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Cancer Commun (Lond). 2019 Jun 24;39(1):38. doi: 10.1186/s40880-019-0384-6.

Pertuzumab in combination with trastuzumab and chemotherapy for Chinese patients with HER2-positive metastatic gastric or gastroesophageal junction cancer: a subpopulation analysis of the JACOB trial.

Liu T1, Qin Y2, Li J3,4, Xu R5, Xu J6, Yang S7, Qin S8, Bai Y9, Wu C10, Mao Y11, Wu H11, Ge Y12, Shen L13.

Author information

1
Department of Oncology, Zhongshan Hospital, Fudan University, Shanghai, 200032, P. R. China.
2
Department of Clinical Oncology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, 450052, Henan, P. R. China.
3
Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, P. R. China.
4
Department of Oncology, Tongji University Eastern Hospital, Shanghai, 200120, P. R. China.
5
Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, Guangdong, P. R. China.
6
Department of Oncology, 307th Hospital of PLA, Academy of Military Medical Sciences, Beijing, 100071, P. R. China.
7
Department of Medical Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, 450008, Henan, P. R. China.
8
Department of Oncology, People's Liberation Army (PLA) Cancer Center, 81st Hospital of PLA, Nanjing, 210002, Jiangsu, P. R. China.
9
Medical Department, Harbin Medical University Cancer Hospital, Harbin, 150081, Heilongjiang, P. R. China.
10
Department of Oncology, First People's Hospital of Changzhou, Changzhou, 213003, Jiangsu, P. R. China.
11
Roche (China) Holding Co., Ltd., Shanghai, 201203, P. R. China.
12
Medical Division, Shanghai Roche Pharmaceuticals Ltd., Shanghai, 201203, P. R. China.
13
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Oncology, Peking University Cancer Hospital and Institute, #52 Fucheng Road, Haidian District, Beijing, 100142, P. R. China. linshenpku@163.com.

Abstract

BACKGROUND:

The JACOB trial (NCT01774786) was a double-blinded, placebo-controlled, randomized, multicenter, international, phase III trial evaluating the efficacy and safety of adding pertuzumab to trastuzumab and chemotherapy in first-line treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic gastric cancer/gastroesophageal junction cancer (GEJC). The aim of this analysis was to investigate efficacy and safety outcomes in the Chinese subpopulation from the JACOB trial.

METHODS:

This post hoc subpopulation analysis included all patients recruited in mainland China (n = 163; 20.9%) between June 2013 and January 2016. The patients were randomly assigned in a 1:1 ratio to receive pertuzumab plus trastuzumab and chemotherapy (pertuzumab group; n = 82) or placebo plus trastuzumab and chemotherapy (control group; n = 81). Intravenous pertuzumab (840 mg) and trastuzumab (8 mg/kg loading and 6 mg/kg maintenance doses) were given every 3 weeks until disease progression or unacceptable toxicity. Chemotherapy was given as per standard regimens/doses of capecitabine or 5-fluorouracil plus cisplatin. The primary endpoint was overall survival (OS); secondary efficacy endpoints included progression-free survival (PFS), and overall objective response rate (ORR).

RESULTS:

The median OS was 18.7 months in the pertuzumab group and 16.1 months in the control group (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.49 to 1.14). The median PFS was 10.5 and 8.6 months in the pertuzumab and control groups, respectively (HR 0.85; 95% CI 0.60 to 1.21), and the median ORRs were 68.9% and 55.7%, respectively. The treatment effect in this Chinese subpopulation showed consistency with that in the global ITT population with numerically lower HR for OS and PFS compared with the control group. The safety profiles of the pertuzumab and control groups in this Chinese subpopulation analysis were generally comparable. The most common grade 3-5 adverse events were neutropenia, anemia, and leukopenia. However, due to the nature of being a post hoc subgroup analysis, the results presented here are descriptive only and need to be interpreted with caution.

CONCLUSIONS:

OS and PFS were numerically improved by adding pertuzumab to trastuzumab and chemotherapy as first-line treatment in Chinese HER2-positive gastric cancer/GEJC patients, and this regimen demonstrated an acceptable safety profile. Trial registration ClinicalTrials.gov. NCT01774786. Registered on 24 January 2013, https://clinicaltrials.gov/ct2/show/NCT01774786.

KEYWORDS:

Chemotherapy; China; Gastric cancer; Gastroesophageal junction cancer; HER2; Overall survival; Pertuzumab; Progression-free survival; Safety; Trastuzumab

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