Prognostic significance of performing universal HER2 testing in cases of advanced gastric cancer

Background Trastuzumab significantly improves overall survival (OS) when added to cisplatin and fluoropyrimidine as a treatment for HER2-positive advanced gastric cancers (AGC). The aim of this study was to evaluate the impact of the gradual implementation of HER2 testing on patient prognosis in a n...

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Published in:	Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association Vol. 20; no. 3; pp. 465 - 474
Main Authors:	Jiménez-Fonseca, Paula, Carmona-Bayonas, Alberto, Sánchez Lorenzo, Maria Luisa, Plazas, Javier Gallego, Custodio, Ana, Hernández, Raquel, Garrido, Marcelo, García, Teresa, Echavarría, Isabel, Cano, Juana María, Rodríguez Palomo, Alberto, Mangas, Monserrat, Macías Declara, Ismael, Ramchandani, Avinash, Visa, Laura, Viudez, Antonio, Buxó, Elvira, Díaz-Serrano, Asunción, López, Carlos, Azkarate, Aitor, Longo, Federico, Castañón, Eduardo, Sánchez Bayona, Rodrigo, Pimentel, Paola, Limón, Maria Luisa, Cerdá, Paula, Álvarez Llosa, Renata, Serrano, Raquel, Lobera, Maria Pilar Felices, Alsina, María, Hurtado Nuño, Alicia, Gómez-Martin, Carlos
Format:	Journal Article
Language:	English
Published:	Tokyo Springer Japan 01-05-2017 Springer Nature B.V
Subjects:	Abdominal Surgery Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biomarkers, Tumor - metabolism Cancer Research Female Gastric cancer Gastroenterology Humans Kaplan-Meier Estimate Male Medicine Medicine & Public Health Middle Aged Oncology Original Article Prognosis Proportional Hazards Models Receptor, ErbB-2 - metabolism Spain Stomach Neoplasms - drug therapy Stomach Neoplasms - metabolism Stomach Neoplasms - mortality Stomach Neoplasms - pathology Surgical Oncology Trastuzumab - administration & dosage Personalized medicine Gastric cancer HER2 testing Trastuzumab Quality of care
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Summary:	Background Trastuzumab significantly improves overall survival (OS) when added to cisplatin and fluoropyrimidine as a treatment for HER2-positive advanced gastric cancers (AGC). The aim of this study was to evaluate the impact of the gradual implementation of HER2 testing on patient prognosis in a national registry of AGC. Methods This Spanish National Cancer Registry includes cases who were consecutively recruited at 28 centers from January 2008 to January 2016. The effect of missing HER2 status was assessed using stratified Cox proportional hazards (PH) regression. Results The rate of HER2 testing increased steadily over time, from 58.3 % in 2008 to 92.9 % in 2016. HER2 was positive in 194 tumors (21.3 %). In the stratified Cox PH regression, each 1 % increase in patients who were not tested for HER2 at the institutions was associated with an approximately 0.3 % increase in the risk of death: hazard ratio, 1.0035 (CI 95 %, 1.001–1.005), P = 0.0019. Median OS was significantly lower at institutions with the highest proportions of patients who were not tested for HER2. Conclusion Patients treated at centers that took longer to implement HER2 testing exhibited worse clinical outcomes. The speed of implementation behaves as a quality-of-care indicator. Reviewed guidelines on HER2 testing should be used to achieve this goal in a timely manner.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1436-3291 1436-3305
DOI:	10.1007/s10120-016-0639-8