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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

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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.

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Author notes

    Authors and Affiliations

    1. Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, 21 Namdong-daero 774beon-gil, Namdong-gu, Incheon, 405-706, Republic of Korea

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

    2. Department of General Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea

      Woon Ki Lee & Min Chung

    3. Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea

      Hyung-Sik Kim

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    1. Young Saing Kim
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    Correspondence to Dong Bok Shin.

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    The authors declare no conflict of interest.

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    Young Saing Kim and Sun Jin Sym have contributed equally to this work.

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    Kim, Y.S., Sym, S.J., Baek, M.Y. et al. 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 Chemother Pharmacol 76, 1267–1272 (2015). https://doi.org/10.1007/s00280-015-2881-x

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    • DOI: https://doi.org/10.1007/s00280-015-2881-x

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