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.
Medscape © 2022 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Elwyn C. Cabebe. Fast Five Quiz: Advanced and Metastatic Gastric Cancer - Medscape - Apr 06, 2022.