Post-progression off-label Trastuzumab treatment of HER2 amplified metastatic gastric cancer – Case study

Background: A change in the HER2 gene copy number can be detected at 16–20% cent of gastric cancer patients. ToGA trial proved that chemotherapy combined with targeted HER-2 antibodies improved survival of this group by 20%, which prompted a registration of Trastuzumab as the first-line treatment of this patient group; its administration is indicated until the onset of progression. Our Patient: In our 72-year-old male patient dysphagia led to a diagnosis of Gr. I T3N3M0cardia adenocarcinoma in the summer of 2009. HER2 FISH (PathVysionHER2/CEP17) confirmed gene amplification. First-line treatment: neoadjuvantradi…