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Are there patients in whom you would modify the course of adjuvant durvalumab in resected gastric/GEJ adenocarcinoma following treatment with neoadjuvant FLOT + durvalumab?
For example would you ever escalate or de-escalate therapy based on extent of residual disease on surgical pathology? Would you consider ctDNA monitoring in these patients in any way?
Answer from: Medical Oncologist at Academic Institution
Beyond established indications for discontinuation of adjuvant durvalumab (such as significant immune-related adverse events or evidence of disease recurrence/progression), modification or omission of adjuvant FLOT and/or durvalumab may be considered in patients who demonstrate no treatment response...
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Answer from: Medical Oncologist at Community Practice
I would not de-escalate or modify the adjuvant course of treatment in the D-FLOT regimen based on the pathologic results. The protocol continues adjuvant durvalumab for 10 additional cycles after FLOT, but almost 50% of patients on the trial did not undergo these full 10 additional cycles, and so if...