We analysed trends over time in palliative first-line chemotherapy in patients with locally advanced or metastatic esophagogastric\ncancer. Special focus was on frequency and quality of HER2-testing and trends in drug use in combination with trastuzumab.\nEarlier published data about patients treated outside clinical studies showed a relatively low rate of HER2-testing and insufficient\ntest quality. A total of 2,808 patients retrospectively documented in The rapiemonitorââ??â?¡ from 2006 to 2013 were analysed regarding\ntreatment intensity and trends in used drugs. Data on HER2-testing and therapies were analysed in two cohorts documented in\n2010 and 2011 (1) compared to 2012 and 2013 (2). Treatment intensity increased: 49.3% of patients received at least a triplet in 2013\ncompared to 10.1% in 2006. In cohort 2 HER2 expression was tested in 79.1% of the cases. Still, in 26.9% testing was not done\nas requested by guidelines. Good performance status, multiple metastases, age ââ?°Â¤ 65 years, the objective ââ?¬Å?to prevent progression,ââ?¬Â\ngood cognitive capabilities, estimated good compliance, and social integration positively influenced the probability of HER2-testing;\ncomorbidities negatively affected it. Usage of the combination of fluoropyrimidines and cisplatin with trastuzumab declined from\n67% in cohort 1 to 50% in cohort 2.
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