Article Text

Download PDFPDF

4CPS-219 Agamenon-seom model for the prediction of survival in patients with HER2-positive advanced oesophagogastric adenocarcinoma receiving trastuzumab-based first-line treatment
  1. L Macía-Rivas1,
  2. CL Fernández-Laguna2,
  3. FJ Álvarez-Manceñido2,
  4. A Arias-Martínez3,
  5. A Martínez-Torrón4,
  6. I Macías-Declara5,
  7. JM Cano-Cano6,
  8. M Diez7,
  9. A Custodio8,
  10. J López-Robles9,
  11. A Lozano-Blázquez2
  1. 1Universidad de Santiago de Compostela / Hospital Universitario Central de Asturias, Doctoral Programme In Medicine Clinical Research / Hospital Pharmacy, Santiago de Compostela, Spain
  2. 2Hospital Universitario Central de Asturias, Hospital Pharmacy, Oviedo, Spain
  3. 3University of Granada / Hospital Universitario Germans Trias I Pujol, Doctoral Programme In Pharmacy- Faculty of Pharmacy / Pharmacy Department, Granada, Spain
  4. 4University of Granada / Hospital Universitario Central de Asturias, Doctoral Programme In Pharmacy- Faculty of Pharmacy / Hospital Pharmacy, Granada, Spain
  5. 5Hospital Universitario Parc Tauli, Medical Oncology, Sabadell, Spain
  6. 6Hospital General Universitario de Ciudad Real, Medical Oncology, Ciudad Real, Spain
  7. 7Hospital Universitario Vall D’hebron, Medical Oncology, Barcelona, Spain
  8. 8Hospital Universitario la Paz, Medical Oncology Department / Ciberonc Cb16/12/00398, Madrid, Spain
  9. 9Hospital Universitario Morales Meseguer, Medical Oncology, Murcia, Spain


Background and Importance Trastuzumab associated with chemotherapy (platinum and fluoropyrimidine) is the standard first-line treatment in HER2-positive advanced oesophagogastric adenocarcinoma (AGA); however, its benefits are heterogeneous.

Aim and Objectives To develop and validate a predictive model for overall survival (OS) and progression-free survival (PFS) in patients with AGA treated with trastuzumab.

Material and Methods Patients from the Spanish Society of Medical Oncology (SEOM)-AGAMENON registry with HER2-positive AGA treated in first-line with chemotherapy and trastuzumab between 2008 and 2021 were selected for this study. An accelerated time-to-event model was developed to predict survival and represented as a nomogram and an online calculator. The nomogram was externally validated in an independent series from The Christie NHS Foundation Trust hospital in Manchester, England.

Results 737 patients were recruited (AGAMENON-SEOM, n= 654; Manchester, n= 83). In the referral cohort the median PFS and OS were 7.76 (95% CI, 7.13-8.25) and 14.0 months (95% CI, 13.0-14.9), respectively. Patients received a median of six cycles of platinum, eight cycles of fluoropyrimidine and trastuzumab for a median of 7.6 months (95% CI, 7.10-8.30).

In the validation cohort, the median PFS and OS were 8.1 (95% CI, 7.1-11.3) and 12.8 months (95% CI, 10.3-20.4), respectively. Patients received chemotherapy for a median of five cycles and trastuzumab for a median of 6.3 months.

Six covariates were significantly associated with OS and were used to construct the nomogram: neutrophil-lymphocyte ratio (time ratio (TR):0.73; 95% CI: 0.63-0.83), ECOG status (TR:0.59; 95% CI 0.48-0.73), Lauren histologic subtype (TR:0.73; 95% CI 0.57-0.94), HER2 expression (TR:0.85; 95% CI 0.73-1), histologic grade (TR:0.87; 95% CI 0.72-1.07), and tumour burden (TR:1.69; 95% CI 1.34-2.13). The AGAMENON-HER2 model demonstrated adequate calibration and fair discriminatory ability with a c-index for PFS and OS of 0.606 (95% CI 0.58-0.64) and 0.623 (95% CI 0.59-0.66), respectively. In the Manchester validation cohort, the model is well calibrated, with a c-index of 0.65 and 0.68 for PFS and OS, respectively.

Conclusion and Relevance HER2-positive AGA patients receiving trastuzumab and chemotherapy can be stratified according to their estimated survival endpoints using the AGAMENON-HER2 prognostic tool. This nomogram could be a valuable tool for making treatment decisions in daily clinical practice.

Conflict of Interest No conflict of interest

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.