TY - JOUR
T1 - Gastric and esophageal cancers
T2 - Guidelines updates
AU - Denlinger, Crystal S.
AU - Matkowskyj, Kristina A.
AU - Mulcahy, Mary F.
N1 - Publisher Copyright:
© JNCCN - Journal of the National Comprehensive Cancer Network.
PY - 2021/5
Y1 - 2021/5
N2 - 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 adenocarcino mas. 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.
AB - 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 adenocarcino mas. 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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U2 - 10.6004/jnccn.2021.5006
DO - 10.6004/jnccn.2021.5006
M3 - Article
AN - SCOPUS:85108549832
SN - 1540-1405
VL - 19
SP - 639
EP - 643
JO - JNCCN Journal of the National Comprehensive Cancer Network
JF - JNCCN Journal of the National Comprehensive Cancer Network
ER -