Yukiya Narita1, Shigenori Kadowaki1, Isao Oze2, Yosuke Kito3, Takeshi Kawakami3, Nozomu Machida3, Hiroya Taniguchi1, Takashi Ura1, Masashi Ando1, Seiji Ito4, Masahiro Tajika5, Yasushi Yatabe6, Hirofumi Yasui3, Kei Muro1. 1. Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan. 2. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan. 3. Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan. 4. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan. 5. Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan. 6. Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
Abstract
BACKGROUND: It remains unclear whether human epidermal growth factor receptor 2 (HER2) status is an outcome-associated biomarker independent of known prognostic factors for metastatic gastric cancer. Moreover, there are few reports about nomograms in inoperable locally advanced or metastatic gastric cancer (AGC), although several studies have been reported regarding other cancer types. This retrospective study aimed to develop nomograms that combine HER2 status and other prognostic factors to predict the survival outcomes of AGC patients starting first-line treatment. METHODS: In this study, 838 consecutive AGC patients starting first-line chemotherapy at the Aichi Cancer Center Hospital (ACC) were included to establish the nomograms that calculated the predicted probability of survival at different time points, 6 months and 1 and 2 years for overall survival (OS) and 3 and 6 months, and 1 year for progression free survival (PFS). Nomograms were independently validated with 269 consecutive AGC patients at the Cancer Center Hospital (SCC) who underwent first-line chemotherapy. The discriminatory ability and accuracy of the models were assessed using Harrell's c-index. IHC3+ or IHC2+/ISH+ tumors were defined as HER2 positive. RESULTS: At a median follow-up of 12.3 (ACC) and 11.6 (SCC) months, the median OS was 12.5 and 12.4 months (P=1.00), and the median PFS was 4.8 and 5.8 months (P=0.03), respectively. The nomograms showed good C-index values: OS was respectively 0.688 and 0.576 and PFS was respectively for 0.643 and 0.544. CONCLUSIONS: The nomograms including HER2 status as covariate are crucial determinants of clinical care.
BACKGROUND: It remains unclear whether human epidermal growth factor receptor 2 (HER2) status is an outcome-associated biomarker independent of known prognostic factors for metastatic gastric cancer. Moreover, there are few reports about nomograms in inoperable locally advanced or metastatic gastric cancer (AGC), although several studies have been reported regarding other cancer types. This retrospective study aimed to develop nomograms that combine HER2 status and other prognostic factors to predict the survival outcomes of AGC patients starting first-line treatment. METHODS: In this study, 838 consecutive AGC patients starting first-line chemotherapy at the Aichi Cancer Center Hospital (ACC) were included to establish the nomograms that calculated the predicted probability of survival at different time points, 6 months and 1 and 2 years for overall survival (OS) and 3 and 6 months, and 1 year for progression free survival (PFS). Nomograms were independently validated with 269 consecutive AGC patients at the Cancer Center Hospital (SCC) who underwent first-line chemotherapy. The discriminatory ability and accuracy of the models were assessed using Harrell's c-index. IHC3+ or IHC2+/ISH+ tumors were defined as HER2 positive. RESULTS: At a median follow-up of 12.3 (ACC) and 11.6 (SCC) months, the median OS was 12.5 and 12.4 months (P=1.00), and the median PFS was 4.8 and 5.8 months (P=0.03), respectively. The nomograms showed good C-index values: OS was respectively 0.688 and 0.576 and PFS was respectively for 0.643 and 0.544. CONCLUSIONS: The nomograms including HER2 status as covariate are crucial determinants of clinical care.
Entities:
Keywords:
Gastric cancer; Japanese Clinical Oncology Group prognostic index; Royal Marsden Hospital prognostic index; human epidermal growth factor receptor 2 (HER2); nomogram; prognostic factor
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