Treatment Sequencing for Metastatic Gastric Cancer Patients

Peter Enzinger, MD


July 02, 2020

The prognosis for patients with gastric cancer/gastroesophageal junction adenocarcinoma is poor, with many living only 1 year from initial diagnosis of metastasis. Dr Peter Enzinger reviews the standard of care, including the FOLFOX regimen for frontline therapy, which is effective in the majority of patients. He explains which criteria determine whether a patient is no longer responding to treatment and should advance to second-line treatments.

Second-line therapy usually combines the monoclonal antibody ramucirumab and paclitaxel, but the addition of trastuzumab to FOLFOX may be considered in patients whose tumors are HER2/neu positive. Targeted therapy for gastric cancer dates from the 2017 FDA approval of trastuzumab for this indication.

Dr Enzinger foresees targeted therapies and more effective combination therapies playing an increasing role in gastric cancer.


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