Evidence map›Paper›PMID 30927036›Full record

Trial reportCancer chemotherapy and pharmacology2019

Phase II study to evaluate the efficacy of Trastuzumab in combination with Capecitabine and Oxaliplatin in first-line treatment of HER2-positive advanced gastric cancer: HERXO trial.

Fernando Rivera, C Romero, P Jimenez-Fonseca, M Izquierdo-Manuel, A Salud, E Martínez, M Jorge, V Arrazubi, J C Méndez, P García-Alfonso and 5 more

Erratum issuedAbstract readClinical Trial, Phase IIMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Cancer chemotherapy and pharmacology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 41 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Japanese gastric cancer treatment guidelines 2025 (7th edition).Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
    Guideline
  2. Trial
  3. Trial
  4. Article
  5. Review
  6. Advancements in targeted therapy for gastric cancer.Therapeutic advances in gastroenterology · 2026
    Review
  7. Article
  8. 3 Biotech · 2025
    Article
  9. Article
  10. Article
  11. Review
  12. Review
  13. Review
  14. Review
  15. Review
  16. Article
  17. Article
  18. German, Austrian, and Swiss guidelines for systemic treatment of gastric cancer.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2024
    Article
  19. Review
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Fernando RiveraMedical Oncology Department, Hospital Universitario Marqués de Valdecilla, Avda Valdecilla SN, 39008, Santander, Spain. Fernando.rivera@scsalud.es.ORCID 0000-0003-4962-3949
C RomeroMedical Oncology Department, POVISA, Vigo, Spain.
P Jimenez-FonsecaMedical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
M Izquierdo-ManuelMedical Oncology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
A SaludMedical Oncology Department, Hospital Arnau de Vilanova, Lleida, Spain.
E MartínezMedical Oncology Department, Hospital Universitario Marqués de Valdecilla, Avda Valdecilla SN, 39008, Santander, Spain.
M JorgeMedical Oncology Department, Hospital Xeral Cies, Vigo, Spain.
V ArrazubiMedical Oncology Department, Complejo Hospitalario de Navarra, Pamplona, Spain.
J C MéndezMedical Oncology Department, Centro Oncológico de Galicia, Coruña, Spain.
P García-AlfonsoMedical Oncology Department, Hospital Gregorio Marañón, Madrid, Spain.
M ReboredoMedical Oncology Department, Complejo Hospitalario de A Coruña, Coruña, Spain.
J BarriusoMedical Oncology Department, Hospital La Paz, Madrid, Spain.
N Muñoz-UncetaMedical Oncology Department, Hospital Universitario Marqués de Valdecilla, Avda Valdecilla SN, 39008, Santander, Spain.
R JimenoMedical Oncology Department, Hospital Universitario Marqués de Valdecilla, Avda Valdecilla SN, 39008, Santander, Spain.
C LópezMedical Oncology Department, Hospital Universitario Marqués de Valdecilla, Avda Valdecilla SN, 39008, Santander, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe phase III ToGA trial established cisplatin, fluoropyrimidine and trastuzumab as the standard treatment in HER2-positive advanced gastric cancer (AGC). However, as demonstrated in HER2-negative AGC, oxaliplatin-based regimens could improve tolerance remaining effective. The aim of this trial was to explore the potential activity and safety of capecitabine, oxaliplatin (XELOX) and trastuzumab in patients with HER-2 positive advanced gastric cancer.

methodsWe conducted a multicentre, prospective, non-randomised, non-controlled, open-label and national (Spanish) phase II study. Patients with HER2-positive advanced gastric or gastro-oesophageal junction (EGJ) cancer received XELOX and trastuzumab as first-line treatment. Primary endpoint was objective tumour response rate (ORR).

results45 patients from ten hospitals in Spain were included from September 2011 to December 2013. Median age was 65 years, 82.2% were male, 69% had gastric cancer and 31% had EGJ tumours. At a median follow-up of 13.7 months (7.1-20.9), the estimated median progression-free survival and overall survival were 7.1 (95% CI 5.5-8.7) and 13.8 months (95% CI 10.1-17.4), respectively, with 8.9%, 37.8% and 31.1% of patients achieving complete response, partial response and stable disease. Regarding safety, 44.4% of the patients had grade 3 or greater adverse events, being the most frequent diarrhoea (26.6%), fatigue (15.5%), nausea (20%) and vomiting (13.3%). Only two patients (4.4%) developed asymptomatic grade 2 left ventricle ejection fraction reduction.

conclusionsXELOX-trastuzumab is a promising and effective therapy as first-line treatment for patients with HER2-positive AGC, with comparable results to the ones obtained with other "platinum-based" regimens. This scheme is feasible and tolerable with a low incidence of cardiac toxicity.

Indexed as

AdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCapecitabineDeoxycytidineErb-b2 Receptor Tyrosine KinasesEsophagogastric JunctionFemaleFluorouracilFollow-Up StudiesHumansMaleMiddle AgedOxaloacetatesProgression-Free SurvivalCapecitabineDeoxycytidineERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesFluorouracilOxaloacetatesTrastuzumabAdvanced gastric cancerCapecitabineHER2 positiveOxaliplatinPhase II studyTrastuzumab

Identifiers

PMID30927036
PMCPMC6779679

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.