Clinical Edge Journal Scan

Key clinical point: Firstline trastuzumab-based chemotherapy shows poorer survival in patients with rescued vs initially human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer.

Major finding: The median follow-up duration was 47.6 months. Rescued HER2-positive patients had a higher rate of immunohistochemistry (IHC) score 2+/in situ hybridization-positive (ISH+; 37.0%) tumors. The median progression-free survival (PFS; 5.7 vs 8.4 months; P = .034) and overall survival (OS; 11.3 vs 16.7 months; P = .02) were significantly shorter in IHC 2+/ISH+ vs IHC 3+ patients. Rescued vs initially HER2-positive patients had worse PFS (5.4 vs 7.8 months; P = .017) and OS (10.4 vs 16.3 months; P = .036).

Study details: A retrospective analysis of 153 patients with HER2-positive advanced gastric cancer who received first-line trastuzumab-based chemotherapy.

Disclosures: No funding source was identified for this work. The authors received consulting fees and honoraria. JH Cheon was the founder and shareholder of Novomics.

Source: Bang K et al. Association between HER2 heterogeneity and clinical outcomes of HER2-positive gastric cancer patients treated with trastuzumab. Gastric Cancer. 2022 (May 7). Doi: 10.1007/s10120-022-01298-6

Key clinical point: Firstline trastuzumab-based chemotherapy shows poorer survival in patients with rescued vs initially human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer.

Major finding: The median follow-up duration was 47.6 months. Rescued HER2-positive patients had a higher rate of immunohistochemistry (IHC) score 2+/in situ hybridization-positive (ISH+; 37.0%) tumors. The median progression-free survival (PFS; 5.7 vs 8.4 months; P = .034) and overall survival (OS; 11.3 vs 16.7 months; P = .02) were significantly shorter in IHC 2+/ISH+ vs IHC 3+ patients. Rescued vs initially HER2-positive patients had worse PFS (5.4 vs 7.8 months; P = .017) and OS (10.4 vs 16.3 months; P = .036).

Study details: A retrospective analysis of 153 patients with HER2-positive advanced gastric cancer who received first-line trastuzumab-based chemotherapy.

Disclosures: No funding source was identified for this work. The authors received consulting fees and honoraria. JH Cheon was the founder and shareholder of Novomics.

Source: Bang K et al. Association between HER2 heterogeneity and clinical outcomes of HER2-positive gastric cancer patients treated with trastuzumab. Gastric Cancer. 2022 (May 7). Doi: 10.1007/s10120-022-01298-6

Key clinical point: Firstline trastuzumab-based chemotherapy shows poorer survival in patients with rescued vs initially human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer.

Major finding: The median follow-up duration was 47.6 months. Rescued HER2-positive patients had a higher rate of immunohistochemistry (IHC) score 2+/in situ hybridization-positive (ISH+; 37.0%) tumors. The median progression-free survival (PFS; 5.7 vs 8.4 months; P = .034) and overall survival (OS; 11.3 vs 16.7 months; P = .02) were significantly shorter in IHC 2+/ISH+ vs IHC 3+ patients. Rescued vs initially HER2-positive patients had worse PFS (5.4 vs 7.8 months; P = .017) and OS (10.4 vs 16.3 months; P = .036).

Study details: A retrospective analysis of 153 patients with HER2-positive advanced gastric cancer who received first-line trastuzumab-based chemotherapy.

Disclosures: No funding source was identified for this work. The authors received consulting fees and honoraria. JH Cheon was the founder and shareholder of Novomics.

Source: Bang K et al. Association between HER2 heterogeneity and clinical outcomes of HER2-positive gastric cancer patients treated with trastuzumab. Gastric Cancer. 2022 (May 7). Doi: 10.1007/s10120-022-01298-6

Key clinical point: Carbon nanoparticle suspension lymphography-guided distal gastrectomy improves postoperative lymph node detection rate in patients with gastric cancer undergoing gastrectomy.

Major finding: A higher mean number of lymph nodes were detected with vs without carbon nanoparticle suspension injection (CNSI; 59.6 vs 30.0; P < .001). A higher number of lymph nodes were detected in black- vs nonblack-stained stations (9.2 vs 3.5 lymph nodes per station; P < .001).

Study details: This was a retrospective cohort study including 156 propensity score-matched patients with clinical T1-T4 gastric cancer who underwent laparoscopic or robotic distal gastrectomy with or without (conventional group) CNSI between May 2019 and December 2020.

