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For HER2-positive esophagogastric adenocarcinoma, adding trastuzumab to first-line chemotherapy with a fluorinated pyrimidine and a platinum agent (FP) improves response and survival (NEJM JW Oncol Hematol Sep 2010 and Lancet 2010; 376:687). Investigators now report the results of an industry-sponsored, international, open-label, randomized, phase II/III trial of the antimicrotubule drug-antibody conjugate trastuzumab emtansine (TDM-1) in patients with HER-positive disease.
Patients were assigned 2:1 to receive TDM-1 or physician choice of a taxane (docetaxel or paclitaxel). Of the 345 patients treated on the phase III trial, all had disease progression on prior FP chemotherapy, 89%–90% tested HER2-positive, 82%–84% had received prior HER2-t…