Efficacy and safety of trastuzumab in combination with chemotherapy treatment for HER2-positive advanced gastric cancer : a systematic review

Abstract

Background: Cancer of stomach is the third most common cancer worldwide and often diagnosed at advanced stage without standard chemotherapy treatment. Trastuzumab is a monoclonal antibody targeting Human epidermal growth factor receptor 2 (HER2) for cancer treatment, including cancer of stomach. Objective of this review is to evaluate the feasibility of applying Trastuzumab with chemotherapy combination to greater extend. Method: Systematic search was performed in PubMed, ISI Web of Science, EMBASE (Ovid) and Cochrane Library to identify clinical trials. Eligible trials should fulfill criteria in terms of treatment with Trastuzumab, patient population with HER2 testing, outcome measures with efficacy and safety data. Result: 10 studies are selected, including TOGA RCT study, seven open-label single-arm studies, one non-randomized controlled trial, and one retrospective analysis. Characteristic, efficacy and safety outcomes are appraised among these studies of Trastuzumab with different background chemotherapy. Conclusion: Clinical trials in this reviews are relatively small-scale and non-randomized study, but still demonstrated feasibility and safety of more chemotherapy combinations with Trastuzumab with credible evidences. Large-scale randomized controlled trial are needed to provide additional evidence for applying Trastuzumab and chemotherapy combination to greater extend.