Disclosures: This study was supported by the University Research Project of Hebei Province and the Medical Research Project of Hebei Province, China. The authors declared no conflicts of interest.

Source: Tian Y et al. Assessment of carbon nanoparticle suspension lymphography–guided distal gastrectomy for gastric cancer. JAMA Netw Open. 2022;5(4):e227739 (Apr 18). Doi: 10.1001/jamanetworkopen.2022.7739

Key clinical point: Carbon nanoparticle suspension lymphography-guided distal gastrectomy improves postoperative lymph node detection rate in patients with gastric cancer undergoing gastrectomy.

Major finding: A higher mean number of lymph nodes were detected with vs without carbon nanoparticle suspension injection (CNSI; 59.6 vs 30.0; P < .001). A higher number of lymph nodes were detected in black- vs nonblack-stained stations (9.2 vs 3.5 lymph nodes per station; P < .001).

Study details: This was a retrospective cohort study including 156 propensity score-matched patients with clinical T1-T4 gastric cancer who underwent laparoscopic or robotic distal gastrectomy with or without (conventional group) CNSI between May 2019 and December 2020.

Disclosures: This study was supported by the University Research Project of Hebei Province and the Medical Research Project of Hebei Province, China. The authors declared no conflicts of interest.

Source: Tian Y et al. Assessment of carbon nanoparticle suspension lymphography–guided distal gastrectomy for gastric cancer. JAMA Netw Open. 2022;5(4):e227739 (Apr 18). Doi: 10.1001/jamanetworkopen.2022.7739

Key clinical point: Carbon nanoparticle suspension lymphography-guided distal gastrectomy improves postoperative lymph node detection rate in patients with gastric cancer undergoing gastrectomy.

Major finding: A higher mean number of lymph nodes were detected with vs without carbon nanoparticle suspension injection (CNSI; 59.6 vs 30.0; P < .001). A higher number of lymph nodes were detected in black- vs nonblack-stained stations (9.2 vs 3.5 lymph nodes per station; P < .001).

Study details: This was a retrospective cohort study including 156 propensity score-matched patients with clinical T1-T4 gastric cancer who underwent laparoscopic or robotic distal gastrectomy with or without (conventional group) CNSI between May 2019 and December 2020.

Disclosures: This study was supported by the University Research Project of Hebei Province and the Medical Research Project of Hebei Province, China. The authors declared no conflicts of interest.

Source: Tian Y et al. Assessment of carbon nanoparticle suspension lymphography–guided distal gastrectomy for gastric cancer. JAMA Netw Open. 2022;5(4):e227739 (Apr 18). Doi: 10.1001/jamanetworkopen.2022.7739

Key clinical point: Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) significantly decreased postoperative peritoneal recurrence and prolonged survival in patients with clinical T4 gastric cancer who underwent gastrectomy with lymphadenectomy.

Major finding: Prophylactic HIPEC vs no HIPEC significantly lowered the overall recurrence rate (34.3% vs 62.9%; P = .04) and postoperative peritoneal carcinomatosis (21.7% vs 57.1%; P = .03). HIPEC significantly improved the overall survival (OS) rate (71.4% vs 40.0%; P = .01). Patients in the HIPEC group had a significantly longer OS (adjusted hazard ratio [aHR] 0.37; P = .035) and disease-free survival (aHR 0.33; P = .017).

Study details: This was a retrospective study of 132 patients with clinical stage T4 gastric cancer who underwent gastrectomy plus D2 lymphadenectomy between 2014 and 2020. Thirty-five of the 132 patients received prophylactic HIPEC perioperatively.

Disclosures: No funding source was identified for this work. The authors declared no competing interests.

Source: Lee TY et al. Prophylactic hyperthermic intraperitoneal chemotherapy for patients with clinical T4 gastric cancer. Eur J Surg Oncol. 2022 (Apr 27). Doi: 10.1016/j.ejso.2022.04.018

Key clinical point: Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) significantly decreased postoperative peritoneal recurrence and prolonged survival in patients with clinical T4 gastric cancer who underwent gastrectomy with lymphadenectomy.

