scholarly journals Effectiveness and Healthcare Cost of Adding Trastuzumab to Standard Chemotherapy for First-Line Treatment of Metastatic Gastric Cancer: A Population-Based Cohort Study

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1691
Author(s):  
Matteo Franchi ◽  
Roberta Tritto ◽  
Lorena Torroni ◽  
Chiara Reno ◽  
Carlo La Vecchia ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Growth Factor Receptor ◽  
Cost Effective ◽  
Metastatic Gastric Cancer ◽  
Population Based ◽  
Standard Chemotherapy ◽  
Epidermal Growth ◽  
Gastric Cancer Patients

A randomized clinical trial showed that trastuzumab, added to traditional chemotherapy, significantly improved overall survival in human epidermal growth factor receptor 2 (HER2)-overexpressing metastatic gastric cancer patients. This population-based study aimed at evaluating both the clinical and economic impact of trastuzumab in a real-world setting. By using the healthcare utilization databases of Lombardy, Italy, a cohort of patients newly diagnosed with metastatic gastric cancer during the period 2011–2016 was selected. Among these, patients initially treated with either trastuzumab-based chemotherapy or standard chemotherapy alone were followed up until death, migration in other regions or June 2018. Overall survival and average cumulative costs were estimated and compared between the two treatment arms. Among the 1198 metastatic gastric cancer patients who started therapy within six months after metastasis detection, 87 were initially treated with trastuzumab-based chemotherapy and 1111 with standard chemotherapy. Median overall survival and restricted mean survival were 10.2 and 7.4 months, and 14.9 and 11.4 months, respectively, in the two treatment arms. The adjusted hazard ratio of death was 0.73 (95% CI 0.57–0.93). The average per capita cumulative healthcare costs were, respectively, EUR 39,337 and 26,504, corresponding to an incremental cost-effectiveness ratio of EUR 43,998 for each year of survival gained. Our study shows that adding trastuzumab to conventional chemotherapy is effective and cost-effective.

scholarly journals Modest overall survival improvements from 1998 to 2009 in metastatic gastric cancer patients: a population-based SEER analysis

2015 ◽  
Vol 19 (3) ◽  
pp. 723-734 ◽  
Author(s):  
Sabrina M. Ebinger ◽  
René Warschkow ◽  
Ignazio Tarantino ◽  
Bruno M. Schmied ◽  
Ulrich Güller ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Metastatic Gastric Cancer ◽  
Population Based ◽  
Gastric Cancer Patients

The prognostic impact of epidermal growth factor receptor (EGFR) in patients with metastatic gastric cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14557-e14557
Author(s):  
Dominique Werner ◽  
Akin Atmaca ◽  
Claudia Pauligk ◽  
Kristina Steinmetz ◽  
Havva Colak ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Mrna Expression ◽  
Growth Factor Receptor ◽  
Metastatic Gastric Cancer ◽  
Staining Intensity ◽  
Epidermal Growth

e14557 Background: The prognostic role of the epidermal growth factor receptor (EGFR) in metastatic gastric cancer has not been established. Methods: EGFR was analyzed by immunohistochemistry (IHC) in a total of 357 patients (formalin-fixed, paraffin-embedded samples) and by real-time quantitative PCR (RTqPCR) in 130 patients with esophagogastric cancer. Staining intensity on IHC was scored in EGFR 0, 1+, 2+ and 3+. Staining intensity (alternatively intensity x % positive cells or the H-Score) and quantitative mRNA expression were correlated with progression-free (PFS) and overall survival (OS) and pathological and clinical characteristics. Results: On IHC, EGFR was negative, 1+, 2+, and 3+ in 205 (57%), 50 (14%), 62 (17%), and 40 (11%) patients, respectively. EGFR 3+ status correlated positively with intestinal type histology (p=.05) but no other correlations between baseline criteria such as age, sex, ECOG, tumor location, type of metastatic sites, and type of sampling and EGFR status were found. PFS and OS were similar in patients with EGFR-positive vs. those with EGFR negative gastric cancer, regardless whether positivity was defined as ≥1+ (PFS, 5.3 vs. 5.7 months, p=.185; OS, 10.6 vs. 10.9 months, p=.463) or as 3+ (PFS, 5.7 vs. 4.9 months, p=.159; OS, 8.6 vs. 10.8 months, p=.377) or when alternative scores were used such as the H-score. The multivariate overall survival analysis indicated that EGFR status is not an independent prognostic factor (hazard ratio 0.84, 0.56 to 1.12, p=.227). There were also no significant differences in progression-free or overall survival when patients were categorized according to median (PFS p=.173, OS p=.116) or quartile (PFS p=.634, OS p=.767) distribution of EGFR mRNA expression or when the cut-off with the highest predictive value was calculated (PFS p=.148, OS p=.189). Conclusions: EGFR status is not prognostic of patient’s outcome in metastatic gastric cancer.

scholarly journals Prolonged overall survival of metastatic gastric cancer patients with BRCA germline mutations

2018 ◽  
Vol 29 ◽  
pp. v15-v16 ◽  
Author(s):  
N. Halpern ◽  
A. Grinshpun ◽  
B. Boursi ◽  
T. Golan ◽  
O. Margalit ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Metastatic Gastric Cancer ◽  
Germline Mutations ◽  
Gastric Cancer Patients

scholarly journals Palliative Gastrectomy Prolongs Survival of Metastatic Gastric Cancer Patients with Normal Preoperative CEA or CA19-9 Values: A Retrospective Cohort Study

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Chang-Fang Chiu ◽  
Horng-Ren Yang ◽  
Mei-Due Yang ◽  
Long-Bin Jeng ◽  
Tse-Yen Yang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Cancer Patients ◽  
Performance Status ◽  
Metastatic Gastric Cancer ◽  
Palliative Gastrectomy ◽  
Cast Doubt ◽  
Gastric Cancer Patients ◽  
Univariate Analyses

Background. Palliative gastrectomy has been suggested to improve survival of patients with metastatic gastric cancer, but limitations in study design and availability of robust prognostic factors have cast doubt on the overall merit of this procedure. Methods. The characteristics and clinical outcomes of 173 patients diagnosed between 2008 and 2012 were analyzed to determine the value of palliative gastrectomy and to identify potential prognostic factors. Results. Median overall patient survival was 6.5 months. To attenuate potential selection bias, patients with adequate performance and survival time of ≥ 2 months since diagnosis were included for risk factor analysis (n=137). The median overall survival was longer for patients who were younger than 60 years, had better performance status (8.7 versus 6.4 months, P=0.015), received systemic chemotherapy, or had palliative gastrectomy in univariate analyses. Gastrectomy (P=0.002) remained statistically significant in multivariate analyses. Subgroup analysis showed that patients aged < 60 years, CEA < 5 ng/mL or CA19-9 < 35 U/mL, obtained a survival advantage from palliative gastrectomy. In fact, palliative gastrectomy doubled overall survival for patients who had normal CEA and/or normal CA19-9. Conclusions. Palliative gastrectomy prolongs the survival of metastatic gastric cancer patients with normal CEA and/or CA19-9 level at the time of diagnosis.

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