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Title: Prognostic significance of performing universal HER2 testing in cases of advanced gastric cancer.
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
Keywords: Gastric cancer;HER2 testing;Personalized medicine;Quality of care;Trastuzumab
metadata.dc.subject.mesh: Adult
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
Biomarkers, Tumor
Kaplan-Meier Estimate
Middle Aged
Proportional Hazards Models
Receptor, ErbB-2
Stomach Neoplasms
Issue Date: 6-Sep-2016
Abstract: 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. 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. 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. 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.
metadata.dc.identifier.doi: 10.1007/s10120-016-0639-8
Appears in Collections:Producción 2020

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