Summary
The results from ToGA, a large international phase III trial, showed the benefit of herceptin plus chemotherapy vs chemotherapy alone as the first therapy for patients with advanced unresectable gastric cancer.
Analysis
It is the second important positive result for Herceptin in 10 days: last week a study showed the benefits in terms of survival in HER2-positive breast cancer patients.
From a medical perspective, despite Roche did not say how relevant was the improvement in terms of survival benefit, this trial is a great achievement considering the lack of an effective therapy in gastric cancer. This is also the first success Herceptin has outside of breast cancer, where it represents a cornerstone treatment.
Herceptin may be the first targeted agent to become approved in gastric cancer in a near future, but it could be followed by other agents in a short while, as results from several highly anticipated phase III trials are expected in the coming 12 months.
Most remarkable is a trial evaluating Avastin with chemotherapy (AVAGAST), which, in contrast to the Herceptin trial, does not seem to use special biological selection criteria, even if we can guess that at the end it will include a large amount of HER-2 negative gastric cancer patients.
