Trastuzumab Based Therapy in HER2 Positive AGC

Inclusion Criteria:

1. pathology and medical imageology proven advanced gastric adenocarcinoma, inoperable;

2. received trastuzumab plus chemotherapy as the first-line palliative chemotherapy;

3. with measurable lesion with a diameter 20 mm using conventional computed tomography (CT) or magnetic resonance imaging (MRI) scans or 10 mm using spiral CT scans;

4. Eastern Cooperative Oncology Group performance status (ECOG PS ) of 0-2;

5. left ventricular ejection fraction(LVEF) more than 50 percents;

6. sufficient bone marrow, liver and renal function.

Exclusion Criteria:

1. received previous systemic therapy for advanced disease (except adjuvant/neoadjuvantchemotherapy completed at least 6 months before enrollment);

2. trastuzumab based adjuvant/neoadjuvant therapy;

3. treatment with any other anticancer therapy (lapatinib, immunotherapy, etc);

4. patients with heart failure, coronary artery disease or myocardial infarction withinthe previous 6 months.

5. trastuzumab based first line therapy started beyond 4 weeks from the first diagnosesof AGC.