ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1624943
This article is part of the Research TopicCheckpoint Immunotherapy: Reshaping the Landscape of Gastrointestinal Cancer TreatmentView all 13 articles
Additions of trastuzumab to preoperative chemotherapy or chemoimmunotherapy for patients with potentially resectable stage III to IVB HER2-positive gastric cancer
Provisionally accepted
Xuchen ZhangYulong TianHuiyun WangShanai SongYunqing Chen
Ning Liu
Chuantao Zhang
Xiao HuangHaitao Jiang
Helei Hou*- The Affiliated Hospital of Qingdao University, Qingdao, China
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Background: Whether the addition of trastuzumab to chemo(immuno)therapy for the preoperative treatment of patients with potentially resectable HER2-positive gastric cancer has clinical benefits remains to be explored. This real-world observational study was designed to evaluate the efficacy and safety of trastuzumab plus chemo(immuno)therapy for neoadjuvant or conversion therapy in patients with potentially resectable HER2-positive gastric cancer.Methods: We retrospectively collected the clinical data of treatment-naïve patients with potentially resectable stage III to IVB HER2-positive gastric cancer who received preoperative therapy prior to D2 gastrectomy. The main outcomes of interest included tumour regression grade (TRG), treatment-related adverse events (TRAEs), and event-free survival (EFS).Results: A total of 40 patients were included in the analysis, specifically, 27 patients (67.5%, 95% CI 0.520-0.799) received preoperative trastuzumab plus chemo(immuno)therapy, and 13 patients (32.5%, 95% CI 0.201-0.480) received chemo(immuno)therapy. All these patients subsequently underwent D2 gastrectomy. Regarding surgical outcomes, TRG0/1 rates were 33.3% (95% CI 0.186-0.522) in the trastuzumab-containing treatment group and 15.4% (95% CI 0.043-0.422) in the chemotherapy/chemoimmunotherapy group (P=0.286). Regarding safety, 66.7% (95% CI 0.478-0.814) of patients in the trastuzumab-containing treatment group and 61.5% (95% CI 0.355-0.823) of patients in the chemotherapy/chemoimmunotherapy group experienced preoperative TRAEs. The probabilities of EFS were not statistically significant between the two groups by the last follow-up.Conclusion: Additions of trastuzumab to preoperative chemotherapy or chemoimmunotherapy resulted in a TRG0/1 rate of 33.3% among patients with potentially resectable HER2-positive gastric cancer, and the combined regimen exhibited a favourable safety profile.
Keywords: HER2-positive gastric cancer, Preoperative therapy, trastuzumab, Immune checkpoint blockade, Tumour regression grade
Received: 08 May 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Zhang, Tian, Wang, Song, Chen, Liu, Zhang, Huang, Jiang and Hou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Helei Hou, The Affiliated Hospital of Qingdao University, Qingdao, China
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