- Design
- Meta-analysis of three single-arm or early-phase trials
- Population
- 685 patients with advanced HER2-positive gastro-oesophageal adenocarcinoma
- Primary outcome
- PFS, response rate, adverse events
- Effect
- ORR 70% (67–74); median PFS 12.6 months; grade ≥3 diarrhoea 26%
A meta-analysis in the Journal of Gastrointestinal Cancer (15 October) pooled three trials of first-line zanidatamab, a HER2 antibody binding two separate domains of the receptor, with chemotherapy and in some cases tislelizumab, in 685 patients with advanced HER2-positive gastro-oesophageal adenocarcinoma.
The pooled response rate was 70%, median progression-free survival about 12.6 months and reconstructed median overall survival about 26 months. Toxicity was substantial: diarrhoea in 89% (grade 3 or worse in 26%), serious adverse events in 66%, immune-mediated events in 25%, left ventricular dysfunction in 6% and non-infectious lung toxicity in 4%.
These are single-arm and pooled results, without a randomised comparison against trastuzumab-based therapy, so they show activity rather than superiority. Regulatory status and access in India are not established here.
- Pooled response rate was 70%, with median PFS about 12.6 months
- Grade 3 or worse diarrhoea affected about a quarter of patients
- Monitor cardiac function and watch for pneumonitis
- No randomised comparison with standard trastuzumab-based therapy is included
Why it matters
A dual-domain HER2 antibody may change first-line therapy if randomised trials confirm these numbers.
Don't overread it
Pooled single-arm data — it cannot show that zanidatamab beats trastuzumab-based treatment.
The statistics, in plain English
Several toxicity estimates have very wide confidence intervals — dose-reducing diarrhoea ranged from 1% to 75% — because only three trials were pooled and they differed. The response rate (95% CI 67% to 74%) is more precise.
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