New HER2-Directed Therapies Reshape First-Line Treatment of Gastroesophageal Adenocarcinoma
Clinical Summary:
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Dr Janjigian discusses first-line treatment strategies for patients with HER2-positive gastric and esophageal adenocarcinoma, focusing on HER2 expression and PD-L1 status to guide treatment selection.
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Zanidatamab-based regimens may expand treatment options alongside pembrolizumab, trastuzumab, and chemotherapy. Practical considerations include diarrhea management, emerging antibody-drug conjugate strategies, and repeat biopsy to reassess HER2 status after progression.
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Biomarker-guided treatment selection and HER2 reassessment after progression can help inform treatment sequencing and subsequent HER2-directed therapy.
Yelena Janjigian, MD, Memorial Sloan Kettering Cancer Center, New York, New York, discusses the evolving first-line treatment landscape for HER2-positive gastric and esophageal adenocarcinoma, including the role of HER2 expression and PD-L1 status in treatment selection.
Dr Janjigian reviews how zanidatamab-based regimens may fit alongside pembrolizumab, trastuzumab, and chemotherapy. She also discusses diarrhea management with zanidatamab, emerging antibody-drug conjugate strategies, and the importance of repeat biopsy and HER2 reassessment after progression to guide subsequent HER2-directed therapy.
