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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Advances in Human Epidermal Growth Factor Receptor 2-Targeted Therapy in Upper Gastrointestinal Cancers
1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Abstract:
The Trastuzumab for Gastric Cancer (ToGA) trial marked a pivotal moment in the adoption of trastuzumab for treating advanced human epidermal growth factor receptor 2 (HER2)-positive esophagogastric (EG) cancer. The KEYNOTE-811 trial brought to light the synergistic effect of immune modulation and HER2 targeting. Additionally, the emergence of trastuzumab deruxtecan (T-DXd) highlighted the potential of new pharmaceutical technologies to extend response, particularly for patients who have advanced beyond initial HER2-targeted therapies. This review aims to navigate through both the successes and challenges encountered historically, as well as promising current trials on innovative and transformative therapeutic strategies, including promising first-in-class and novel first-in-human agents.
Insights
Trastuzumab improved outcomes in HER2-positive esophagogastric cancer. New therapies like T-DXd and combination treatments show promise for advanced disease, expanding treatment options.
Area of Science:
- Oncology
- Gastroenterology
- Pharmacology
Background:
- The Trastuzumab for Gastric Cancer (ToGA) trial established trastuzumab for HER2-positive esophagogastric cancer.
- The KEYNOTE-811 trial demonstrated synergy between immune modulation and HER2 targeting.
- Trastuzumab deruxtecan (T-DXd) offers new hope for patients with advanced HER2-positive disease.
Purpose of the Study:
- To review historical successes and challenges in HER2-targeted therapy for esophagogastric cancer.
- To explore current innovative therapeutic strategies and ongoing clinical trials.
- To highlight the potential of novel agents in advanced HER2-positive esophagogastric cancer.
Main Methods:
- Literature review of key clinical trials (e.g., ToGA, KEYNOTE-811).
- Analysis of emerging therapeutic technologies, including antibody-drug conjugates.
- Examination of ongoing trials for first-in-class and first-in-human agents.
Main Results:
- Trastuzumab is a cornerstone therapy for HER2-positive esophagogastric cancer.
- Combination therapies and novel agents are expanding treatment paradigms.
- T-DXd shows efficacy in patients progressing on prior HER2-targeted treatments.
Conclusions:
- HER2-targeted therapies have significantly advanced esophagogastric cancer treatment.
- Ongoing research into novel agents and combinations promises further improvements.
- Personalized therapeutic strategies are crucial for managing advanced HER2-positive disease.
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