Therapeutic Advances in Medical Oncology (Mar 2023)

The AGAMENON-SEOM model for prediction of survival in patients with advanced HER2-positive oesophagogastric adenocarcinoma receiving first-line trastuzumab-based therapy

  • Paula Jimenez-Fonseca,
  • Victoria Foy,
  • Sophie Raby,
  • Alberto Carmona-Bayonas,
  • Lola Macía-Rivas,
  • Virginia Arrazubi,
  • Diego Cacho Lavin,
  • Raquel Hernandez San Gil,
  • Ana Custodio,
  • Juana María Cano,
  • Ana Fernández Montes,
  • Oriol Mirallas,
  • Ismael Macias Declara,
  • Rosario Vidal Tocino,
  • Laura Visa,
  • María Luisa Limón,
  • Paola Pimentel,
  • Nieves Martínez Lago,
  • Tamara Sauri,
  • Marta Martín Richard,
  • Monserrat Mangas,
  • Mireia Gil Raga,
  • Aitana Calvo,
  • Pablo Reguera,
  • Mónica Granja,
  • Alfonso Martín Carnicero,
  • Carolina Hernández Pérez,
  • Paula Cerdá,
  • Lucía Gomez Gonzalez,
  • Francisco Garcia Navalon,
  • Vilma Pacheco Barcia,
  • David Gutierrez Abad,
  • Maribel Ruiz Martín,
  • Jamie Weaver,
  • Wasat Mansoor,
  • Javier Gallego

DOI
https://doi.org/10.1177/17588359231157641
Journal volume & issue
Vol. 15

Abstract

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Background: Trastuzumab and chemotherapy is the standard first-line treatment in human epidermal growth factor receptor 2 (HER2)-positive advanced gastro-oesophageal cancer. The objective was to develop a predictive model for overall survival (OS) and progression-free survival (PFS) in patients treated with trastuzumab. Methods: Patients with HER2-positive advanced gastro-oesophageal adenocarcinoma (AGA) from the Spanish Society of Medical Oncology (SEOM)-AGAMENON registry and treated first line with trastuzumab and chemotherapy between 2008 and 2021 were included. The model was externally validated in an independent series (The Christie NHS Foundation Trust, Manchester, UK). Results: In all, 737 patients were recruited (AGAMENON-SEOM, n = 654; Manchester, n = 83). Median PFS and OS in the training cohort were 7.76 [95% confidence interval (CI), 7.13–8.25] and 14.0 months (95% CI, 13.0–14.9), respectively. Six covariates were significantly associated with OS: neutrophil-to-lymphocyte ratio, Eastern Cooperative Oncology Group performance status, Lauren subtype, HER2 expression, histological grade and tumour burden. The AGAMENON-HER2 model demonstrated adequate calibration and fair discriminatory ability with a c-index for corrected PFS/OS of 0.606 (95% CI, 0.578–0.636) and 0.623 (95% CI, 0.594–0.655), respectively. In the validation cohort, the model is well calibrated, with a c-index of 0.650 and 0.683 for PFS and OS, respectively. Conclusion: The AGAMENON-HER2 prognostic tool stratifies HER2-positive AGA patients receiving trastuzumab and chemotherapy according to their estimated survival endpoints.