Navigating the Surgical Approach to Gastric Cancers With Ryan Fields, MD, FACP

For patients with gastric and gastroesophageal cancers, questions remain in the optimal approaches to treatment and surgery. At the recent American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium, Ryan Fields, MD, Chief of the Section of Surgical Oncology at Washington University School of Medicine and the Alvin J. Siteman Cancer Center, discussed recent developments in the surgical approach to these diseases. In this interview with Oncology Data Advisor, Dr. Fields delves...

Continue reading

Pembrolizumab Approval Withdrawn for Third-Line Gastric Cancer Treatment

Yesterday, Merck announced that it will voluntarily withdraw the accelerated approval indication of pembrolizumab (Keytruda®, Merck) for patients with recurrent locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma whose tumors express programmed death-ligand 1 (PD-L1) with a combined positive score (CPS) ≥1 and who experienced disease progression on or after two or more prior lines of therapy, including fluoropyrimidine- and platinum-containing chemotherapy and human e...

Continue reading

Pembrolizumab Approved for HER2-Positive Gastric Cancer

The FDA has granted accelerated approval to pembrolizumab (Keytruda®, Merck & Co.) in combination with trastuzumab, fluoropyrimidine- and platinum-containing chemotherapy for first-line treatment of patients with locally advanced unresectable or metastatic HER2- positive gastric or gastroesophageal junction (GEJ) adenocarcinoma. "The PD-1 (programmed cell death protein 1)/PD-L1 (programmed death-ligand 1) pathway is an important regulatory component of the immune response and plays a critica...

Continue reading

FDA Approves Nivolumab With Chemotherapy for Gastric and Esophageal Cancer

The FDA has granted approval to nivolumab (Opdivo®, Bristol-Myers Squibb Company) in combination with fluoropyrimidine- and platinum-containing chemotherapy for the initial treatment of patients with advanced/metastatic gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma. "Standard first-line chemotherapy options for advanced or metastatic human epidermal growth factor receptor 2 (HER2)-negative gastric cancer/gastroesophageal junction cancer result in poor overall su...

Continue reading

Kohei Shitara, MD: Fam-Trastuzumab Deruxtecan-Nxki for Gastric Cancer

Kohei Shitara, MD

Fam-trastuzumab deruxtecan-nxki (Enhertu®, Daiichi Sankyo) has recently been FDA approved for the treatment of adult patients with locally advanced or metastatic human epidermal growth factor receptor 2 (HER2)-positive gastric or gastroesophageal adenocarcinoma previously treated with a trastuzumab-based regimen. In this interview with i3 Health, Kohei Shitara, MD, Chief of the Department of Gastrointestinal Oncology at the National Cancer Center Hospital East in Kashiwa, Japan, and lead investigator of the phase 3 DESTINY-Gastric01 trial, on which the approval was based, shares his insights on this approval, on the challenges of treating this patient population, and on the future of treatment for patients with gastric or gastroesophageal adenocarcinoma.

Continue reading

Metastatic Gastric Cancer: Educational Needs

Due to the advances in treatment options for metastatic gastric cancer in recent years, oncology physicians and nurses can individualize treatment selection for patients by considering pathologic and molecular characteristics and emerging efficacy and safety data on novel therapies. Baseline data collected from i3 Health's continuing medical education (CME)/nursing continuing professional development (NCPD)–approved visiting faculty meeting series titled Challenges and Opportunities in Metastati...

Continue reading

Fam-Trastuzumab Deruxtecan-Nxki Approved for Advanced Gastric Cancer

The FDA approved fam-trastuzumab deruxtecan-nxki (Enhertu®, Daiichi Sankyo) for the treatment of adult patients with locally advanced or metastatic human epidermal growth factor receptor 2 (HER2)-positive gastric or gastroesophageal adenocarcinoma previously treated with a trastuzumab-based regimen. Approval was based on DESTINY-Gastric01 (NCT03329690), a multicenter, open-label, randomized trial. For this study, led by study author Kohei Shitara, MD, Chief of the Department of Gastrointestinal ...

Continue reading

Perioperative TAS-118 Plus Oxaliplatin Feasible in Gastric Cancer

In patients with locally advanced gastric cancer, perioperative chemotherapy consisting of TAS-118 (S-1 and leucovorin) plus oxaliplatin shows promise with a tolerable safety profile, according to safety and efficacy results of the APOLLO-11 feasibility study to be presented this week at the 2021 Gastrointestinal Cancers Symposium. While preoperative TAS-118 plus oxaliplatin followed by D2 gastrectomy has been shown to be feasible for patients with gastric cancer, the efficacy of this regimen in...

Continue reading

Nivolumab Plus Chemotherapy for Gastric/Gastroesophageal Junction Cancer: Kohei Shitara, MD

In advanced gastric cancer and gastroesophageal junction cancer, treatment options remain limited. Results of the phase 3 CheckMate 649 and phase 2/3 ATTRACTION-4 studies, both of which investigated chemotherapy with or without nivolumab in patients with previously untreated unresectable, advanced, or recurrent gastric/gastroesophageal junction (G/GEJ) cancer, were recently presented at the European Society of Medical Oncology (ESMO) Virtual Congress 2020. CheckMate 649 reported significant impr...

Continue reading

Frontline Pembrolizumab for PD-L1–Positive Gastric Cancer: Kohei Shitara, MD

Gastric or gastroesophageal junction (G/GEJ) cancer constitutes the third leading cause of cancer death worldwide, and more therapeutic options are needed. In results from the phase 3 KEYNOTE-062 study, published last week in JAMA Oncology, Kohei Shitara, MD, and colleagues reported that in patients with previously untreated G/GEJ cancer with a programmed cell death ligand 1 (PD-L1) combined positive score (CPS) of 1 or greater, pembrolizumab, alone or in combination with chemotherapy, was nonin...

