Effects Of Trastuzumab Plus Chemoheraphy For The HER-2-positive Advanced Gastric Cancer Patients:a Meta‐analysis

Background&Objective Based on the patients with advanced gastric cancer treatment effect is not ideal, and high morbidity and mortality of gastric cancer treatment for gastric cancer research poor out continuously, and achieved some results. In recent years, with the development of molecular biology, molecular targeted drugs by bead sheet resistance also had certain progress in the treatment of gastric cancer, and has obtained certain achievement. The main purpose of this paper is on the clinical efficacy of chemotherapy treatment of Her‐2positive advanced gastric cancer patients evaluated molecular systems targeted drug trastuzumab combined with chemotherapy controls to guide clinical treatment.Method Use computer to retrieve Chinese aaa: a database of ten thousand d PuZhongWen science and technology periodical database Chinese biomedical database hownet database in China, English literature database retrieval PubMed Ebsco database Ovid database, retrieval time is the deadline to March1,2014; use manual retrieval related magazines and literature references, to retrieve relevant by its ehrs bead sheet resistance to treatment‐ 2positive patients with gastric cancer clinical research, using Review Manager analysis software for Meta analysis. The main outcome measure was effective, disease control rate,2years survival, overall survival, and secondary outcome measures of the incidence of adverse reactions: nausea, vomiting, diarrhea, liver damage, such as the incidence of bone marrow suppression. Volume effect used is OR (Odds ratio): odds ratio and95%CI (95%Confidence intervals):95%confidence interval.Result The retrieval, and eventually into research have6items, the experimental group a total of529cases, control group a total of488cases. Interventions in the experimental group were: trastuzumab combined with chemotherapy, the control group was chemotherapy treatment.Meta analysis results showed that by bead sheet resistance to chemotherapy compared with simple chemotherapy, the experimental group’s recent curative effect evaluation and the evaluation of the long‐term curative effect is superior to the control group. Trastuzumab combination with chemotherapy in patients with improved efficiency (0R=1.91,95%CI of1.45‐2.52, P <0.00001), disease control rate (OR=2.05,95%CI of1.49‐2.81, P <0.00001),12‐month overall survival (OR=1.42,95%CI of1.03‐1.96, P=0.03),18‐month overall survival (OR=2.01,95%CI of1.32‐3.07, P=0.001),24month overall survival (OR=1.88,95%CI of1.05‐3.35, P=0.03), extending the OS (MDIV=0.74,95%CI为0.74‐0.75，P<0.00001), but not fully evidence that can improve the overall survival of6months (OR=1.40,95%CI of1.00‐1.99, P=0.05); adverse reaction analysis showed that: HER‐2positive progress trastuzumab combined with chemotherapy patients with gastric cancer, increased grade3‐4adverse reactions in patients with diarrhea, but there is no sufficient evidence to show that it will increase other adverse reactions in patients.Conclusions For the treatment of patients with HER‐2‐positive advanced gastric cancer among trastuzumab combined with chemotherapy can improve the efficiency of patient care, disease control rate and1‐year,2‐year survival rate. Trastuzumab combined with chemotherapy in patients with HER‐2‐positive gastric cancer, can prolong the overall survival of patients. Trastuzumab combined with chemotherapy in patients with HER‐2‐positive gastric cancer, increased grade3‐4adverse reactions in patients with diarrhea, but there is no sufficient evidence that will increase other adverse reactions in patients. For trastuzumab combined with chemotherapy study in patients with HER‐2‐positive gastric cancer, the current temporary lack of long‐term follow‐up data.