Treatment and Outcomes in Advanced Gastroesophageal Adenocarcinoma in the Pre-Immunotherapy Era Based on the Spanish AGAMENON-SEOM Registry

Background/Objectives: Human epidermal growth factor receptor 2-negative (HER2-negative), locally advanced or metastatic gastric/gastroesophageal junction adenocarcinoma (advanced G/GEJa) is associated with poor survival outcomes, and there is an unmet need for targeted therapy. This study, conducte...

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Detalles Bibliográficos
Autores: Jimenez-Fonseca, Paula, Carmona-Bayonas, Alberto, Álvarez-Cañada, Jaime, Storfer-Isser, Amy, Martin-Richard, Marta, Sauri, Tamara, Cano, Juana María, Martínez Moreno, Elia, Pérez-Wert, Pablo, López, Javier, Garcia Navalon, Francisco, Gómez-González, Lucía, Ruiz Martín, Maribel, Rupérez Blanco, Ana Belén, López-López, Flora, Roncancio-Díaz, Emilse, Corbacho, Belén, Mateo, Marta, Anguita-Alonso, Paloma, Gallego Plazas, Javier
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/25412
Acceso en línea:https://hdl.handle.net/20.500.13003/25412
Access Level:acceso abierto
Palabra clave:Adenocarcinoma
Digestive System Neoplasms
Esophagogastric Junction
Neoplasms
Survival
Neoplasias del Sistema Digestivo
Unión Esofagogástrica
Neoplasias
Sobrevida
HER2
adenocarcinoma
gastric neoplasms
gastroesophageal junction
neoplasms
survival
Descripción
Sumario:Background/Objectives: Human epidermal growth factor receptor 2-negative (HER2-negative), locally advanced or metastatic gastric/gastroesophageal junction adenocarcinoma (advanced G/GEJa) is associated with poor survival outcomes, and there is an unmet need for targeted therapy. This study, conducted in the pre-immunotherapy era, aimed to describe the characteristics and management, and compare the survival, of HER2-negative and HER2-positive patients initiating first-line (1L) treatment for advanced G/GEJa in Spain and estimate the number of HER2-negative patients eligible for 1L polychemotherapy. Methods: Patients from the AGAMENON-SEOM registry who initiated 1L polychemotherapy for advanced G/GEJa (2015-2019) in Spain were included. Results: In total, 1357 patients were included (951 [70.1%] HER2-negative; 315 [23.2%] HER2-positive; 91 [6.7%] unknown HER2 status). Most patients (56.3%) received one line of therapy; 27.6% received two lines; and 16.1% received three lines. Among HER2-positive patients, 92.7% received trastuzumab as part of 1L treatment. The use of FOLFOX and CAPOX increased over the study period (2015-2019). HER2-negative patients had significantly shorter progression-free survival (median, 5.92 months [95% CI, 5.59-6.38] vs. 7.37 months [95% CI, 6.55-8.29]; log-rank p < 0.0001) and overall survival (median, 10.49 months [95% CI, 9.74-11.05] vs. 13.82 months [95% CI, 12.30-14.74]; adjusted time ratio, 0.812 [95% CI, 0.722-0.913]; p = 0.0005) than HER2-positive patients. Per probabilistic sensitivity analyses, an estimated 2856 (95% CI, 1619-4134) Spanish patients with HER2-negative advanced G/GEJa were eligible for 1L polychemotherapy in 2024. Conclusions: The survival difference between HER2-positive and HER2-negative patients underscores the critical need for targeted therapies for HER2-negative patients in the 1L setting.

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