Efficacy and prognosis of trastuzumab deruxtecan combined with IP chemotherapy regimen in the treat-ment of HER2-positive advanced gastric cancer
DING Yanyan
ZHOU Shenglin
WU Linlin
WANG Yanling
Abstract：Objective To investigate the short-term efficacy,long-term prognosis,and safety of trastu-zumab deruxtecan(T-DXd)combined with the IP chemotherapy regimen(irinotecan+cisplatin)in the treatment of HER2-positive advanced gastric cancer,as well as its effects on the serum tumor markers of patients.Methods A prospective,randomized,and controlled study design was employed to enroll 96 patients with HER2-positive advanced gastric cancer who received treatment at the hospital from August 2021 to August 2023.The patients were randomly assigned to the observation group(n=48,treated with the T-DXd+IP chemotherapy regimen)and the control group(n=48,treated with the trastuzumab+IP chemotherapy regimen)using the random number table method.The objective response rate(ORR),disease control rate(DCR),overall survival(OS),progression-free survival(PFS),and 2-year survival rate were compared between the two groups,and the safety of the treatment was assessed.Serum tumor markers[carbohydrate antigen 724(CA72-4),carbohydrate antigen 199(CA19-9),carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF)],serum inflammatory indicators[monocyte chemoattractant protein-1(MCP-1),interleukin-1β(IL-1β)],and immune response indicators[soluble programmed death ligand-1(sPD-L1),IL-2,interferon-γ(IFN-γ)]were measured.Results The objective response rate(ORR)of the observation group was 58.33%,which showed no significant difference compared to that of the control group(45.83%)(P>0.05).The disease control rate(DCR)in the observation group was 87.50%,which was higher than the 70.83%in the control group(P<0.05).After treatment,the levels of carcino-embryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 72-4(CA72-4),vascular endothelial growth factor(VEGF),monocyte chemoattractant protein-1(MCP-1),and interleukin-1β(IL-1β)in both groups decreased from the baseline levels(P<0.05).Moreover,the above-mentioned levels in the observation group were lower than those in the control group(P<0.05).The incidence rates of grade 3 or higher neutropenia and anemia in the observation group were higher than those in the control group(P<0.05),while there was no statistical significance in the incidence rate of cardiac toxicity between the two groups(P>0.05).The median progression-free survival(PFS)and median overall survival(OS)were significantly higher in the test group than those in the control group(P<0.05),and there were no statistical differences in the 2-year overall survival rate(P>0.05).Conclusion T-DXd combined with IP chemotherapy regimen improves the short-term efficacy in patients with HER2-positive advanced gastric cancer,reduces the serum levels of tumor markers,VEGF,and MCP-1,and prolongs the median PFS and OS.Although it is associated with an increased risk of hematological and gastrointestinal adverse events,the overall safety is controllable,suggesting that the combined regimen may become a new treatment option for this population.
Keywords：HER2-positive advanced gastric cancertrastuzumab deruxtecanIP chemotherapy regimenefficacysafety
Publication Date：2026-03-10
Online Publishing Date：2026-03-20(First online date of this platform, not the publication date of the document)
Pages：8( 742-749 )