Evolution of Real-World Treatment Patterns over Time in Patients with HER2-Negative Advanced Gastric Cancer: A Retrospective Database Cohort Study from Japan.

Authors

Shuichi Hironaka, Yuya Kimijima, Yusuke Shinno, Eiji Nishiyama, Yorifumi Kikko, Yuko Matsuda, Tsunehisa Yamamoto, Bruno Casaes Teixeira, Takaki Yoshikawa

Published in

Advances in therapy. Sep 11, 2026. Epub Sep 11, 2026.

Abstract

The treatment paradigm for patients with human epidermal growth factor receptor 2 (HER2)-negative advanced gastric cancer (aGC) has shifted after the introduction of new regimens.
This retrospective analysis of hospital-based administrative claims data included adults (aged ≥ 20 years) who received guideline-recommended first-line treatment for HER2-negative aGC from January 1, 2012 to December 31, 2023. The primary objective was to examine the evolution of real-world treatment patterns in these patients across six eras, each spanning two calendar-year intervals from 2012 to 2023 (era 1, 2012-2013; era 2, 2014-2015; era 3, 2016-2017; era 4, 2018-2019; era 5, 2020-2021; era 6, 2022-2023).
Among 16,573 patients (72.1% male, 27.9% female; median age 70 years), tegafur-gimeracil-oteracil (S-1) plus cisplatin (SP) was the most common first-line regimen in 2012-2013 (94.0%). S-1 plus oxaliplatin (SOX) use increased from 22.4% in 2014-2015 to 66.3% in 2020-2021. Capecitabine plus oxaliplatin (CapeOX) and folinic acid-fluorouracil plus oxaliplatin (FOLFOX) use also increased in 2020-2021 (to 6.0% and 10.5%, respectively), whereas SP decreased (to 14.8%). In 2022-2023, first-line nivolumab plus chemotherapy (SOX, FOLFOX, or CapeOX) became the most common regimens (48.1%, 11.0%, and 2.6%, respectively), while SOX and SP decreased (to 26.2% and 2.0%, respectively). The proportion of patients aged ≥ 75 years increased over time. Median overall duration of therapy (DoT) also increased from 2012-2013 (8.5 months) to 2022-2023 (12.5 months). DoT did not change in the second- and third-line setting. In 2022-2023, median first-line DoT was longer with nivolumab plus chemotherapy versus chemotherapy alone (6.3 vs 5.0 months).
Use of newly introduced first-line regimens for HER2-negative aGC in Japanese clinical practice has increased over time, with an increase in the overall DoT.

PMID:
42726375
Bibliographic data and abstract were imported from PubMed on 12 Sep 2026.

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