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Human Epidermal Growth Factor Receptor 2 (HER-2) Status in Gastric and Gastro-Esophageal Junction (GEJ) Carcinoma

Evaluation of Human HER-2 Status in Gastric and Gastro-Oesophageal Junction Cancer.

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT02731313
Enrollment
420
Registered
2016-04-07
Start date
2012-07-31
Completion date
2014-10-31
Last updated
2016-10-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Gastric Cancer, Gastroesophageal Junction Cancer

Brief summary

The primary objective is to evaluate the concordance between human epidermal growth factor receptor 2 (HER2) status determined by the participating laboratory and by the centralized laboratory. HER2 status of samples was tested by the participating laboratories (investigator's choice of immunohistochemistry \[IHC\] and in situ hybridization \[ISH\] methods) and by the centralized laboratories (IHC using the 4B5 anti-HER antibody and Silver ISH). Positive HER2 status was defined as a score of IHC3+ or IHC2+/ISH+.

Interventions

BIOLOGICALTrastuzumab

Trastuzumab was not administered in this study. This study informs future trastuzumab treatment decisions.

Sponsors

Hoffmann-La Roche
Lead SponsorINDUSTRY

Study design

Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL

Eligibility

Sex/Gender
ALL
Healthy volunteers
No

Inclusion criteria

* Tumor samples with histologically confirmed gastric or gastro-esophageal junction (GEJ) adenocarcinoma, any stage * Samples with sufficient tumor material for centralized analysis * Samples fixed and embedded in paraffin (formalin-fixed paraffin-embedded tissue \[FFPET\] samples).

Exclusion criteria

\- Fixatives not allowed: Bouin's solution

Design outcomes

Primary

MeasureTime frameDescription
Simple Kappa Coefficient of Human Epidermal Growth Factor Receptor 2 (HER-2) Status Between Local and Centralized Laboratory AssessmentsAt enrollmentPositive HER-2 status was defined as either immunohistochemistry (IHC) score of 3+ or IHC score 2+/in situ hybridization (ISH) score +, as per the trastuzumab Summary of Product Characteristics (SPC). The HER-2 status in tumor specimens was determined using the pathologist's choice of IHC and ISH techniques in local laboratories, and using IHC 4B5 and silver ISH (SISH) in centralized laboratories. The kappa coefficient was used to evaluate the true concordance between the HER-2 status determined by local and centralized laboratories. The kappa coefficient value was interpreted according to the Landis and Koch classification as follows: a) less than (\<) 0: less than chance agreement, b) 0.01-0.20: slight agreement, c) 0.21-0.40: fair agreement, d) 0.41-0.60: moderate agreement, e) 0.61-0.80: substantial agreement, and f) 0.81-0.99: almost perfect agreement.

Secondary

MeasureTime frameDescription
Cancer Characteristics: Percentage of Participants With Initial Location of Adenocarcinoma in Stomach Versus Esogastric LocationAt enrollment
Cancer Characteristics: Percentage of Participants With Samples in Each of the Histologic Type Lauren's Classifications, Including Diffuse Type, Intestinal and MixedAt enrollmentThe Lauren classification is based on examination of histologic specimens under the microscope and divides adenocarcinoma of the stomach into 3 types: 1) Diffuse type: tumor cells are poorly differentiated, behave aggressively and tend to scatter throughout the stomach (rather than form glands). This type metastasizes to other parts of the body much quicker than intestinal type tumors, 2) Intestinal type: tumor cells are well differentiated, grow slowly and tend to form glands, 3) Mixed type: this type is made up of both intestinal and diffuse types.
Cancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesAt enrollmentThe TNM stage system includes information about the size of the primary tumor (T), whether the cancer has spread to nearby lymph nodes (N) and whether the cancer has metastasized to other parts of the body (M). In the T classification TX indicates that the main tumor cannot be measured, T1, T2, T3 and T4 refer to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. In the N classification NX indicates that the cancer in nearby lymph nodes cannot be measured, N0 indicates that there is no cancer in nearby lymph nodes, N1, N2 and N3 refer to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer. In the M classification MX indicates that the metastasis cannot be measured, M0 indicates that the cancer has not spread to other parts of the body and M1 indicates that the cancer has spread to other parts of the body.
Weighted Kappa Coefficient Between Immunohistochemistry (IHC) 4B5 and Silver in Situ Hybridization (SISH) Techniques for HER-2 Testing in Centralized LaboratoriesAt enrollmentPositive HER-2 status was defined as either immunohistochemistry (IHC) score of 3+ or IHC score 2+/in situ hybridization (ISH) score +, as per the trastuzumab Summary of Product Characteristics (SPC). The HER-2 status in tumor specimens was determined using IHC 4B5 and silver ISH (SISH) in centralized laboratories. The weighted kappa coefficient was used to evaluate the true concordance between the HER-2 status determined by IHC 4B5 and SISH. The weighted kappa coefficient value was interpreted according to the Landis and Koch classification as follows: a) less than (\<) 0: less than chance agreement, b) 0.01-0.20: slight agreement, c) 0.21-0.40: fair agreement, d) 0.41-0.60: moderate agreement, e) 0.61-0.80: substantial agreement, and f) 0.81-0.99: almost perfect agreement.

