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Targeting HER2 and Focusing on Patients With Gastric Cancer

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Targeting HER2 and Focusing on Patients With Gastric Cancer Jose Maria Vieitez, MD, PhD Assistant Professor of Oncology Department of Medical Oncology – PowerPoint PPT presentation

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Title: Targeting HER2 and Focusing on Patients With Gastric Cancer


1
Targeting HER2 and Focusing on Patients With
Gastric Cancer
  • Jose Maria Vieitez, MD, PhD
  • Assistant Professor of OncologyDepartment of
    Medical OncologyHospital Universitario Central
    de AsturiasOviedo, Spain

2
Patient History and Presentation of Disease
  • Personal history
  • 46-year-old woman
  • No other relevant history
  • Family history
  • Paternal grandfather stomach cancer (51 years
    old)
  • Maternal aunt breast cancer (45 years old)
  • Disease presentation February 2008
  • Decreased appetite, early satiety, weight loss,
    and vomiting

3
Diagnosis Stage IV Adenocarcinoma of Stomach
  • Gastroscopy ulcerated lesion in antrum
  • Biopsy poorly differentiated, diffuse
    adenocarcinoma
  • CT scan and abdominal echography
  • Liver lesions 2.1 and 0.7 cm
  • Tumor markers elevated CEA, CA 19.9 and CA 72.4

CA carbohydrate antigen CEA
carcinoembryonic antigen CT computed tomography
4
Treatment
  • Surgical resection April 2008
  • Partial gastrectomy and left anexectomy
  • Miliary lesions in peritoneum, lesions in liver
    and left ovary
  • Systemic therapy May 2008
  • Cycle 16 cisplatin 70 mg/m2, capecitabine 850
    mg/m2 D114
  • Based on the literature HER2 testing requested
  • HER2 test result IHC 3
  • Cycle 727 trastuzumab 6 mg/kg/q3w capecitabine

HER2 human epidermal growth factor receptor 2
IHC immunohistochemistry
5
Tumor Assessment Stable Disease at Cycle 3
  • Baseline before treatment
  • Cisplatin capecitabine

Imaging studies property of Jose Maria Vieitez,
MD.
6
Tumor Assessment Complete Response at Cycle 17
  • Trastuzumab capecitabine

Imaging studies property of Jose Maria Vieitez,
MD.
7
Tumor Assessment Disease Progression at Cycle 27
  • Trastuzumab capecitabine
  • Good quality of life and symptom relief
  • Grade 1 anemia
  • Grade 2 asthenia
  • Grade 3 vomiting (responded to antiemetics)

Jan 2010
Time to progression 17 months
Imaging studies property of Jose Maria Vieitez,
MD.
8
Conclusions
  • Treatment with trastuzumab is well tolerated,
    even in prolonged treatment
  • Addition of trastuzumab in appropriately selected
    patients can increase efficacy, time to
    progression, and overall survival outside of
    clinical trial setting
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