Analysis of prognosis factors in patients with metastatic HER2‑positive gastric/cardioesophageal transition cancer treated in oncological clinics of Moscow

Introduction. Cancer of the stomach and cardio-esophageal transition is one of the key causes of mortality from malignant neoplasms in the world. Despite advances in targeted therapy in the treatment of HER2-positive gastric adenocarcinoma, the prognosis for most patients remains poor. The high degree of heterogeneity of the disease, relapse rates and limited treatment efficacy highlight the need to examine factors influencing therapy outcomes and possibility of their accounting in order to perform a personalized treatment.Aim. To evaluate the factors influencing progression-free survival and overall survival in patients with metastatic HER2-positive gastric cancer and/or cardio-esophageal transition.Materials and methods. The study included data from patients with metastatic HER2- positive gastric cancer from 5 oncology hospitals who received 1st-line trastuzumab between 2019 and 2024. Statistical analysis was performed using univariate and multivariate analyses to assess the impact of different clinical characteristics on progression-free survival and overall survival.Results. The study included 117 patients with metastatic gastric cancer who received trastuzumab in the 1st line of therapy. In univariate analysis of patient characteristics, the presence of bone metastases, age over 65 years, presence of ascites, ECOG status 1–2, degree of G3 differentiation, female sex were prognostically significant for progression-free survival and overall survival. As a result of multivariate analysis, age 65 years and older (p = 0.016), female sex (p = 0.003), presence of poorly differentiated tumors (p = 0.021), the presence of metastases in supraclavicular lymph nodes (p = 0.043) were prognosis factors associated with decreased overall survival. And the presence of secondary foci in bones was an independent prognosis factor associated with decrease in PFS according to results of multifactorial analysis (p = 0.043).Conclusion. Despite the effectiveness of targeted therapies, factors such as age, sex, functional status and metastasis localization have a decisive impact on the disease prognosis. Analysis of larger sample of patients is needed to definitively confirm the findings.