FCCC LOGO Faculty Publications
Denlinger CS , Matkowskyj KA , Mulcahy MF
Gastric and esophageal cancers: Guidelines updates
JNCCN Journal of the National Comprehensive Cancer Network. 2021 May;19(5.5) :639-643
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Abstract
For the treatment of gastric and esophageal cancers, several pivotal trials-especially those evaluating immune checkpoint inhibitors (ICIs)-have altered the treatment landscape and led to changes in the NCCN Guidelines. In addition to pembrolizumab and nivolumab, new treatment options include trastuzumab-deruxtecan (T-DXd), ramucirumab, and trifluridine/tipiracil. These agents convey varying degrees of benefit depending on treatment line, PD-L1 expression, HER2 expression, and tumor histology. Recently, ICIs have been incorporated into the first-line treatment of HER2-negative advanced esophageal, gastroesophageal junction (GEJ), and gastric cancers, in addition to second-line treatment of advanced esophageal and GEJ cancer of squamous histology. T-DXd is another new second-line option for HER2-positive esophageal, GEJ, and gastric adenocarcinomas. ICIs are now moving into the adjuvant setting as well, and a new recommendation is nivolumab use after preoperative chemoradiation and surgery in patients who have residual disease identified at the time of their R0 resections.
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Export Date: 1 July 2021