Neither pharmacokinetic measures nor tumor activity on [18F]fluorodeoxyglucose positron emission tomography predicted outcomes. But patients whose tumors had 3+ immunohistochemical HER2 expression had better overall survival (P = .007), and patients whose tumors were positive for growth factor receptor-bound protein 7 (Grb7) had a better treatment response (P = .016).
“This is the first study to our knowledge demonstrating the feasibility of the addition of both trastuzumab and pertuzumab to standard neoadjuvant chemoradiotherapy with carboplatin and paclitaxel in patients with resectable HER2-positive esophageal adenocarcinoma ... ” Dr. van Laarhoven and coinvestigators wrote.
“[T]he addition of trastuzumab and pertuzumab to neoadjuvant chemoradiotherapy is safe and tolerable for patients with HER2-positive esophageal adenocarcinoma, and preliminary efficacy results seem promising,” they concluded. “Because data on an HER2-positive control group are lacking, a randomized phase III study is warranted to demonstrate the superiority of the addition of trastuzumab and pertuzumab.”
Dr. van Laarhoven disclosed honoraria from Lilly/ImClone; a consulting or advisory role with Lilly/ImClone, Nordic Group, Bristol-Myers Squibb, and Servier; research funding to her institution from numerous pharmaceutical companies; and travel, accommodations, and/or expenses from AstraZeneca. The study was supported by the Academic Medical Center, Amsterdam, and by an unrestricted research grant from Hoffmann-LaRoche, Basel, Switzerland.
SOURCE: Stroes CI et al. J Clin Oncol. 2019 Dec 6. doi: 10.1200/JCO.19.01814.