embargo |
2026-12-31 |
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dc.rights.accessRights |
info:eu-repo/semantics/embargoedAccess |
|
dc.identifier.doi |
https://doi.org/10.1177/17588359211019672 |
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