Real-World (RW) United States (US) First-Line (1L) Treatment (TX) Patterns and Overall Survival (OS) of Patients (PTS) with Unresectable Advanced or Metastatic (ADV/MET) Gastric Cancer, Gastroesophageal Junction Cancer and Esophageal Adenoc ...


Xiao H1, You M2, Zhang Y3
1Bristol Myers Squibb, Lawrence Township, NJ, USA, 2Bristol-Myers Squibb, Plainsboro, NJ, USA, 3Bristol Myers Squibb, Princeton, NJ, USA

Presentation Documents

Background: Guidelines recommend 1L trastuzumab for HER2+ adv/met GC/GEJC/EAC yet many pts initiate 1L tx with status unknown (HER2un). This study investigated RW US tx patterns and OS by HER2 status, including 1L tx of pts with HER2un.

Methods: Demographics, clinical characteristics and 1L tx were described by HER2 status for adult pts diagnosed with adv/met GC/GEJC/EAC from January 2011 to December 2020 in the US Flatiron Health database. Tx similarities/dissimilarities between HER2−, HER2+ and HER2un pts were examined using Kendall’s test. OS, defined as time from 1L tx initiation to death or loss of follow-up, was analyzed by Kaplan-Meier methods with log-rank test and a Cox proportional hazards model.

Results: Of 3643 pts with adv/met GC/GEJC/EAC, the proportions with HER2−, HER2+ and HER2un were 19%, 57% and 24%, respectively. Demographics and most clinical characteristics were similar, although fewer HER2un pts (48%) had ECOG performance status assessed at initiation of 1L, compared with HER2+ (56%) and HER2− (58%) pts. Not surprisingly, a majority (65%) of HER2+ pts received trastuzumab. HER2un pts were less likely to receive 1L tx, compared with HER2+/− pts (63% vs 82%, Chi-square p<0.0001). Among HER2un pts receiving 1L tx, 5% received trastuzumab and the majority received fluoropyrimidine and platin-based chemotherapies. Kendall’s test showed that the top 5 1L regimens received by pts with HER2− and HER2un were similar. Cox proportional hazard model of OS showed that compared with HER2− pts, HER2+ and HER2un pts were 26% less and 22% more likely to die from the disease, respectively (p<0.0001 for each). Median OS for HER2+, HER2− and HER2un pts was 12.2, 9.8 and 7.6 months, respectively.

Conclusion: HER2un pts had poor OS compared with HER2+ and HER2− pts. Tx patterns for pts with HER2− and HER2un were similar, suggesting that most HER2un pts may be HER2−.

Conference/Value in Health Info

2022-05, ISPOR 2022, Washington, DC, USA

Value in Health, Volume 25, Issue 6, S1 (June 2022)




Clinical Outcomes, Study Approaches

Topic Subcategory

Clinical Outcomes Assessment, Electronic Medical & Health Records


Gastrointestinal Disorders

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