Gastric Cancer Updates

Important considerations regarding the sequencing of novel therapies for gastric cancer based on updates presented at the ASCO 2020 Virtual Meeting.

Data from the following clinical trials is discussed:

• Pembrolizumab vs paclitaxel for previously treated pts with PD-L1–positive advanced gastric or gastroesophageal junction cancer (GC): Update from the phase 3 KEYNOTE-061 trial. (Fuchs CS, et al. ASCO 2020. Abstract 4503)

• KEYNOTE-158: FDA approval of pembrolizumab based on tumor mutational burden-high (TMB-high) (FDA.gov; Marabelle A, et al. J Clin Oncol. 2020)

  • WES, cut-off 175 mutations/exome (Fuchs CS, et al. ASCO 2020. Abstract 4512)

  • FoundationOne CDx (F1CDx); Foundation Medicine cut-off 10 mut/MB (Shitara K, et al. ASCO 2020. Abstract 4537)

• T-DXd; DS-8201 in pts with HER2-positive advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma: A randomized, phase 2, multicenter, open-label study (DESTINY-Gastric01). (Shitara K, et al. ASCO 2020. Abstract 4513)

• Trastuzumab with trimodality treatment for esophageal adenocarcinoma with HER2 overexpression: NRG Oncology/RTOG 1010. (Safran H, et al. ASCO 2020. Abstract 4500)

• Perioperative trastuzumab and pertuzumab in combination with FLOT for HER2-positive resectable esophagogastric adenocarcinoma: Final results of the PETRARCA multicenter randomized phase 2 trial of the AIO. (Dieter Hofheinz R, et al. ASCO 2020. Abstract 4502)

• FOLFIRI plus ramucirumab versus paclitaxel plus ramucirumab as second-line therapy for pts with advanced or metastatic gastroesophageal adenocarcinoma with or without prior docetaxel: Results from the phase 2 RAMIRIS Study of the AIO. (Lorenzen S, et al. ASCO 2020. Abstract 4514)