(Q)-TWiST analysis of trastuzumab plus fluoropyrimidine/cisplatin (T-XP/FP) versus XP/FP alone as first-line therapy for advanced HER2-positive gastric cancer.

Chung, Hyun Cheol; Bang, Y.; Cutsem, E. Van; Kang, Younhee; Hamamoto, Yasushi; Moiseyenko, V.; Gotovkin, E.; Urspruch, A.; Ducournau, P

doi:10.1200/jco.2010.28.15_suppl.4048

Cited by 7 publications

(5 citation statements)

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“…Quality of life assessments showed that disease-specific and symptom-specific scores improved over time in both treatment arms, and that pain intensity scores and use of analgesic medicine were similar between the two treatment arms, indicating that adding trastuzumab to chemo therapy does not compromise quality of life compared with chemotherapy alone [41]. These results have been corroborated using Quality-Adjusted Time Without Symptoms of Disease or Toxicity (Q-TWIST) methodology to assess the quality-adjusted overall survival gain with trastuzumab plus chemotherapy compared with chemotherapy alone [42]. The Q-TWIST analysis demonstrated that trastuzumab plus chemotherapy was associated with significantly improved quality-adjusted survival compared with chemotherapy alone (6.82 vs 4.55 months, respectively; mean incremental difference: 2.27 months; 95% CI: 1.15-3.80; p < 0.001).…”

Section: Quality Of Lifementioning

confidence: 81%

“…The Q-TWIST analysis demonstrated that trastuzumab plus chemotherapy was associated with significantly improved quality-adjusted survival compared with chemotherapy alone (6.82 vs 4.55 months, respectively; mean incremental difference: 2.27 months; 95% CI: 1.15-3.80; p < 0.001). Quality-adjusted overall survival was 11.88 months versus 9.46 months, respectively, with a mean difference of 2.42 months between the two treatments arms (95% CI: 1.24-3.86; p = 0.001) [42].…”

Section: Quality Of Lifementioning

confidence: 99%

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Trastuzumab: A New Treatment Option for HER2-Positive Metastatic Gastric and Gastroesophageal Junction Cancer

Lordick

2011

Future Oncol.

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In patients with metastatic gastric cancer, median overall survival with standard chemotherapy remains under 1 year. As such, effective new treatments with acceptable tolerability are urgently needed. Amplification/overexpression of HER2 is reported in approximately 20% of gastric tumors, providing a rationale to investigate trastuzumab, a monoclonal antibody against HER2, in this setting. In the Phase III international Trastuzumab for Gastric Cancer (ToGA) study, the addition of trastuzumab to chemotherapy significantly improved overall survival without compromising safety in patients with HER2-positive metastatic gastric or gastroesophageal junction cancer. The purpose of this review is to discuss clinical data supporting the role of trastuzumab in metastatic gastric cancer, and consider the optimization of gastric cancer-specific HER2 testing and analysis.

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Section: Quality Of Lifementioning

confidence: 81%

Section: Quality Of Lifementioning

confidence: 99%

Trastuzumab: A New Treatment Option for HER2-Positive Metastatic Gastric and Gastroesophageal Junction Cancer

Lordick

2011

Future Oncol.

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“…The Q-TWiST method has been applied in numerous treatment comparisons across multiple indications. Additionally, more than 50 such analyses in oncology have been published, including a study comparing trastuzumab plus chemotherapy versus chemotherapy alone as first-line treatment for advanced HER2-positive GC using data from the phase 3 ToGA (Trastuzumab for Gastric Cancer) trial [ 21 ]. These analyses serve as benchmarks that allow a comparison between our study findings and published results.…”

Section: Discussionmentioning

confidence: 99%

Quality-adjusted time without symptoms or toxicity analysis of nivolumab plus chemotherapy versus chemotherapy alone for the management of previously untreated patients with advanced gastric cancer, gastroesophageal junction cancer, or esophageal adenocarcinoma

Lin

Nguyen

Shah³

et al. 2023

Gastric Cancer

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Background The phase 3 CheckMate 649 established superior overall survival of nivolumab in combination with chemotherapy (NIVO + chemo) compared with chemotherapy (chemo) alone as a first-line treatment for patients with Her2-negative advanced gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma (GC/GEJC/EAC). This post hoc trial analysis aimed to evaluate the benefit of NIVO + chemo using quality-adjusted time without symptoms or toxicity (Q-TWiST) to further account for quality of life (QoL) in different health states depending on disease progression and treatment toxicity. Methods Using data from CheckMate 649, we evaluated the quality-adjusted survival gain associated with NIVO + chemo compared with chemo alone among all randomized patients and repeated similar analyses among those with programmed cell death-ligand 1 (PD-L1) combined positive score (CPS) ≥ 5. Relative Q-TWiST gains of ≥ 10% were predefined as clinically important. Results In all randomized patients, those receiving NIVO + chemo had a mean Q-TWiST gain of 1.8 (95% CI 0.9, 2.7) months compared with those receiving chemo alone. The relative Q-TWiST gain was estimated to be 12.8%. Patients with PD-L1 CPS ≥ 5 had greater quality-adjusted survival gain from NIVO + chemo with an estimated Q-TWiST gain of 2.8 (95% CI 1.5, 4.1) months, representing a relative gain of 20.6%. Subgroup analyses and sensitivity analyses with various QoL utility values yielded consistent findings in favor of NIVO + chemo compared with chemo alone. Q-TWiST gain from NIVO + chemo increased with longer duration of follow-up. Conclusions NIVO + chemo was associated with a statistically significant and clinically important gain in quality-adjusted survival compared with chemo alone among previously untreated patients with advanced GC/GEJC/EAC.

