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

Activity

Progress
1
Course Completed

References

  1. American Cancer Society. Cancer Facts & Figures 2023. Atlanta, GA: American Cancer Society; 2023. 
  2. Bonelli P, Borrelli A, Tuccillo FM, Silvestro L, Palaia R, Buonaguro FM. Precision medicine in gastric cancer. World J Gastrointest Oncol. 2019;11:804-829.
  3. Smyth EC, Nilsson M, Grabsch HI, et al. Gastric cancer. Lancet. 2020;396:635-648.
  4. National Comprehensive Cancer Network. Gastric cancer. Version 1.2023. www.nccn.org. Accessed March 30, 2023.
  5. Shitara K, Bang Y-J, Iwasa S, et al. Exploratory analysis of the impact of prior immune checkpoint inhibitor (ICI) on trastuzumab deruxtecan (T-DXd; DS-8201) clinical outcomes and biomarkers (BM) in DESTINY-Gastric01 (DG-01), a randomized, phase 2, multicenter, open-label study in patients (pts) with HER2+ advanced gastric or gastroesophageal junction adenocarcinoma. J  Clin Oncol. 2022;40:322-322.
  6.  Janjigian YY, Shitara K, Moehler M, et al. First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric, gastro-oesophageal junction, and oesophageal adenocarcinoma (CheckMate 649): a randomised, open-label, phase 3 trial. Lancet. 2021;398:27-40.
  7.  Janjigian YY, Shitara K, Moehler, et al. Nivolumab plus chemotherapy vs chemotherapy as first-line treatment for advanced gastric cancer/gastroesophageal junction cancer/esophageal adenocarcinoma: 3-year follow-up from CheckMate 649. Presented at: American Society of Clinical Oncology Gastrointestinal Cancers Symposium; January 19-21, 2023. Abstract 291. 
  8. Shah MA, Kennedy EB, Alarcon-Rozas AE, et al. Immunotherapy and targeted therapy for advanced gastroesophageal cancer: ASCO guideline. J Clin Oncol. 2023;41:1470-1491.
  9. Nivolumab [prescribing information]. Princeton, NJ: Bristol-Myers Squibb; 2022.
  10. Sun JM, Shen L, Shah MA, et al. Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): a randomised, placebo-controlled, phase 3 study. Lancet. 2021;398:759-771.
  11. Bang YJ, Van Cutsem E, Feyereislova A, et al. Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet. 2010;376:687-697.
  12. Janjigian YY, Kawazoe A, Yanez P, et al. The KEYNOTE-811 trial of dual PD-1 and HER2 blockade in HER2-positive gastric cancer. Nature. 2021;600:727-730.
  13. Pembrolizumab [prescribing information]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp.; 2023.
  14. National Comprehensive Cancer Network. Management of immune-related toxicities. Version 1.2023. www.nccn.org. Accessed March 20, 2023.
  15. Schneider BJ, Naidoo J, Santomasso BD, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update. J Clin Oncol. 2021;39:4073-4126.
  16. Raschi E, Gatti M, Gelsomino F, Ardizzoni A, Poluzzi E, De Ponti F. Lessons to be learnt from real-world studies on immune-related adverse events with checkpoint inhibitors: A clinical perspective from pharmacovigilance. Target Oncol. 2020;15:449-466.
  17. Wood LS. Immune-related adverse events from immunotherapy: Incorporating care step pathways to improve management across tumor types. J Adv Pract Oncol. 2019;10:47-62.
  18. Martins F, Sofiya L, Sykiotis GP, et al. Adverse effects of immune-checkpoint inhibitors: epidemiology, management and surveillance. Nat Rev Clin Oncol. 2019;16:563-580.
  19. Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2018;36:1714-1768.
  20. Dougan M, Blidner AG, Choi J, et al. Multinational Association of Supportive Care in Cancer (MASCC) 2020 clinical practice recommendations for the management of severe gastrointestinal and hepatic toxicities from checkpoint inhibitors. Support Care Cancer. 2020;28:6129-6143.