Countries

France

Participant flow

Pre-assignment details

A total of 448 tumor specimens originating from 420 participants were assessed for inclusion in the study. Of these 448 specimens, 54 were excluded from analysis. 394 tumor specimen were included in the study which were derived from a population of 367 participants. This population (n=367) is reported in this study.

Participants by arm

ArmCount
Gastric and Gastro-Esophageal Junction (GEJ) Carcinoma Samples
Tumor samples with histologically confirmed gastric or GEJ adenocarcinoma, any stage, were collected and analyzed. No study visits or interventions were planned Trastuzumab: Trastuzumab was not administered in this study. This study informs future trastuzumab treatment decisions.
367
Total367

Baseline characteristics

CharacteristicGastric and Gastro-Esophageal Junction (GEJ) Carcinoma Samples
Age, Continuous66.4 years
STANDARD_DEVIATION 13.2
Sex: Female, Male
Female
113 Participants
Sex: Female, Male
Male
254 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
— / —
other
Total, other adverse events
0 / 0
serious
Total, serious adverse events
0 / 0

Outcome results

Primary

Simple Kappa Coefficient of Human Epidermal Growth Factor Receptor 2 (HER-2) Status Between Local and Centralized Laboratory Assessments

Positive HER-2 status was defined as either immunohistochemistry (IHC) score of 3+ or IHC score 2+/in situ hybridization (ISH) score +, as per the trastuzumab Summary of Product Characteristics (SPC). The HER-2 status in tumor specimens was determined using the pathologist's choice of IHC and ISH techniques in local laboratories, and using IHC 4B5 and silver ISH (SISH) in centralized laboratories. The kappa coefficient was used to evaluate the true concordance between the HER-2 status determined by local and centralized laboratories. The kappa coefficient value was interpreted according to the Landis and Koch classification as follows: a) less than (\<) 0: less than chance agreement, b) 0.01-0.20: slight agreement, c) 0.21-0.40: fair agreement, d) 0.41-0.60: moderate agreement, e) 0.61-0.80: substantial agreement, and f) 0.81-0.99: almost perfect agreement.

Time frame: At enrollment

Population: The specimens' population is defined as all specimens for which at least one IHC and/or ISH test was done in the centralized laboratory, without any reasons for exclusion.

ArmMeasureValue (NUMBER)
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaSimple Kappa Coefficient of Human Epidermal Growth Factor Receptor 2 (HER-2) Status Between Local and Centralized Laboratory Assessments0.69 kappa coefficient
Comparison: Rationale for the determination of the number of samples:The following hypotheses were considered: two-sided risk alpha = 5%, power (1 - beta) = 90%, a success rate (rate of positive HER-2 status) = 17%, null hypothesis (H0): kappa coefficient = 0.90. 359 samples would allow determining a first estimate of the 0.90 coefficient of correlation kappa. The total number of samples, which had to be included in this study was 395, considering a 10% rate of non-evaluable samples.p-value: 0.7436Kappa-test p-value, 2 sided
Secondary

Cancer Characteristics: Percentage of Participants With Initial Location of Adenocarcinoma in Stomach Versus Esogastric Location

Time frame: At enrollment

Population: The participants' sub-population being all participants from the specimen population, which is defined as all specimens for which at least one IHC and/or ISH test was done in the centralized laboratory, without any reasons for exclusion. Here, 'n' is number of participants with available data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Initial Location of Adenocarcinoma in Stomach Versus Esogastric LocationStomach59.6 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Initial Location of Adenocarcinoma in Stomach Versus Esogastric LocationEsogastric junction40.4 percentage of participants
Secondary

Cancer Characteristics: Percentage of Participants With Samples in Each of the Histologic Type Lauren's Classifications, Including Diffuse Type, Intestinal and Mixed

The Lauren classification is based on examination of histologic specimens under the microscope and divides adenocarcinoma of the stomach into 3 types: 1) Diffuse type: tumor cells are poorly differentiated, behave aggressively and tend to scatter throughout the stomach (rather than form glands). This type metastasizes to other parts of the body much quicker than intestinal type tumors, 2) Intestinal type: tumor cells are well differentiated, grow slowly and tend to form glands, 3) Mixed type: this type is made up of both intestinal and diffuse types.

