Gastric & gastro-oesophageal junction cancer: guideline history

Anchored to: FDA approvals of trastuzumab deruxtecan for HER2-positive gastric cancer (January 2021, DESTINY-Gastric01) and nivolumab with chemotherapy (April 2021, CheckMate 649)

• addedMetastatic, HER2-positive, second line: Trastuzumab deruxtecan after trastuzumab-based therapy.
• addedMetastatic, HER2-negative, first line: Nivolumab with fluoropyrimidine-platinum chemotherapy, preferred for PD-L1 CPS 5 or above.

Anchored to: Annals of Oncology publication, 2022

• addedMetastatic, HER2-negative, PD-L1 CPS 5 or above, first line: Nivolumab plus chemotherapy recommended for CPS 5 or above [I, A; ESMO-MCBS 4].
• addedMetastatic, HER2-positive, first line: Pembrolizumab added to trastuzumab and chemotherapy for PD-L1-positive HER2-positive disease (KEYNOTE-811) [I, B].

Anchored to: FDA approvals of pembrolizumab with chemotherapy for HER2-negative disease (November 2023, KEYNOTE-859) and zolbetuximab (October 2024, SPOTLIGHT and GLOW)

• addedMetastatic, HER2-negative, first line: Pembrolizumab with chemotherapy for PD-L1 CPS 1 or above.
• addedMetastatic, HER2-negative, Claudin 18.2-positive, first line: Zolbetuximab with chemotherapy for tumours with Claudin 18.2 staining in 75% or more of cells.