Major finding: Prophylactic HIPEC vs no HIPEC significantly lowered the overall recurrence rate (34.3% vs 62.9%; P = .04) and postoperative peritoneal carcinomatosis (21.7% vs 57.1%; P = .03). HIPEC significantly improved the overall survival (OS) rate (71.4% vs 40.0%; P = .01). Patients in the HIPEC group had a significantly longer OS (adjusted hazard ratio [aHR] 0.37; P = .035) and disease-free survival (aHR 0.33; P = .017).

Study details: This was a retrospective study of 132 patients with clinical stage T4 gastric cancer who underwent gastrectomy plus D2 lymphadenectomy between 2014 and 2020. Thirty-five of the 132 patients received prophylactic HIPEC perioperatively.

Disclosures: No funding source was identified for this work. The authors declared no competing interests.

Source: Lee TY et al. Prophylactic hyperthermic intraperitoneal chemotherapy for patients with clinical T4 gastric cancer. Eur J Surg Oncol. 2022 (Apr 27). Doi: 10.1016/j.ejso.2022.04.018

Key clinical point: Prophylactic hyperthermic intraperitoneal chemotherapy (HIPEC) significantly decreased postoperative peritoneal recurrence and prolonged survival in patients with clinical T4 gastric cancer who underwent gastrectomy with lymphadenectomy.

Major finding: Prophylactic HIPEC vs no HIPEC significantly lowered the overall recurrence rate (34.3% vs 62.9%; P = .04) and postoperative peritoneal carcinomatosis (21.7% vs 57.1%; P = .03). HIPEC significantly improved the overall survival (OS) rate (71.4% vs 40.0%; P = .01). Patients in the HIPEC group had a significantly longer OS (adjusted hazard ratio [aHR] 0.37; P = .035) and disease-free survival (aHR 0.33; P = .017).

Study details: This was a retrospective study of 132 patients with clinical stage T4 gastric cancer who underwent gastrectomy plus D2 lymphadenectomy between 2014 and 2020. Thirty-five of the 132 patients received prophylactic HIPEC perioperatively.

Disclosures: No funding source was identified for this work. The authors declared no competing interests.

Source: Lee TY et al. Prophylactic hyperthermic intraperitoneal chemotherapy for patients with clinical T4 gastric cancer. Eur J Surg Oncol. 2022 (Apr 27). Doi: 10.1016/j.ejso.2022.04.018

Key clinical point: The body composition variables were associated with major postoperative complications in patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy.

Major finding: A high skeletal muscle (SM)-mass Z-score (difference in each patient’s standard deviation from the mean value) was associated with a lower risk for major postoperative complications (relative risk [RR] 0.47, P = .004). High visceral adipose tissue-radiation attenuation (VAT-RA; RR 2.82; P = .001) and subcutaneous adipose tissue-RA (SAT-RA; RR 1.95; P = .015) Z-scores were associated with an increased risk for major postoperative complications.

Study details: This was a side study of 112 patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy in the LOGICA trial. The preoperative computed tomography scan was used to calculate the mass and RA for SM, VAT, and SAT.

Disclosures: This study was sponsored by the Netherlands Organization for Health Research and Development. The authors received consulting or advisory fees, travel or accommodations expenses, or grants outside this work.

Source: Tweed TTT et al. Body composition is a predictor for postoperative complications after gastrectomy for gastric cancer: A prospective side study of the LOGICA trial. J Gastrointest Surg. 2022 (Apr 29). Doi: 10.1007/s11605-022-05321-0

Key clinical point: The body composition variables were associated with major postoperative complications in patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy.

Major finding: A high skeletal muscle (SM)-mass Z-score (difference in each patient’s standard deviation from the mean value) was associated with a lower risk for major postoperative complications (relative risk [RR] 0.47, P = .004). High visceral adipose tissue-radiation attenuation (VAT-RA; RR 2.82; P = .001) and subcutaneous adipose tissue-RA (SAT-RA; RR 1.95; P = .015) Z-scores were associated with an increased risk for major postoperative complications.

Study details: This was a side study of 112 patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy in the LOGICA trial. The preoperative computed tomography scan was used to calculate the mass and RA for SM, VAT, and SAT.

Disclosures: This study was sponsored by the Netherlands Organization for Health Research and Development. The authors received consulting or advisory fees, travel or accommodations expenses, or grants outside this work.

Source: Tweed TTT et al. Body composition is a predictor for postoperative complications after gastrectomy for gastric cancer: A prospective side study of the LOGICA trial. J Gastrointest Surg. 2022 (Apr 29). Doi: 10.1007/s11605-022-05321-0

Key clinical point: The body composition variables were associated with major postoperative complications in patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy.