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“…On the basis of these data, trastuzumab was approved by the regulatory authorities for HER2 positive patients with advanced gastric cancer. At this year's ASCO further quality of life data were presented [12]. Th e authors showed that the addition of trastuzumab leads to a gain in median overall survival that translates into longer progression free survival without worsening of tumour symptoms or toxicity from treatment.…”

Section: Biologicalsmentioning

confidence: 97%

Gastric cancer – ASCO 2010

Wöll¹

2010

memo

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Gastric cancer is still a devastating disease. Two thirds of the patients are diagnosed in a locally advanced or metastatic stage. Even if surgery is possible, long-term survival is low. Optimal therapy in a curative and a palliative setting is still not clear yet. ASCO 2010 could shed some light on optimal chemotherapy and the introduction of molecular targeted therapy. Th e aim of this article is to summarize the most important publications at this year's ASCO annual meeting and to put them into context of current therapeutic strategies.Patients with operable gastric cancer still have a poor prognosis and eff ective pre-or postoperative therapy is warranted. In a large Cochrane meta-analysis [1] 2128 patients from 13 randomized trials were analyzed. Patients received perioperative chemotherapy or radiotherapy for locally advanced adenocarcinoma of the stomach or the distal esophagus. With preoperative chemotherapy a signifi cant overall survival benefi t (hazard ratio (HR) 0.81; p< 0.0001) could be shown. Th is meta-analysis enforces the use of preoperative chemotherapy as standard of care for locally advanced gastric cancer and is well in line with recent phase III trials (MAGIC, ACCORD07; [2, 3]). Th e optimal neoadjuvant regimen, however, is still unclear [4]. In recent trials CF (cisplatin, 5FU) or ECF (epirubicin, cisplatin, 5FU) are investigated. Infusional 5FU however via continuous infusion is unpopular. In Abstract 4019 the fi rst safety data of the STO3 trial are presented [5]. In this large phase III trial inclusion of 1100 patients with operable gastric cancer is planned. Patients are randomized to receive ECX (epirubicin, cisplatin, and capecitabine) in the control arm and ECX plus bevacizumab in the experimental arm. Th ree cycles are administered preoperatively and three more after surgery. Th e fi rst 104 patients are analyzed and toxicity seems acceptable and comparable in both arms. Th e role of bevacizumab in the perioperative setting will be answered after the study is closed but the control arm may be a good choice for a feasible perioperative regimen since continuous infusional 5FU is replaced by oral capecitabine.Optimal preoperative staging in operable gastric cancer is still a matter of debate. If a staging laparoscopy is performed, it has been shown that a positive lavage is associated with a worse prognosis. An interesting study investigated this procedure in patients who received neoadjuvant chemotherapy [6]. As expected median survival was worse in patients with free peritoneal tumour cells in the lavage. 37% of these patients however presented with a negative lavage after neoadjuvant chemotherapy. Th ese patients showed the same favourable prognosis as patients with a negative fi rst peritoneal lavage. Patients who present with free peritoneal tumour cells should receive neoadjuvant chemotherapy. If their lavage turns negative, a median survival of 36 months and a twoyear survival rate of 71.4% could be reached (Tab. 1). Palliative chemotherapy First line therapyTh e optimal fi rst...

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(Q)-TWiST analysis of trastuzumab plus fluoropyrimidine/cisplatin (T-XP/FP) versus XP/FP alone as first-line therapy for advanced HER2-positive gastric cancer.

Cited by 7 publications

References 0 publications

Trastuzumab: A New Treatment Option for HER2-Positive Metastatic Gastric and Gastroesophageal Junction Cancer

Trastuzumab: A New Treatment Option for HER2-Positive Metastatic Gastric and Gastroesophageal Junction Cancer

Quality-adjusted time without symptoms or toxicity analysis of nivolumab plus chemotherapy versus chemotherapy alone for the management of previously untreated patients with advanced gastric cancer, gastroesophageal junction cancer, or esophageal adenocarcinoma

Gastric cancer – ASCO 2010

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