For a patient with metastatic gastric adenocarcinoma with CT showing NED after 4 months of FOLFOX + pembrolizumab + trastuzumab, would you consider resection of the primary and/or a chemo break?
Would your thinking change if the patient continues to be NED after an unplanned chemo break, e.g. for insurance issues?
Answer from: Medical Oncologist at Community Practice
This question is about a patient with gastric cancer who has a complete response to therapy with chemotherapy, trastuzumab, and checkpoint inhibitor blockade. The patient had a radiographic CR after 4 months of therapy. How to proceed from here is an interesting question, and would be influenced by ...
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Answer from: Medical Oncologist at Academic Institution
I absolutely agree with @Gabriel A. Brooks about the duration of systemic therapy (6-12 months at a minimum) before considering surgical management. Most of the surgeons I work with wouldn't even think about operating with curative intent before the 12 month mark. I also think that the nature o...