  21. Li Y, Kang X, Wang H, et al. Clinical diagnosis and treatment of immune checkpoint inhibitor-associated adverse events in the digestive system. Thorac Cancer. 2020;11:829-834.
  22. Barroso-Sousa R, Barry WT, Garrido-Castro AC, et al. Incidence of endocrine dysfunction following the use of different immune checkpoint inhibitor regimens: A systematic review and meta-analysis. JAMA Oncol. 2018;4:173-182.
  23. Haanen J, Carbonnel F, Robert C, et al. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28:iv119-iv142.
  24. Ramucirumab [prescribing information]. Indianapolis, IN: Eli Lilly & Co.; 2022.
  25. Wilke H, Muro K, Van Cutsem E, et al. Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised phase 3 trial. Lancet Oncol. 2014;15:1224-1235.
  26. Shitara K, Bang YJ, Iwasa S, et al. Trastuzumab deruxtecan in previously treated HER2-positive gastric cancer. N Engl J Med. 2020;382:2419-2430.
  27. Yamaguchi K, Bang Y-J, Iwasa S, et al. Trastuzumab deruxtecan (T-DXd; DS-8201) in patients with HER2–positive advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma: Final overall survival (OS) results from a randomized, multicenter, open-label, phase 2 study (DESTINY-Gastric01). Journal of Clinical Oncology. 2022;40:242-242.
  28.  Trastuzumab deruxtecan [prescribing information]. Basking Ridge, NJ: Daiichi Sankyo, Inc; 2022.
  29. Ku G, Di Bartolomeo M, Smyth E, et al. Updated analysis of DESTINY-Gastric02: A phase II single-arm trial of trastuzumab deruxtecan (T-DXd) in western patients (Pts) with HER2-positive (HER2+) unresectable/metastatic gastric/gastroesophageal junction (GEJ) cancer who progressed on or after trastuzumab-containing regimen. Ann Oncol. 2022;33(suppl_7):S555-S580.
  30. Shitara K, Bang Y-J, Iwasa S, et al. Exploratory analysis of the impact of prior immune checkpoint inhibitor (ICI) on trastuzumab deruxtecan (T-DXd; DS-8201) clinical outcomes and biomarkers (BM) in DESTINY-Gastric01 (DG-01), a randomized, phase 2, multicenter, open-label study in patients (pts) with HER2+ advanced gastric or gastroesophageal junction adenocarcinoma. J Clin Oncol. 2022;40:322-322.
  31. Yamaguchi K, Bang YJ, Iwasa S, et al. Trastuzumab deruxtecan in anti-human epidermal growth factor receptor 2 treatment-naive patients with human epidermal growth factor receptor 2-low gastric or gastroesophageal junction adenocarcinoma: Exploratory cohort results in a phase II trial. J Clin Oncol. 2023;41:816-825.
  32. Thuss-Patience PC, Shah MA, Ohtsu A, et al. Trastuzumab emtansine versus taxane use for previously treated HER2-positive locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma (GATSBY): an international randomised, open-label, adaptive, phase 2/3 study. Lancet Oncol. 2017;18:640-653.
  33. Powell CA, Modi S, Iwata H, et al. Pooled analysis of drug-related interstitial lung disease and/or pneumonitis in nine trastuzumab deruxtecan monotherapy studies. ESMO Open. 2022;7:1.
  34.  Andre T, Berton D, Curigliano G, et al. Efficacy and safety of dostarlimab in patients (pts) with mismatch repair deficient (dMMR) solid tumors: Analysis of 2 cohorts in the GARNET study.  . Presented at: American Society of Clinical Oncology Annual Meeting; June 3-7, 2022. Abstract 2587. 
  35. Larotrectinib [prescribing information]. Whippany, NJ: Bayer HealthCare Pharmaceuticals Inc; 2021.
  36. Entrectinib [prescribing information]. South San Francisco, CA: Genentech USA, Inc.; 2019.
  37. Selpercatinib [prescribing information]. Indianapolis, IN: Lilly USA, LLC; 2022.
  38. Rha SY, Wyrwicz LS, Yañez Weber PE, et al. Pembrolizumab plus chemotherapy as first-line therapy for advanced HER2-negative gastric or gastroesophageal junction cancer: phase 3 KEYNOTE-859 study. Presented at: European Society for Medical Oncology Virtual Plenary; February 16-17, 2023. Abstract VP-1.