Increased treatment options and improved survival in real-world patients with HER2-positive advanced gastric cancer from 2011 to 2023

Background: Although the emergence of multiple therapeutic agents has benefited patients with human epidermal growth factor receptor 2 (HER2)-positive advanced gastric cancer (AGC), chronological improvements in treatment outcomes for real-world patients remain unclear. Objectives: The present study aimed to evaluate the treatment features of various agents according to their approval periods and investigate outcomes in daily practice. Design: Retrospective observational study. Methods: We retrospectively evaluated the clinical outcomes of patients with HER2-positive AGC who received first-line fluoropyrimidine-containing chemotherapy between 2011 and 2023 according to the approval period of each agent in Japan: group A (pre-immunotherapy approval), 2011-2016; group B (nivolumab approval for third-line or later treatment), 2017-2019; and group C (trastuzumab deruxtecan approval for third-line treatment), 2020-2023. Results: < 0.0001). Conclusion: The emergence of novel agents and treatment modalities may have contributed to improvements in the survival of patients with HER2-positive AGC. This highlights the benefits of effective treatment strategies, including efforts to identify biomarkers and develop new agents.