Advanced Gastric Cancer

CE / CME

Cases and Challenges in the Optimal Treatment of Advanced Gastric Cancer

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurse Practitioners: 1.00 Nursing contact hours, includes 1.00 hour of pharmacotherapy credit

Released: April 27, 2023

Expiration: April 26, 2024

Steven Maron
Steven Maron, MD

Activity

Progress
1
Course Completed

Which of the following biomarkers should be assessed in all patients with newly diagnosed advanced gastric cancer (GC) to inform initial systemic therapy recommendations?

For what level of PD-L1 expression is the chemotherapy + trastuzumab + pembrolizumab regimen indicated in HER2-positive advanced GC?

What is the most appropriate next step with trastuzumab deruxtecan if grade 2 interstitial lung disease (ILD) is suspected?

How often do you currently consider using chemotherapy + nivolumab as first-line treatment for HER2-negative advanced GC?

 How often do you currently test for mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) status in patients with suspected mGC?

How often do you currently counsel patients treated with T-DXd to report any symptoms of ILD?

David, age 65, is diagnosed with  HER2-negative mGC. In current guidelines, which of these PD-L1 levels would make chemotherapy + nivolumab a Category 1 recommendation for initial therapy?

At 2 months on CT + nivolumab, David has a partial response. Regular on-treatment monitoring reveals primary hypothyroidism. Which of the following approaches would you recommend for David?

Gary has HER2+ mGC, with PD-L1 CPS ≤1, tumor mutation burden (TMB)-low, and no actionable mutations. He has progressed after 1L chemoimmunotherapy + trastuzumab and has grade 2 neuropathy. What is the recommended next treatment?