Major finding: A high skeletal muscle (SM)-mass Z-score (difference in each patient’s standard deviation from the mean value) was associated with a lower risk for major postoperative complications (relative risk [RR] 0.47, P = .004). High visceral adipose tissue-radiation attenuation (VAT-RA; RR 2.82; P = .001) and subcutaneous adipose tissue-RA (SAT-RA; RR 1.95; P = .015) Z-scores were associated with an increased risk for major postoperative complications.

Study details: This was a side study of 112 patients with gastric cancer who received preoperative chemotherapy followed by gastrectomy in the LOGICA trial. The preoperative computed tomography scan was used to calculate the mass and RA for SM, VAT, and SAT.

Disclosures: This study was sponsored by the Netherlands Organization for Health Research and Development. The authors received consulting or advisory fees, travel or accommodations expenses, or grants outside this work.

Source: Tweed TTT et al. Body composition is a predictor for postoperative complications after gastrectomy for gastric cancer: A prospective side study of the LOGICA trial. J Gastrointest Surg. 2022 (Apr 29). Doi: 10.1007/s11605-022-05321-0

Key clinical point: First-degree relatives of patients with gastric cancer show a high prevalence of preneoplastic lesions (PNL).

Major finding: The prevalence of PNL, atrophic gastritis, and intestinal metaplasia in first-degree relatives of gastric cancer patients were 86.4%, 82.7%, and 54.5%, respectively. The incidence of PNL was not significantly associated with sex (odds ratio [OR] 3.10; 95% confidence interval [CI] 1.00-9.64), age (OR 0.74; 95% CI, 0.26-2.14), and Helicobacter pylorii infection (OR 0.58; 95% CI 0.12-2.77). The advanced stages of Operative Link on Gastritis Assessment and Operative Link on Gastritis/Intestinal-Metaplasia Assessment were verified in 18.0% and 16.3% of the first-degree relatives, respectively.

Study details: This was a cross-sectional study including 110 first-degree relatives of patients with gastric cancer.

Disclosures: This study was partially supported by CONICYT, Chile. The authors declared no conflicts of interest.

Source: Sotelo S et al. Prevalence of gastric preneoplastic lesions in first-degree relatives of patients with gastric cancer: A cross-sectional study. J Gastrointest Cancer. 2022 (Apr 30). Doi: 10.1007/s12029-022-00827-x

Key clinical point: First-degree relatives of patients with gastric cancer show a high prevalence of preneoplastic lesions (PNL).

Major finding: The prevalence of PNL, atrophic gastritis, and intestinal metaplasia in first-degree relatives of gastric cancer patients were 86.4%, 82.7%, and 54.5%, respectively. The incidence of PNL was not significantly associated with sex (odds ratio [OR] 3.10; 95% confidence interval [CI] 1.00-9.64), age (OR 0.74; 95% CI, 0.26-2.14), and Helicobacter pylorii infection (OR 0.58; 95% CI 0.12-2.77). The advanced stages of Operative Link on Gastritis Assessment and Operative Link on Gastritis/Intestinal-Metaplasia Assessment were verified in 18.0% and 16.3% of the first-degree relatives, respectively.

Study details: This was a cross-sectional study including 110 first-degree relatives of patients with gastric cancer.

Disclosures: This study was partially supported by CONICYT, Chile. The authors declared no conflicts of interest.

Source: Sotelo S et al. Prevalence of gastric preneoplastic lesions in first-degree relatives of patients with gastric cancer: A cross-sectional study. J Gastrointest Cancer. 2022 (Apr 30). Doi: 10.1007/s12029-022-00827-x

Key clinical point: First-degree relatives of patients with gastric cancer show a high prevalence of preneoplastic lesions (PNL).

Major finding: The prevalence of PNL, atrophic gastritis, and intestinal metaplasia in first-degree relatives of gastric cancer patients were 86.4%, 82.7%, and 54.5%, respectively. The incidence of PNL was not significantly associated with sex (odds ratio [OR] 3.10; 95% confidence interval [CI] 1.00-9.64), age (OR 0.74; 95% CI, 0.26-2.14), and Helicobacter pylorii infection (OR 0.58; 95% CI 0.12-2.77). The advanced stages of Operative Link on Gastritis Assessment and Operative Link on Gastritis/Intestinal-Metaplasia Assessment were verified in 18.0% and 16.3% of the first-degree relatives, respectively.

