Low-dose capecitabine plus trastuzumab as first-line treatment in patients 75 years of age or older with HER2-positive advanced gastric cancer: A pilot study

Young Saing Kim, Sun Jin Sym, Min Young Baek, Inkeun Park, Junshik Hong, Hee Kyung Ahn, Jinny Park, Eun Kyung Cho, Woon Ki Lee, Min Chung, Hyung Sik Kim, Jae Hoon Lee, Dong Bok Shin

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5 Scopus citations

Abstract

Background: Single-agent chemotherapy is considered a good and safe treatment option for elderly patients with advanced gastric cancer (AGC). We investigated the efficacy and safety of trastuzumab plus low-dose capecitabine in elderly patients with previously untreated human epidermal growth factor receptor 2 (HER2)-positive AGC. Methods: Patients aged 75 years or older with tumors having HER2 overexpression defined as either immunohistochemistry (IHC) 3+ or IHC 2+ and in situ hybridization-positive were eligible for inclusion. Patients received capecitabine (1000 mg/m2) orally twice daily on days 1-14 and trastuzumab (8 mg/kg for cycle 1, followed by 6 mg/kg) intravenously on day 1 of a 21-day cycle. The primary endpoint was progression-free survival (PFS). Results: Twenty patients were enrolled. The median age was 79 years (range 75-91). Nine patients (45 %) had ECOG performance status 2. Median PFS was 5.2 months (95 % CI 1.9-8.4 months), and median overall survival was 9.3 months (95 % CI 4.0-14.6 months). The confirmed response rate was 40 % (95 % CI 19-64 %) with disease control rate of 80 %. Grade 3-4 toxicities were anorexia (10 %), fatigue (5 %), stomatitis (5 %), and anemia (5 %). No treatment-related deaths or symptomatic congestive heart failure were observed. Conclusions: Low-dose capecitabine plus trastuzumab is effective and well tolerated in elderly patients with HER2-positive AGC.

Original languageEnglish
Pages (from-to)1267-1272
Number of pages6
JournalCancer Chemotherapy and Pharmacology
Volume76
Issue number6
DOIs
StatePublished - 1 Dec 2015

Keywords

  • Capecitabine
  • Elderly
  • Gastric cancer
  • HER2
  • Trastuzumab

Cite this

Kim, Y. S., Sym, S. J., Baek, M. Y., Park, I., Hong, J., Ahn, H. K., Park, J., Cho, E. K., Lee, W. K., Chung, M., Kim, H. S., Lee, J. H., & Shin, D. B. (2015). Low-dose capecitabine plus trastuzumab as first-line treatment in patients 75 years of age or older with HER2-positive advanced gastric cancer: A pilot study. Cancer Chemotherapy and Pharmacology, 76(6), 1267-1272. https://doi.org/10.1007/s00280-015-2881-x