Herceptin is a HER2/neu receptor antagonist indicated for:...The treatment of HER2-overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma.

Esophageal and Esophagogastric Junction Cancers: Trastuzumab should be added to first-line chemotherapy for HER2 overexpression positive adenocarcinoma…Esophageal and Esophagogastric Junction Cancers: HER2 overexpression positive adenocarcinoma...Fluoropyrimidine (fluorouracil or capecitabine) and oxaliplatin and trastuzumab…Fluoropyrimidine (fluorouracil or capecitabine) and cisplatin and trastuzumab…Esophageal and Esophagogastric Junction Cancers: Other Recommended Regimens (trastuzumab should be added to first-line chemotherapy for HER2 overexpression positive adenocarcinoma)...Fluorouracil, and irinotecan…Paclitaxel with or without cisplatin or carboplatin…Docetaxel with or without cisplatin…Fluoropyrimidine (fluorouracil or capecitabine)…Docetaxel, cisplatin or oxaliplatin, and fluorouracil…Docetaxel, carboplatin, and fluorouracil (category 2B)…

Trastuzumab, a monoclonal antibody against human epidermal growth factor receptor 2 (HER2; also known as ERBB2), was investigated in combination with chemotherapy for first-line treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer...Median follow-up was 18.6 months (IQR 11-25) in the trastuzumab plus chemotherapy group and 17.1 months (9-25) in the chemotherapy alone group. Median overall survival was 13.8 months (95% CI 12-16) in those assigned to trastuzumab plus chemotherapy compared with 11.1 months (10-13) in those assigned to chemotherapy alone (hazard ratio 0.74; 95% CI 0.60-0.91; p=0.0046).

...- HER2 positive tumors (primary or metastatic) with overexpression HER2 determinated by IHQ +++ (IHQ3+) o IHQ ++ confirmed by FISH/SISH positive (IHQ2+/FISH+)...

...Age > 18 years (ethnical group: any; gender: female and male) Progression under or after one prior platinum-based or 5-fluoropyrimidine-based chemotherapy in metastatic disease At least four weeks from the last platinum-based or 5-fluoropyrimidin-based chemotherapy Histological proof of gastric adenocarcinoma including adenocarcinoma of the gastroesophageal junction with HER2 overexpression of the primary or metastatic tumor tissue determined by immunohistochemistry and FISH (Score IHC 3+ or Score IHC 2+ and FISH +) Metastatic (M1) or locally advanced disease At least one measurable lesion evaluable for response (RECIST criteria) Estimated life expectancy of > 3 months ECOG Performance Status: 0-2 Adequate cardiac function: LVEF > 50% (detected by echocardiogram) Absolute neutrophil count > 1,500/µl Absolute platelet count > 100,000 /µl Serum total bilirubin: < 2.0 x upper normal limit (UNL) Creatinine < 1.5 x UNL AST and ALT < 2.5 x UNL; < 5 x UNL in patients with documented liver metastases Alkaline phosphatase: < 2.5 UNL Negative pregnancy test Willingness to give written informed consent, written consent for data protection and willingness to participate and comply with the study...

Relative to nontimely initiation, timely trastuzumab was associated with significantly higher OS (2-year OS, 32.1% vs 15.3%; adjusted hazard ratio [HR], 0.67; 95% CI, 0.51-0.88) and PFS (2-year PFS, 9.2% vs 3.7%; adjusted HR, 0.71; 95% CI, 0.55-0.93)….Improved survival was observed among metastatic HER2+ GEA patients treated with trastuzumab versus those who were not...

...Esophagogastroduodenoscopy (EGD) confirmed the diagnosis of GEJ tumor and biopsy returned as adenocarcinoma with human epidermal growth factor receptor 2 (HER2) overexpression. Leukocytosis resolved after the first round of chemotherapy and the patient remains progression-free with the addition of trastuzumab to her chemotherapy regimen.