Study details: This was a cross-sectional study including 110 first-degree relatives of patients with gastric cancer.

Disclosures: This study was partially supported by CONICYT, Chile. The authors declared no conflicts of interest.

Source: Sotelo S et al. Prevalence of gastric preneoplastic lesions in first-degree relatives of patients with gastric cancer: A cross-sectional study. J Gastrointest Cancer. 2022 (Apr 30). Doi: 10.1007/s12029-022-00827-x

Key clinical point: The oxaliplatin- vs cisplatin-based regimen does not show significant difference in survival benefits in elderly patients with advanced gastric cancer.

Major finding: The overall survival was not significantly different between the oxaliplatin and cisplatin groups (hazard ratio 1.13; P = .70). A significantly lower number of patients received granulocyte colony-stimulating factor in the oxaliplatin vs cisplatin group (2.3% vs 22.7%; P = .01).

Study details: This was a propensity score-matched analysis of 242 patients aged ≥70 years with advanced gastric cancer who received oxaliplatin- or cisplatin-based treatment regimen.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. The authors declared no competing interests.

Source: Chinen T et al. Oxaliplatin- versus cisplatin-based regimens for elderly individuals with advanced gastric cancer: a retrospective cohort study. BMC Cancer. 2022;22:460 (Apr 26). Doi: 10.1186/s12885-022-09581-6

Key clinical point: The oxaliplatin- vs cisplatin-based regimen does not show significant difference in survival benefits in elderly patients with advanced gastric cancer.

Major finding: The overall survival was not significantly different between the oxaliplatin and cisplatin groups (hazard ratio 1.13; P = .70). A significantly lower number of patients received granulocyte colony-stimulating factor in the oxaliplatin vs cisplatin group (2.3% vs 22.7%; P = .01).

Study details: This was a propensity score-matched analysis of 242 patients aged ≥70 years with advanced gastric cancer who received oxaliplatin- or cisplatin-based treatment regimen.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. The authors declared no competing interests.

Source: Chinen T et al. Oxaliplatin- versus cisplatin-based regimens for elderly individuals with advanced gastric cancer: a retrospective cohort study. BMC Cancer. 2022;22:460 (Apr 26). Doi: 10.1186/s12885-022-09581-6

Key clinical point: The oxaliplatin- vs cisplatin-based regimen does not show significant difference in survival benefits in elderly patients with advanced gastric cancer.

Major finding: The overall survival was not significantly different between the oxaliplatin and cisplatin groups (hazard ratio 1.13; P = .70). A significantly lower number of patients received granulocyte colony-stimulating factor in the oxaliplatin vs cisplatin group (2.3% vs 22.7%; P = .01).

Study details: This was a propensity score-matched analysis of 242 patients aged ≥70 years with advanced gastric cancer who received oxaliplatin- or cisplatin-based treatment regimen.

Disclosures: This study was supported by the Ministry of Education, Culture, Sports, Science, and Technology, Japan. The authors declared no competing interests.

Source: Chinen T et al. Oxaliplatin- versus cisplatin-based regimens for elderly individuals with advanced gastric cancer: a retrospective cohort study. BMC Cancer. 2022;22:460 (Apr 26). Doi: 10.1186/s12885-022-09581-6

Key clinical point: Baseline serum pepsinogen levels are associated with a significant risk for gastric cancer, particularly the noncardia type.

Major finding: A higher proportion of patients with gastric cancer vs matched controls had a positive baseline serum pepsinogen status (31.4% vs 5.5%; P < .001). A positive serum pepsinogen status was associated with an increased risk for gastric cancer (adjusted odds ratio [aOR] 10.6; 95% CI 4.3-26.2). In subgroup analysis, a positive pepsinogen status was associated with a higher risk for noncardia gastric cancer (aOR 14.3; 95% CI 4.8-42.0).

Study details: This was a nested case-control study using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial data of 105 participants who developed gastric cancer and 209 matched control individuals.

Disclosures: This study was sponsored by the Society for Surgery of the Alimentary Tract Health Care Disparities Research Award and National Institutes of Health-National Center for Advancing Translational Sciences grant. The authors declared no competing interests.