Time frame: At enrollment

Population: The participants' sub-population being all participants from the specimen population, which is defined as all specimens for which at least one IHC and/or ISH test was done in the centralized laboratory, without any reasons for exclusion. Here, 'n' is number of participants with available data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Histologic Type Lauren's Classifications, Including Diffuse Type, Intestinal and MixedDiffuse type29.6 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Histologic Type Lauren's Classifications, Including Diffuse Type, Intestinal and MixedIntestinal type54.8 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Histologic Type Lauren's Classifications, Including Diffuse Type, Intestinal and MixedMixed type9.6 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Histologic Type Lauren's Classifications, Including Diffuse Type, Intestinal and MixedNon-evaluable0.3 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Histologic Type Lauren's Classifications, Including Diffuse Type, Intestinal and MixedOther types5.8 percentage of participants
Secondary

Cancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) Stages

The TNM stage system includes information about the size of the primary tumor (T), whether the cancer has spread to nearby lymph nodes (N) and whether the cancer has metastasized to other parts of the body (M). In the T classification TX indicates that the main tumor cannot be measured, T1, T2, T3 and T4 refer to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. In the N classification NX indicates that the cancer in nearby lymph nodes cannot be measured, N0 indicates that there is no cancer in nearby lymph nodes, N1, N2 and N3 refer to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer. In the M classification MX indicates that the metastasis cannot be measured, M0 indicates that the cancer has not spread to other parts of the body and M1 indicates that the cancer has spread to other parts of the body.

Time frame: At enrollment

Population: The participants' sub-population being all participants from the specimen population, which is defined as all specimens for which at least one IHC and/or ISH test was done in the centralized laboratory, without any reasons for exclusion. Here, 'n' is number of participants with available data for this outcome measure.

ArmMeasureGroupValue (NUMBER)
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesN212.0 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesT19.8 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesT28.2 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesT326.0 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesT412.6 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesTx43.4 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesN023.0 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesN110.7 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesN39.0 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesNx45.4 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesM018.6 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesM15.5 percentage of participants
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaCancer Characteristics: Percentage of Participants With Samples in Each of the Tumor-Node-Metastasis (TNM) StagesMx76.0 percentage of participants
Secondary

Weighted Kappa Coefficient Between Immunohistochemistry (IHC) 4B5 and Silver in Situ Hybridization (SISH) Techniques for HER-2 Testing in Centralized Laboratories

Positive HER-2 status was defined as either immunohistochemistry (IHC) score of 3+ or IHC score 2+/in situ hybridization (ISH) score +, as per the trastuzumab Summary of Product Characteristics (SPC). The HER-2 status in tumor specimens was determined using IHC 4B5 and silver ISH (SISH) in centralized laboratories. The weighted kappa coefficient was used to evaluate the true concordance between the HER-2 status determined by IHC 4B5 and SISH. The weighted kappa coefficient value was interpreted according to the Landis and Koch classification as follows: a) less than (\<) 0: less than chance agreement, b) 0.01-0.20: slight agreement, c) 0.21-0.40: fair agreement, d) 0.41-0.60: moderate agreement, e) 0.61-0.80: substantial agreement, and f) 0.81-0.99: almost perfect agreement.

Time frame: At enrollment

Population: The specimens' population is defined as all specimens for which at least one IHC and/or ISH test was done in the centralized laboratory, without any reasons for exclusion. Here, 'n' is number of specimens with available data for this outcome measure.

ArmMeasureValue (NUMBER)
Gastric and Gastro-Esophageal Junction (GEJ) CarcinomaWeighted Kappa Coefficient Between Immunohistochemistry (IHC) 4B5 and Silver in Situ Hybridization (SISH) Techniques for HER-2 Testing in Centralized Laboratories0.64 weighted kappa coefficient

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026