Fast Five Quiz: Advanced and Metastatic Gastric Cancer

Elwyn C. Cabebe, MD


April 06, 2022

Oxaliplatin + trastuzumab are active drugs for stage IV HER2+ gastric cancer. Trastuzumab should be added to first-line chemotherapy for HER2/neu overexpressing adenocarcinomas but is not recommended in regimens containing an anthracycline. Oxaliplatin is generally preferred over cisplatin owing to lower toxicity. Similarly, two-drug regimens are preferred because of lower toxicity. Triplet regimens should be reserved for patients who are medically fit and have access to frequent follow-up.

5-FU alone is not the preferred first-line treatment for patients with HER2 overexpressing cancers.

For patients with HER2-positive disease previously treated with trastuzumab plus one or more lines of chemotherapy, a recent phase 2 study showed significant complete and partial response rates with margetuximab plus pembrolizumab. The most benefit was seen in those with HER2-IHC3-positive/PDL-1-positive tumors.

Learn more about gastric cancer treatment protocols.


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