Source: In H et al. Serum pepsinogen as a biomarker for gastric cancer in the United States: A nested case-control study using the PLCO Cancer Screening Trial Data. Cancer Epidemiol Biomarkers Prev. 2022 (May 9). Doi: 10.1158/1055-9965.EPI-21-1328

Key clinical point: Baseline serum pepsinogen levels are associated with a significant risk for gastric cancer, particularly the noncardia type.

Major finding: A higher proportion of patients with gastric cancer vs matched controls had a positive baseline serum pepsinogen status (31.4% vs 5.5%; P < .001). A positive serum pepsinogen status was associated with an increased risk for gastric cancer (adjusted odds ratio [aOR] 10.6; 95% CI 4.3-26.2). In subgroup analysis, a positive pepsinogen status was associated with a higher risk for noncardia gastric cancer (aOR 14.3; 95% CI 4.8-42.0).

Study details: This was a nested case-control study using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial data of 105 participants who developed gastric cancer and 209 matched control individuals.

Disclosures: This study was sponsored by the Society for Surgery of the Alimentary Tract Health Care Disparities Research Award and National Institutes of Health-National Center for Advancing Translational Sciences grant. The authors declared no competing interests.

Source: In H et al. Serum pepsinogen as a biomarker for gastric cancer in the United States: A nested case-control study using the PLCO Cancer Screening Trial Data. Cancer Epidemiol Biomarkers Prev. 2022 (May 9). Doi: 10.1158/1055-9965.EPI-21-1328

Key clinical point: Baseline serum pepsinogen levels are associated with a significant risk for gastric cancer, particularly the noncardia type.

Major finding: A higher proportion of patients with gastric cancer vs matched controls had a positive baseline serum pepsinogen status (31.4% vs 5.5%; P < .001). A positive serum pepsinogen status was associated with an increased risk for gastric cancer (adjusted odds ratio [aOR] 10.6; 95% CI 4.3-26.2). In subgroup analysis, a positive pepsinogen status was associated with a higher risk for noncardia gastric cancer (aOR 14.3; 95% CI 4.8-42.0).

Study details: This was a nested case-control study using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial data of 105 participants who developed gastric cancer and 209 matched control individuals.

Disclosures: This study was sponsored by the Society for Surgery of the Alimentary Tract Health Care Disparities Research Award and National Institutes of Health-National Center for Advancing Translational Sciences grant. The authors declared no competing interests.

Source: In H et al. Serum pepsinogen as a biomarker for gastric cancer in the United States: A nested case-control study using the PLCO Cancer Screening Trial Data. Cancer Epidemiol Biomarkers Prev. 2022 (May 9). Doi: 10.1158/1055-9965.EPI-21-1328

Key clinical point: Taxanes plus basic chemotherapy vs basic chemotherapy alone improves oncologic outcomes in treatment-naive patients with advanced gastric cancer.

Major finding: Basic chemotherapy with vs without taxanes significantly improved progression-free survival (hazard ratio [HR] 0.73; P = .001), overall survival (HR 0.80; P = .003), objective response rate (risk ratio [RR] 1.34; P = .0001), and disease control rate (RR 1.20; P = .001). Patients who received taxanes had a significantly higher risk for neutropenia (RR 3.54; P = .0003), leucopenia (RR 24.99; P = .03), and diarrhea (RR 4.41; P < .00001).

Study details: A meta-analysis of six randomized controlled trials including 2263 patients with advanced gastric cancer who received first-line chemotherapy.

Disclosures: This study was supported by Beijing Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Ma X et al. Efficacy and safety of combination chemotherapy regimens containing taxanes for first-line treatment in advanced gastric cancer. Clin Exp Med. 2022 (Apr 16). Doi: 10.1007/s10238-022-00824-1

Key clinical point: Taxanes plus basic chemotherapy vs basic chemotherapy alone improves oncologic outcomes in treatment-naive patients with advanced gastric cancer.

Major finding: Basic chemotherapy with vs without taxanes significantly improved progression-free survival (hazard ratio [HR] 0.73; P = .001), overall survival (HR 0.80; P = .003), objective response rate (risk ratio [RR] 1.34; P = .0001), and disease control rate (RR 1.20; P = .001). Patients who received taxanes had a significantly higher risk for neutropenia (RR 3.54; P = .0003), leucopenia (RR 24.99; P = .03), and diarrhea (RR 4.41; P < .00001).

Study details: A meta-analysis of six randomized controlled trials including 2263 patients with advanced gastric cancer who received first-line chemotherapy.

