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Trastuzumab improves response and survival when added to first-line chemotherapy in HER2+ metastatic esophagogastric cancer. However, the role of trastuzumab continuation into later lines of therapy has not been defined.
Investigators from Japan now report results of an investigator-initiated, open-label, randomized, phase II trial of second-line trastuzumab in 91 patients with advanced HER2+ gastric cancer refractory to trastuzumab, fluoropyrimidine, and platinum combination therapy. Patients had IHC 3+ or IHC2+/FISH+ disease and had disease progression within 6 weeks of the last dose of trastuzumab. Of these patients, 75% had IHC 3+ disease, 25% had IHC2+/FISH+ disease, and 56%–57% had liver metastases. Patients were assigned to receive we…