Continue reading

Advanced Gastric Cancer: [Fam-] Trastuzumab Deruxtecan Shows Promise

A phase 1 clinical trial reports that [fam-] trastuzumab deruxtecan shows preliminary activity in patients with heavily pretreated human epidermal growth factor receptor 2 (HER2)-positive gastric or gastro-esophageal junction cancer. "These results are encouraging given the limited options for patients with advanced HER2-positive gastric cancer that progresses after initial treatment regimens including trastuzumab," commented Kohei Shitara, MD, Chief of the Department of Experimental Therapeutic...

Continue reading

[Fam-] Trastuzumab Deruxtecan in Advanced Gastric Cancer With Kohei Shitara, MD

Current treatment options are highly limited for patients with advanced human epidermal growth factor receptor 2 (HER2)-positive gastric or gastro-esophageal junction cancer, particularly after trastuzumab. A potential new treatment has emerged in a phase 1 clinical trial, which reports that [fam-] trastuzumab deruxtecan shows preliminary activity in patients with heavily pretreated HER2-positive gastric or gastro-esophageal junction cancer. In this interview with i3 Health, Kohei Shitara, MD, l...

Continue reading

PD-L1–Positive Gastric Cancer: Frontline Pembrolizumab Noninferior to Chemotherapy

Data from the phase 3 KEYNOTE-062 trial have revealed that in patients with advanced gastric or gastroesophageal junction (G/GEJ) cancer with a programmed cell death ligand 1 (PD-L1) combined positive score (CPS) of 1 or greater, first-line pembrolizumab, alone or in combination with chemotherapy, is noninferior but not superior to chemotherapy alone. In patients with a PD-L1 CPS of 10 or greater, pembrolizumab monotherapy showed a possible benefit, but one that cannot be considered definitive o...

Continue reading

Eradicating H. Pylori Reduces Gastric Cancer Risk

Being infected with Helicobacter pylori (H. pylori), a bacterium that grows in the stomach, and having a family history of gastric cancer are the two main risk factors for developing gastric cancer. Results from a recent study revealed that treatment to eradicate H. pylori can help reduce gastric cancer risk in those who have the bacterium and a family history of the disease. For the single-center, double-blind, placebo-controlled study, results of which are published in The New England Journal ...

Continue reading

Weight Loss Associated With Lower Survival in Patients With Gastric Cancer

Many patients with advanced gastric cancer inevitably lose weight while receiving systemic treatment, with some patients struggling with maintaining adequate nutrition. Researchers set out to investigate the impact of losing weight early on in treatment on patients' survival. For this study, results of which are published in Journal of Clinical Oncology, phase 3 trials involving patients with gastric/gastroesophageal junction (GEJ) cancer receiving ramucirumab were analyzed by the researchers: R...

Continue reading

Trifluridine/Tipiracil Approved for Metastatic Gastric Cancer

Gastric cancer, the fifth most common cancer worldwide and the third most common cause of cancer-related death, is particularly difficult to treat because most patients present with advanced or metastatic disease. However, patients with metastatic disease now have a new treatment option through the FDA's recent approval of trifluridine/tipiracil tablets (Lonsurf®, Taiho Pharmaceutical Co., Ltd.). Trifluridine/tipiracil, a fixed combination of the nucleoside metabolic inhibitor trifluridine and t...

Continue reading

Heavily Pretreated Metastatic Gastric Cancer: Dr. Kohei Shitara on Trifluridine/Tipiracil Approval

The FDA's recent approval of trifluridine/tipiracil tablets (Lonsurf®, Taiho Pharmaceutical Co., Ltd.) for heavily pretreated metastatic gastric adenocarcinoma and gastroesophageal junction adenocarcinoma represents a significant development for patients with gastric cancer, the third most frequent cause of cancer-related death. In this interview with i3 Health, Kohei Shitara, MD, speaks about the significance of this approval. Dr. Shitara was the lead author of the phase 3 TAGS study (NCT0...

Continue reading

Therapeutic Target Found in MSI-High Tumors

​Microsatellite instability (MSI), characteristic variations in the length of tandem nucleotide repeats across the genome, has been seen in a wide variety of cancers, including colon cancer, gastric cancer, endometrium cancer, ovarian cancer, hepatobiliary tract cancer, urinary tract cancer, brain cancer, and skin cancers. Researchers' discovery of the important role played by Werner syndrome helicase (WRN) in MSI-high (MSI-H) tumors presents a new opportunity for the development of targeted the...

Continue reading

Toripalimab for Advanced Gastric Cancer

​In a phase 1b/2 clinical trial, researchers report promising results for an immunotherapy drug called toripalimab in patients with advanced gastric cancer. Toripalimab is a monoclonal antibody that inhibits programmed cell death protein 1 (PD-1) from binding to the PD-1 ligand, preventing the activation of PD-1 and its downstream signaling pathways. This allows for certain aspects of the immune system to be restored, such as the activation of T cells and T-cell-mediated immune responses against...

Continue reading

Ramucirumab/Pembrolizumab in Patients With NSCLC, Gastric Cancer, or Urothelial Carcinoma

A phase 1a/b trial (NCT02443324) reports that ramucirumab in conjunction with pembrolizumab is effective in patients with previously treated advanced non-small cell lung cancer (NSCLC), gastroesophageal cancer, or urothelial carcinomas. Ramucirumab, a monoclonal antibody, blocks vascular endothelial growth factor receptor 2 (VEGFR2), which allows cancer cells to grow and metastasize. Pembrolizumab is also a monoclonal antibody, but it works by blocking programmed cell death protein-1 (PD-1), in ...

Continue reading

Copyright © 2022 Oncology Data Advisor. All rights reserved.