The AGAMENON-SEOM model for prediction of survival in patients with advanced HER2-positive oesophagogastric adenocarcinoma receiving first-line trastuzumab-based therapy

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Institut Català de la Salut

[Jimenez-Fonseca P] Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain. [Foy V, Raby S] Department of Medical Oncology, Christie Hospital, Manchester, UK. [Carmona-Bayonas A] Medical Oncology Department, Hospital Universitario Morales Meseguer, Murcia, Spain. [Macía-Rivas L] Pharmacy Department, Hospital Universitario Central de Asturias, Oviedo, Spain. [Arrazubi V] Medical Oncology Department, Complejo Hospitalario de Navarra, IdiSNA (Navarra Institute for Health Research), Pamplona, Spain. [Mirallas O] Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain

Vall d'Hebron Barcelona Hospital Campus

Fecha de publicación

2023-03-22T13:03:29Z

2023-03-22T13:03:29Z

2023-03-04

Resumen

Gastric cancer; Survival; Trastuzumab


Càncer gàstric; Supervivència; Trastuzumab


Cáncer gástrico; Supervivencia; Trastuzumab


Background: Trastuzumab and chemotherapy is the standard first-line treatment in human epidermal growth factor receptor 2 (HER2)-positive advanced gastro-oesophageal cancer. The objective was to develop a predictive model for overall survival (OS) and progression-free survival (PFS) in patients treated with trastuzumab. Methods: Patients with HER2-positive advanced gastro-oesophageal adenocarcinoma (AGA) from the Spanish Society of Medical Oncology (SEOM)-AGAMENON registry and treated first line with trastuzumab and chemotherapy between 2008 and 2021 were included. The model was externally validated in an independent series (The Christie NHS Foundation Trust, Manchester, UK). Results: In all, 737 patients were recruited (AGAMENON-SEOM, n = 654; Manchester, n = 83). Median PFS and OS in the training cohort were 7.76 [95% confidence interval (CI), 7.13–8.25] and 14.0 months (95% CI, 13.0–14.9), respectively. Six covariates were significantly associated with OS: neutrophil-to-lymphocyte ratio, Eastern Cooperative Oncology Group performance status, Lauren subtype, HER2 expression, histological grade and tumour burden. The AGAMENON-HER2 model demonstrated adequate calibration and fair discriminatory ability with a c-index for corrected PFS/OS of 0.606 (95% CI, 0.578–0.636) and 0.623 (95% CI, 0.594–0.655), respectively. In the validation cohort, the model is well calibrated, with a c-index of 0.650 and 0.683 for PFS and OS, respectively. Conclusion: The AGAMENON-HER2 prognostic tool stratifies HER2-positive AGA patients receiving trastuzumab and chemotherapy according to their estimated survival endpoints.

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SAGE Publications

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Attribution-NonCommercial 4.0 International

http://creativecommons.org/licenses/by-nc/4.0/

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