Advances in Human Epidermal Growth Factor Receptor 2-Targeted Therapy in Upper Gastrointestinal Cancers

Jaeyop Lee1, Geoffrey Ku2

  • 1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

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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