Abstract

e16028 Background: Patients with HER2-positive advanced gastric cancer have a poor prognosis. Trastuzumab combined with chemotherapy is the first-line standard treatment. Inetetamab is a novel anti-HER2 drug, and its efficacy and safety in gastric cancer have not been reported yet. Methods: Thirty-eight patients with HER2-positive advanced gastric cancer or gastroesophageal junction adenocarcinoma were randomly divided into two groups: one group received inetetamab combined with the SOX regimen, and the other group received trastuzumab combined with the SOX regimen. After 4-6 cycles, patients with stable disease received maintenance therapy. The primary endpoints were progression-free survival (PFS) and overall survival (OS), and the secondary endpoints were the objective response rate (ORR), disease control rate (DCR), and adverse events (AEs). Results: Thirty-seven patients completed the trial, with 18 patients in the inetetamab group and 19 patients in the trastuzumab group. In the inetetamab group, the median PFS was 8.5 months, compared to 7.3 months in the trastuzumab group (P = 0.046), indicating a significant difference. The median OS was 15.3 months vs. 14.3 months (P = 0.46), and the ORR was 50% vs. 42% (P = 0.63), with no significant differences between groups. Common AEs included leukopenia, thrombocytopenia, nausea, and vomiting. The incidence rates of grade ≥ 3 AEs were 56% in the inetetamab group and 47% in the trastuzumab group (P = 0.63), with no significant difference. Conclusions: In the first-line treatment of HER2-positive advanced gastric cancer, the efficacy of inetetamab and trastuzumab was comparable. The inetetamab group had superior PFS benefits, and both groups had good safety.

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