Metastatic Gastric Cancer Treatment Sequencing

Jaffer A. Ajani, MD


October 03, 2022

For patients with advanced/metastatic disease who receive first-line combination chemotherapy with supportive care, the median overall survival is around 12 months.

Newer targeted therapies have shown improved outcomes, however, and their introduction has expanded the armamentarium of first-, second-, and third-line options.

Dr Jaffer Ajani, a gastrointestinal oncologist at MD Anderson Cancer Center, discusses the optimal approaches to treatment sequencing in metastatic gastric cancer.

First, Dr Ajani shares recommendations for biomarker testing to identify patients for whom HER2 inhibitors and PD-1/PD-L1 inhibitors should be combined with chemotherapy for first-line therapy.

He then discusses why next-generation sequencing in the second-line setting should be standard practice, as well as approaches to second- and third-line therapy.

Finally, Dr Ajani underscores the importance of patient education throughout the course of gastric cancer treatment.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.