Disclosures: This study was supported by Beijing Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Ma X et al. Efficacy and safety of combination chemotherapy regimens containing taxanes for first-line treatment in advanced gastric cancer. Clin Exp Med. 2022 (Apr 16). Doi: 10.1007/s10238-022-00824-1

Key clinical point: Taxanes plus basic chemotherapy vs basic chemotherapy alone improves oncologic outcomes in treatment-naive patients with advanced gastric cancer.

Major finding: Basic chemotherapy with vs without taxanes significantly improved progression-free survival (hazard ratio [HR] 0.73; P = .001), overall survival (HR 0.80; P = .003), objective response rate (risk ratio [RR] 1.34; P = .0001), and disease control rate (RR 1.20; P = .001). Patients who received taxanes had a significantly higher risk for neutropenia (RR 3.54; P = .0003), leucopenia (RR 24.99; P = .03), and diarrhea (RR 4.41; P < .00001).

Study details: A meta-analysis of six randomized controlled trials including 2263 patients with advanced gastric cancer who received first-line chemotherapy.

Disclosures: This study was supported by Beijing Natural Science Foundation of China. The authors declared no conflicts of interest.

Source: Ma X et al. Efficacy and safety of combination chemotherapy regimens containing taxanes for first-line treatment in advanced gastric cancer. Clin Exp Med. 2022 (Apr 16). Doi: 10.1007/s10238-022-00824-1

Key clinical point: Patients with left-sided breast cancer (BC) who received radiation doses to the left anterior descending artery (LAD) experienced an elevated risk for adverse cardiac outcomes.

Major finding: Mean dose to LAD was associated with an increased risk for any cardiac event (hazard ratio [HR] 1.09; P = .006) and major cardiac events (HR 1.08; P = .022). Receiver operating characteristics analysis identified 2.8 Gy (area under the curve 0.69) as the mean LAD dose threshold, above which the risk for any cardiac event was higher (P = .001).

Study details: Findings are from a retrospective study of 375 consecutively treated female patients with nonmetastatic, left-sided BC who received breast-conserving surgery/mastectomy and adjuvant radiation therapy.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Zureick AH et al. Dose to the left anterior descending artery correlates with cardiac events following irradiation for breast cancer. Int J Radiat Oncol Biol Phys. 2022 (Apr 24). Doi: 10.1016/j.ijrobp.2022.04.019

Key clinical point: Patients with left-sided breast cancer (BC) who received radiation doses to the left anterior descending artery (LAD) experienced an elevated risk for adverse cardiac outcomes.

Major finding: Mean dose to LAD was associated with an increased risk for any cardiac event (hazard ratio [HR] 1.09; P = .006) and major cardiac events (HR 1.08; P = .022). Receiver operating characteristics analysis identified 2.8 Gy (area under the curve 0.69) as the mean LAD dose threshold, above which the risk for any cardiac event was higher (P = .001).

Study details: Findings are from a retrospective study of 375 consecutively treated female patients with nonmetastatic, left-sided BC who received breast-conserving surgery/mastectomy and adjuvant radiation therapy.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Zureick AH et al. Dose to the left anterior descending artery correlates with cardiac events following irradiation for breast cancer. Int J Radiat Oncol Biol Phys. 2022 (Apr 24). Doi: 10.1016/j.ijrobp.2022.04.019

Key clinical point: Patients with left-sided breast cancer (BC) who received radiation doses to the left anterior descending artery (LAD) experienced an elevated risk for adverse cardiac outcomes.

Major finding: Mean dose to LAD was associated with an increased risk for any cardiac event (hazard ratio [HR] 1.09; P = .006) and major cardiac events (HR 1.08; P = .022). Receiver operating characteristics analysis identified 2.8 Gy (area under the curve 0.69) as the mean LAD dose threshold, above which the risk for any cardiac event was higher (P = .001).

Study details: Findings are from a retrospective study of 375 consecutively treated female patients with nonmetastatic, left-sided BC who received breast-conserving surgery/mastectomy and adjuvant radiation therapy.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Zureick AH et al. Dose to the left anterior descending artery correlates with cardiac events following irradiation for breast cancer. Int J Radiat Oncol Biol Phys. 2022 (Apr 24). Doi: 10.1016/j.ijrobp.2022.04.019

Key clinical point: Young age at diagnosis of human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) was not associated with any detrimental prognostic value and had no effect on the efficacy of adjuvant dual anti-HER2 targeted therapy.

