Atezolizumab and Trastuzumab Plus Chemotherapy for ERBB2 -Positive Locally Advanced Resectable Gastric Cancer

作者：Zhi Peng, Xiaotian Zhang, Han Liang, Zhichao Zheng, Zhenning Wang, Hao Liu, Jian‐Kun Hu, Yihong Sun, Yanqiao Zhang, Yan Han, Tong Lin, Jiahui Xu, Jiafu Ji, Lin Shen · 发表于：JAMA Oncology · 年份：2025 · DOI：10.1001/jamaoncol.2025.0522 · 被引用次数：19 · 研究领域：Gastric Cancer Management and Outcomes、HER2/EGFR in Cancer Research、Esophageal Cancer Research and Treatment

Importance: Effective treatment of locally advanced gastric cancer (GC) or gastroesophageal junction (GEJ) cancer remains a challenge. Objective: To compare the efficacy and safety of atezolizumab plus trastuzumab plus capecitabine and oxaliplatin chemotherapy (XELOX) vs trastuzumab plus XELOX in Chinese patients with locally advanced human epidermal growth factor receptor 2 (ERBB2; formerly HER2)-positive GC or adenocarcinoma of the GEJ. Design, Setting, and Participants: This was an open-label phase 2 randomized clinical trial conducted at 8 study sites in China. Patient recruitment started on February 25, 2021, and this study is ongoing as participants are still being actively followed up. Chinese patients eligible for surgery with locally advanced ERBB2-positive GC or adenocarcinoma of the GEJ were included. Data were analyzed from March 2021 to October 2023. Interventions: Eligible patients were enrolled and randomly assigned 1:1 to perioperative treatment with either atezolizumab plus trastuzumab plus XELOX (arm A) or trastuzumab plus XELOX (arm B) for 3 neoadjuvant cycles (3 weeks per cycle) and 5 adjuvant cycles. Main Outcomes and Measures: The primary efficacy end point was the pathological complete response (pCR) rate following completion of neoadjuvant therapy and surgery. Results: In total, 42 patients were screened and randomly assigned to arm A (n = 21) or arm B (n = 21). The median (range) ages were 61 (33-72) years and 65 (49-72) years in arm A and arm B, resp...