Major finding: Young age had no effect on invasive disease-free survival (adjusted hazard ratio [aHR] 1.07; 95% CI 0.84-1.35), regardless of hormone receptor status (positive: aHR 1.10; 95% CI 0.82-1.44 or negative: aHR 0.99; 95% CI 0.62-1.51) and anti-HER2 treatment administered (chemotherapy+trastuzumab+pertuzumab: aHR 1.20; 95% CI 0.83-1.68 or chemotherapy+trastuzumab+placebo: aHR, 0.99; 95% CI, 0.71-1.35).

Study details: Findings are from the phase 3 APHINITY trial including 768 patients aged ≤40 years with HER2+ early BC who were randomly assigned to receive chemotherapy+trastuzumab+placebo or chemotherapy+trastuzumab+pertuzumab.

Disclosures: The APHINITY trial was supported by F Hoffmann-La Roche Ltd/Genentech. Some authors declared receiving research funding, honoraria, grants, or nonfinancial support or serving as advisors, speakers, or consultants for several sources, including Roche/Genentech.

Source: Lambertini M et al. Impact of age on clinical outcomes and efficacy of adjuvant dual anti-HER2 targeted therapy. J Natl Cancer Inst. 2022 (May 5). Doi: 10.1093/jnci/djac096 

Key clinical point: Young age at diagnosis of human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) was not associated with any detrimental prognostic value and had no effect on the efficacy of adjuvant dual anti-HER2 targeted therapy.

Major finding: Young age had no effect on invasive disease-free survival (adjusted hazard ratio [aHR] 1.07; 95% CI 0.84-1.35), regardless of hormone receptor status (positive: aHR 1.10; 95% CI 0.82-1.44 or negative: aHR 0.99; 95% CI 0.62-1.51) and anti-HER2 treatment administered (chemotherapy+trastuzumab+pertuzumab: aHR 1.20; 95% CI 0.83-1.68 or chemotherapy+trastuzumab+placebo: aHR, 0.99; 95% CI, 0.71-1.35).

Study details: Findings are from the phase 3 APHINITY trial including 768 patients aged ≤40 years with HER2+ early BC who were randomly assigned to receive chemotherapy+trastuzumab+placebo or chemotherapy+trastuzumab+pertuzumab.

Disclosures: The APHINITY trial was supported by F Hoffmann-La Roche Ltd/Genentech. Some authors declared receiving research funding, honoraria, grants, or nonfinancial support or serving as advisors, speakers, or consultants for several sources, including Roche/Genentech.

Source: Lambertini M et al. Impact of age on clinical outcomes and efficacy of adjuvant dual anti-HER2 targeted therapy. J Natl Cancer Inst. 2022 (May 5). Doi: 10.1093/jnci/djac096 

Key clinical point: Young age at diagnosis of human epidermal growth factor receptor 2-positive (HER2+) early breast cancer (BC) was not associated with any detrimental prognostic value and had no effect on the efficacy of adjuvant dual anti-HER2 targeted therapy.

Major finding: Young age had no effect on invasive disease-free survival (adjusted hazard ratio [aHR] 1.07; 95% CI 0.84-1.35), regardless of hormone receptor status (positive: aHR 1.10; 95% CI 0.82-1.44 or negative: aHR 0.99; 95% CI 0.62-1.51) and anti-HER2 treatment administered (chemotherapy+trastuzumab+pertuzumab: aHR 1.20; 95% CI 0.83-1.68 or chemotherapy+trastuzumab+placebo: aHR, 0.99; 95% CI, 0.71-1.35).

Study details: Findings are from the phase 3 APHINITY trial including 768 patients aged ≤40 years with HER2+ early BC who were randomly assigned to receive chemotherapy+trastuzumab+placebo or chemotherapy+trastuzumab+pertuzumab.

Disclosures: The APHINITY trial was supported by F Hoffmann-La Roche Ltd/Genentech. Some authors declared receiving research funding, honoraria, grants, or nonfinancial support or serving as advisors, speakers, or consultants for several sources, including Roche/Genentech.

Source: Lambertini M et al. Impact of age on clinical outcomes and efficacy of adjuvant dual anti-HER2 targeted therapy. J Natl Cancer Inst. 2022 (May 5). Doi: 10.1093/jnci/djac096